Researchers identify opportunities to advance genomic medicine
Genetic discoveries over the past 25 years have substantially advanced understanding of both rare and common diseases, furthering the development of treatment and prevention for ailments ranging from inflammatory bowel diseases to diabetes, according to a study published in Nature Research in January.
The paper, titled “A brief history of human disease genetics,” reviews breakthroughs in the association of specific genes with particular disorders, progress mostly driven by advances in technology and analytical approaches. The study also provides a framework for medical innovation to improve clinical care in the field.
“The future of medicine will increasingly focus on delivering care that is tailored to an individual’s genetic makeup and patterns,” says Judy H. Cho, MD, Dean of Translational Genetics at the Icahn School of Medicine at Mount Sinai, Director of The Charles Bronfman Institute for Personalized Medicine, and a co-author of the report. “Applying this knowledge will help us to enhance personalized health and medicine for patients at The Mount Sinai Hospital now and for years to come.”
The study tracks advances in genomics over the past two decades through better technology, expanded access to vast and diverse data, and the development of other foundational resources and tools. The researchers also note the evolution of how diseases were discovered and identified.
Another major advancement is the increasing availability of large prospective population-based cohorts, known as biobanks. These biobanks often include tissue samples from individuals of many ethnic backgrounds and provide access to a wide range of demographic, clinical, and lifestyle data. The study finds that systematic approaches to data sharing, such as global collaborative networks, are critical in characterizing new disorders.
Today, genetic testing for individuals with symptoms and for at-risk relatives occurs routinely; it ranges from cancer screenings to noninvasive prenatal tests. But challenges remain, including the absence of evidence-based guidelines to support health care recommendations, disparities in testing across society, and the lack of experience in genomics by some health care professionals.
The researchers say the biggest task in the coming decade will be to optimize and broadly implement strategies that use human genetics to enhance understanding of health and disease, and maximize the benefits of treatment. This will require joint efforts by the industry and academia to establish:
- comprehensive inventories of genotype-phenotype relationships across populations and environments;
- proactive measures to address entrenched disparities in scientific capacity and clinical opportunities that benefit individuals and societies across the world;
- a systematic assessment of variant and gene-level function across cell types, states, and exposures;
- improved strategies for turning basic knowledge from assessments into fully developed molecular, cellular, and physiological models of disease development; and
- application of these biological insights to drive new treatment and preventive options.
The report was co-authored by Eimear Kenny, PhD, Director of the Institute for Genomic Health and Associate Professor of Medicine, and Genetics and Genomic Sciences, at the Icahn School of Medicine at Mount Sinai.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City’s largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai’s vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report’s “Best Medical Schools”, aligned with a U.S. News & World Report’s “Honor Roll” Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report’s “Honor Roll” of top U.S. hospitals; it is one of the nation’s top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 “Best Hospitals” issue. Mount Sinai’s Kravis Children’s Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology, Mount Sinai St. Luke’s and Mount Sinai West are ranked 23rd nationally for Nephrology and 25th for Diabetes/Endocrinology, and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke’s, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.
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Stacy A. Anderson