Genomics: how unlocking our genes is transforming healthcare
This progress has not come without challenges. For example, many questions and concerns have emerged around the ethical, legal and societal contexts of genomics research. These must be openly discussed and researched so that, ultimately, everyone can feel the positive impacts of genomics research on their health.
As genomics research improves to meaningfully include everyone everywhere, we are likely to see more breakthroughs that will have implications for health. But what impact has genomics made on health so far?
What is genomics and the Human Genome Project?
Genomics is the study of the structure and function of genomes, which is the entire set of DNA in an organism. It looks at how genes interact with each other and the environment.
Genomics helps us understand which genes are linked to physical traits, but this is not always easy. Many parts of our DNA don't seem to do anything obvious, and characteristics can be influenced by many different genes. To better understand how our DNA works, scientists need data from a lot of people. This data can come from reading parts or the whole genome of a person.
The Human Genome Project, completed between 1990 and 2003, was a major step in mapping the human genome. Since then, technology has greatly improved, allowing us to sequence DNA much faster and more efficiently, creating vast amounts of genetic data.
Genome sequencing leads to better cancer treatments
Cancer treatment has traditionally been based on where the cancer is found in the body – such as breast cancer or lung cancer. Genomics changes that approach by focusing on the genetic changes that cause cancer in the first place.
Looking at the whole genome of a cancer cell allows doctors to better understand the mutations driving the cancer and choose the most effective treatment. Understanding the genetic code of cancer cells can lead to the development of drugs that can impede the cancer cells but not normal cells. It can also inhibit the enzymes that trigger cancer cell growth and halt the molecular signalling pathways that are in overdrive in cancer cells.
Currently, patients with certain mutations in lung cancer can be treated with targeted therapies that focus on the genetic changes within the cancer. Predicting and preventing diseases using polygenic risk scores
Genomics has a huge potential to predict disease. Polygenic risk scores are developed using large-scale genomics studies. They use genetic information to estimate a person’s risk of developing common diseases like heart disease, diabetes and even some cancers. Polygenic risk scores are already being trialled as an approach. These scores incorporate many small genetic changes, each contributing a little bit to the risk of a disease.
Someone with a high-risk score for heart disease may be advised to take steps to lower their risk, like adopting a healthier lifestyle or getting regular checkups. This type of personalised medicine could save lives by catching diseases early.
Genomics in action: gene therapy for genetic diseases
One of the most exciting advances in medicine is gene therapy, a treatment that changes a person’s DNA to cure or treat diseases caused by genetic mutations.
For example, gene therapy has shown promise in treating sickle cell disease, a serious inherited blood disorder. It’s caused by a mutation in the gene that helps make haemoglobin, the protein in red blood cells that carries oxygen. This mutation causes haemoglobin to stick together, forming sickle-shaped cells that can block blood flow and cause pain.
Around 100 million people worldwide carry the sickle cell trait, but the disease only occurs if both parents pass it on. In parts of Africa where the disease is common, up to 20% of people may be affected. Gene therapy can fix the faulty gene in a patient’s cells, leading to huge improvements in health. In some cases, patients have even been completely cured. This same approach could also be used to treat other genetic disorders, like cystic fibrosis or Duchenne muscular dystrophy, offering hope for new treatments.
Our improved understanding of the genome and its role in health and disease makes treatments like gene therapy possible. This is one of the many potential applications of genomics beyond prevention and diagnosis of disease.
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