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Vol. LVIII, No. 4
February 24, 2006

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NHGRI, NIEHS Take 'Major Step Forward' for Medicine

NIH director Dr. Elias Zerhouni, along with Dr. Francis Collins, director of NHGRI, and Dr. David Schwartz, director of NIEHS, announced two new initiatives that will take advantage of recent technological advances to move health care research to the next level.

Zerhouni described the next level as the "Three Ps" of medicine: predictive, personalized and preemptive.

"We have not yet found the very fundamental molecular events that start the disease process," Zerhouni said at a press conference Feb. 8 at the National Press Club. "The paradigm has always been to wait for somebody to be struck by a disease, and then we intervene to bring that patient back from illness to health. The vision has always been to alter that process, to understand enough of the fundamental determinants of disease, understand their regulation, understand their interaction with the environment, and hopefully, to usher in a new era in medicine."

On hand at the Feb. 8 press conference were (from l) NHGRI director Dr. Francis Collins, NIH director Dr. Elias Zerhouni and NIEHS director Dr. David Schwartz.  
Schwartz models a formaldehyde monitor, an example of a wearable device, a more extensive version of which NIEHS intends to develop as part of the GEI.  

HHS Secretary Mike Leavitt announced Feb. 6 that the President's fiscal year 2007 budget calls for $40 million a year for the multi-year Genes and Environment Initiative. The GEI will combine genetic analysis with the development of new environmental monitoring technology to accelerate research on common diseases such as asthma, arthritis and Alzheimer's disease. Collins and Schwartz will serve as co-chairs for the GEI coordinating committee.

The FY 2007 budget represents a $40 million increase above the $28 million already planned for these efforts in the NIH budget. Of the first year's funding, $26 million will go to genetic analysis and $14 million for the development of new tools to measure environmental exposures that affect health. As a result, GEI will have two main components: a laboratory procedure for efficiently analyzing genetic variation in groups of patients with specific illnesses, and a technology development program to devise new ways of monitoring personal environmental exposures that interact with genetic variations and result in human diseases.

The other initiative, the Genetic Association Information Network, is a partnership between private industry and government researchers to determine genetic contributions to seven common diseases, and includes pledges of $25 million from Pfizer and Affymetrix. Run by the Foundation for the NIH, this initiative includes plans to raise more money from private industry and non-profit organizations to fund research on additional diseases. Zerhouni said the GAIN initiative complies with one of the objectives of the NIH Roadmap for Medical Research: accelerating public-private partnerships.

The GEI and GAIN initiatives will affect both the scientific community and the public health community, Zerhouni said. With 75 percent of the nation's health care costs associated with common chronic, long-term diseases, he said, the initiatives provide the nation's greatest hope to control these skyrocketing health care costs.

Both the GEI and the GAIN initiatives focus on genetic analysis of single nucleotide polymorphisms, or SNPs, that normally occur within the 3 billion DNA base pairs that make up a person's genome. While most of the genetic variations are biologically meaningless, one-tenth of 1 percent of these SNPs alter the function of a gene, and the combination of many slightly altered genes may significantly increase the risk of developing a specific disease, according to an HHS press release.

Data gained from the new initiatives will be freely available for the scientific community. The National Center for Biotechnology Information, part of the National Library of Medicine, will maintain databases to manage the vast amount of data generated by these initiatives. The data, in turn, will be available to researchers in public and private sectors, NIH officials said.

"Both initiatives promise to rapidly identify the myriad genes in an individual that, taken together, contribute to an increased risk of illness — or that increase the chances of a healthy life," said Collins. "As the genetic underpinnings of health and common diseases become clearer, researchers will be empowered to develop targeted treatments that either prevent illness from occurring or treat it effectively once it does."

The GEI initiative will provide $14 million a year to develop high-tech tools to measure environmental exposure and the biological responses to these exposures. These new tools could include small, wearable sensors, Schwartz said.

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