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.