Genes called handy for tailoring medical care

"Personalized medicine" has nothing to do with bedside manner and everything to do with single nucleotide polymorphisms and all the other tiny genetic ways that one human is different from another.

The significance of these variations can be summarized in two statistics offered Wednesday at the Personalized Medicine in Utah Conference: Every year 100,000 people die from the side effects of the medicines they took to make them well, and any given drug works effectively for only 40 percent of the people who take it.

One-size-fits-all doesn't work in health care because genetically, some of us are "responders" to certain drugs and therapies and some of us aren't. In some of us, those drugs will be toxic, and yet most drugs are prescribed as if we were all the same.

That's the premise behind the emerging field of personalized medicine that may revolutionize medical care, said state science adviser Dr. Greg Jones. And Utah is poised to take advantage of the new push.

That was the gist of the state-sponsored conference that brought Utah doctors, researchers and investors together at the Grand America Hotel to learn and network. There was a lot of talk about science, but the underlying message, Jones said, was "economic development all the way."

Utah's assets, Jones said, include the Utah Population Database, talented researchers such as the University of Utah's Mario Capecchi , and companies such as Myriad Genetics that have sprung up to take advantage of the research. Now, Jones said, the state needs to "broaden the depths of the pool" to include lawyers and accountants and more investors.

One familiar way to think of personalized medicine is the old-fashioned blood typing that makes transfusions possible. But the new personalized medicine uses gene discoveries to refine health-care delivery.

Already, molecular diagnostic tests are being used to tailor treatments for diseases such as a type of childhood leukemia and certain malignant gastrointestinal tumors, according to a report released last month by the Washington, D.C.-based Personalized Medicine Coalition.

But we still "remain woefully ignorant of the fundamental molecular pathophysiology of complex human diseases," said conference speaker Dr. Aravinda Chakravarti, a professor of genetic medicine at Johns Hopkins University School of Medicine and the president of the Human Genetics Society.

Only 1.5 percent of human disease is caused by simple gene disorders, and 3.5 percent is caused by chromosomal anomalies. The vast majority of common, chronic diseases result from a complex interplay of many genetic variations, he said. These are the diseases that research is not focusing on.