The announcement from the White House’s Precision Medicine Initiative (PMI) Summit marks a brighter future for patient care globally. However, we should anticipate that recent advances in precision medicine simply begin our journey down a road that will take time and resolve to complete. From a physiological standpoint humans are very complicated systems and our individual differences have a great impact on our susceptibility to different illnesses and diseases.
Currently, much of precision medicine is based on genomics, because the nucleic acids that make up genes are relatively easy to manipulate and decipher. But sequencing genes only provides us with a list of possible proteins that an organism can make, much like having a materials list in home building without a plan of how things work together and interact. One could end up with a house where the air conditioning and heating run at the same time, or the gas furnace is vented into the house with the carbon monoxide detectors on the exterior.
Similarly, while we can identify some diseases from genomics--generally those that are the result of broken or missing parts--there are many that we simply cannot diagnosis or understand fully with genomics alone. As further progress is made, and the tools for analysis of the other cellular components (including proteins and metabolites) improve, we will gain a better understanding of cellular function and dysfunction and can anticipate more treatments that are tailored for the natural differences in people.
This more holistic approach is critical to understanding the chemical and physical processes that control illness and disease, and it will be required if we are to realize the goals outlined in Washington.
Aaron Timperman is Associate Director-Research at the University of Notre Dame's Advanced Diagnostics & Therapeutics initiative, including its Precision Medicine Program, and Concurrent Professor of Chemistry & Biochemistry. He is a former Professor of Chemistry at West Virginia University and Research Chemist at the US Army Corps of Engineer’s Engineering Research and Development Center.