The Omics Blog by Dr. James Weiss – Part V: Chronic Diseases

 

Every thought you think, every movement you make and everything you put in your mouth makes you who you are via gene expression.  Genes define one’s potential but the decisions we each make, moment by moment, create the signals that dictate which of our genes are turned on and which ones are turned off.  Send the wrong signal to your genes and your body can create the conditions needed for the development of chronic diseases such as diabetes, arthritis, heart disease, osteoporosis, Alzheimer’s, osteoporosis, and others.  The devastating effects of these diseases is related to the damage they cause on various organs; the joints in the case of arthritis, the brain in the case of Alzheimer’s, as examples. The goal for prevention of these conditions is to maximize gene expression for the creation of a healthful state prior to the onset of damage to the organs because, often times, once the damage has been done it cannot be undone.

In this blog series I have explored how the emerging science of genomics is currently being used in the following clinical settings: the diagnostic odyssey, pharmacology and cancer.  In all three of these instances, while the topics may be complex, the genetics are fairly simple because only one or a small number of genes is involved for a given clinical situation.  In the chronic diseases, such as the ones listed above many more genes are involved.  One estimate indicates that in type 2 diabetes there are probably over 100 genes that function both individually and in tandem to create this disease.  The possibility for combinations is almost limitless. Understanding and using the science of genomics, alone, will not be sufficient to fully understand, prevent, or reverse these diseases.

Genes express their function by coding for proteins and it is these proteins that can work to create the milieu in the body necessary for chronic diseases.  By measuring certain compounds in the blood, called biomarkers, the work of these proteins may be followed over time.  The natural history of these diseases is such that the biomarkers become elevated first, long before there is organ damage.  Once we have a better understanding of how and when these biomarkers become elevated prevention will be possible.  This can be done in two ways.  By changing the signals sent to one’s genes, the unhealthy state may be reversed after it has started but before any damage has been done.  Alternatively, a genetic tendency for development of one of these diseases may be predicted based on knowing one’s personal genome.  When the science of genomics is more fully understood, I believe, it should be possible for specific lifestyle recommendations to be made that will allow healthy gene expression to be maximized even before the release of the unhealthy biomarkers.

Michael Snyder, PhD, Director, Stanford Center for Genomics and Personalized Medicine, is doing groundbreaking research that will help us understand how to put this concept into clinical practice.  He has a fascinating study underway in which he has sequenced his own genome and has been following literally thousands of biomarkers in his blood over time.  At one point, by measuring his biomarkers, he found that he had developed very early insulin resistance and was able to change his lifestyle.  He reversed the condition long before any tissue damage was done.  Now, if he choses to continue those lifestyle changes, he will most likely never develop diabetes.

Americans suffer the ravages of many chronic diseases.  As our understanding of these diseases grows through research, such as Dr Snyder’s at Stanford, we should be able to reverse the process of these diseases before organ damage occurs.  Combining this knowledge with our understanding of the science of genomics will allow for a healthy, vital, robust aging process.

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