Optimal Health Newsletter #9

 

Genomic Medicine

 

 

   Several months ago I attended a meeting that absolutely ‘blew me away’! Never in my life have I felt so much on the ‘cutting edge’ of anything as I did that day.  At several points during the sessions I looked around the room and realized how few people anywhere knew the information that we were learning that moment.  It was that new!  The meeting was a day-long presentation on ‘genomic medicine’, i.e., how knowledge of the genetic sequencing of a person's DNA could be used in health care diagnosis and decision-making.  We were being shown how laboratory tests were rapidly becoming available that would not only tell us the complete genetic sequence of an individual’s DNA, but, more significantly, how this information could be used in the prediction, detection, and management of various health-related conditions.  The main application of this testing was in the early detection of traits leading to certain disease states.  Knowing this, early preventive measures could be determined and applied.  The procedure for obtaining the test material is amazingly simple. By swishing around a mouthwash and spitting into a cup, an individual’s saliva can be analyzed for markers associated with an increased risk to various illnesses.  This technology is expanding rapidly in all areas of medicine.  The meeting that I attended dealt with the predictive elements of osteoporosis, heart disease, liver dysfunction, and cancer.  The most remarkable thing to me about this meeting was that it was hardly a year ago (April 2001) that the complete sequence of human DNA had been defined.  Everyone knew that, at some point in the future, knowledge of a person’s genetic DNA sequence would translate into significant medical applications.  Nevertheless, I was not personally expecting a practical application of this new knowledge and technology to come so soon.  I thought that this was probably going to be years away, and certainly long after I had ceased practicing medicine.  No way!  I was astonished to learn that, only a year after the decoding of the complete genome sequence, that practical testing would be available utilizing this information.

 

   So, now that we are able to exactly determine the complete genetic sequence of any individual, what practical health benefit does this knowledge give us?  Does it make any difference?  If a person’s genetic constitution is not changeable, why bother to know it?  The fundamental reason that this knowledge is important is that, even though we can’t change our genetic makeup, we are not ‘prisoners’ of our genotype (genome).  This is because the actual expression of our genes, our phenotype, can be modified by alteration of the surrounding environment.  The environment that matters is called the ‘epigenomic’ or ‘epicellular’ environment and basically consists of the biochemical and cellular material that surround the genetic material.  The makeup of this epicellular environment is determined largely by the nutritional constituents of the intra and extracellular fluids and membrane structures.  

 

   The principle application of this type of testing lies in the arena of preventive medicine, especially in terms of chronic progressive conditions and those associated with advancing age.  Currently this type of testing is only in its earliest stages of development and at the present time only a few health conditions have been defined.  In the not distant future there will be many more conditions and applications.  Nevertheless, even now we can look for genetic predisposition to major health issues such as coronary artery disease, cancer, and osteoporosis.  These are common conditions that affect and will affect a large portion of the population.  By detecting these predispositions at an early stage, we can institute epicellular nutritional modifications and potentially change the ‘natural’ course of progression of these conditions.  These testing procedures also emphasize the genetic individuality of each person.  Although all humans have most physiological and biochemical features in common, there are differences that are important and now can be identified and treated in an individualized manner.  The ‘one size fits all’ approach to health care has never worked optimally and we are now developing the technology to improve upon it.

 

   Although the benefits, in terms of prevention, of this testing is awesome, there is a potential downside. Insurance companies might try to utilize genetic information to restrict or limit health coverage.  Although I have some ideas, I don’t have any specific answers on how to deal with this privacy issue.  At the present time, since this testing is new and not ‘FDA approved’ (since it hasn’t been around long enough) it does not legally have to be included in a patient record.

 

   The testing is available now.  If you have questions or an interest in obtaining any of these tests, call our office.

 

Best regards,