The formal announcement of a partnership between the Medical Center and The Center for Advancement of Genomics heralds the onset of what could prove to be a revolutionary step toward preventive medicine.
Last Thursday's agreement between the two parties outlined plans for the creation of the first "fully integrated, comprehensive practice of genomic-based prospective medicine."
Leading TCAG in this collaborative effort is genetics wonder Craig Venter, who started his own research institute in the early 1990s, when the National Institutes of Health declined to support his genetics research. He is better known, however, for beating the government-funded Human Genome Project and other groups in the race to map the human genome.
"One of my reasons for wanting to sequence the human genome more rapidly was to get to this point in history where genomics could begin to be used to better understand and potentially treat or prevent human disease," Venter said in a statement.
The idea of a Duke-TCAG partnership to "work toward creating a medical paradigm based on genomics" grew from a discussion among Medical Center administrators and Venter when he visited the University to give a lecture at the Kenan Institute of Ethics last year, said Vanessa King, TCAG vice president of external development and collaborations.
"Duke and TCAG share a common vision to integrate genomics into the multiple disciplines that it cuts across," King said. "Duke, possibly more so than other academic medical centers, has a well-defined genomics program which they have integrated into their medical school as well as the law school."
While the current focus of medical care involves the treatment of chronic disease once it has already developed in patients--an "inherently wasteful" system as Dr. Sandy Williams, vice chancellor of academic affairs and dean of the medical school, said in a statement--the Medical Center and TCAG both see genetics-based preventive medicine as the future of health care.
"This [collaboration with TCAG] will allow us to make the first practical steps into the new area of Genomic Medicine, using genome information to develop a truly modern and individual-based form of health care," said Vice Chancellor for Genome Sciences and Director of the Institute for Genome Sciences and Policy Huntington Willard.
The plan for the collaboration is to include focused research in genomic predictors of cancer as well as cardiovascular, hematologic and infectious diseases in order to generate predictive and prognostic data. Integrating TCAG's powerful DNA sequencing technologies with the Medical Center's extensive medical expertise and clinical population resources, the groups intend to sequence the DNA of the patient pool and correlate genetic variations to complex diseases.
"TCAG offers a sequencing and informatics capacity that is second to none. They are committed to high throughput sequencing of many, many genes and eventually the entire genome," Willard said. "This technology focus nicely complements our own strengths in clinical medicine and in the IGSP."
Beyond the development of the sequencing information infrastructure, one of the most important goals of the collaboration is to "develop an economic and policy model for integrating this information into the actual practice of medicine," Willard said. Such advances in genomics will lead to strategies allowing for the earlier detection and better treatment of these illnesses.
"Genomics is basic science of the ultimate degree," said Dr. William Kraus, associate professor of medicine in the division of cardiology and a researcher involved in one of the collaborative genetics studies in cardiovascular disease. "I believe that genetics will be able to offer us the ability to better define risk and that this collaboration will be helpful in furthering the science of genomics medicine."
According to Venter, the first results of this multi-million dollar venture could be see as soon as five to 10 years from now.
"The sooner genomic data is a routine part of medical care, the sooner we will all have more power over our health--and enable a truly preventive medicine paradigm," King said.
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