Genomics

Elizabeth Prom-Wormley Ph. D.

Review pages 20 and 21 in the required textbook. You will see issues related to genomics and chronic diseases in many of the daily lists of research results you will be receiving. Consider some of the recommendations made in these papers that illustrate the state of the art and changes we may see in the next few years. What have you learned from past presentations on social determinants of health and whether these includes genomics? To illustrate your appreciation for the issue bring with you at least two papers/URLS that indicate how new genetic information may help prevent or delay onset of the conditions you presented during the course, positive or negative. Be prepared to discuss some translational research that could be used to improve population interventions for these conditions. There are a number of studies that show a the effects of environment and development of the disease such as that which has documented the relationship of sickle cell disease to protection from malaria. In addition a recent analysis of chronic kidney diseaseamong African-Americans has shown that genetic variations may also account for an excess of chronic kidney disease among African-Americans. It is thought that these particular genes may have been in response to exposure to sleeping sickness but they have now been passed from generation to generation.. Read this recent paper from JAMA on Epigenetics, and this JAMA Viewpopint on geneticsa and 'Personalized Medicine', Also read this paper on precautions you should take when assessing the ability of the genetic ability to intervene in the disease of interest.

Review the CDC Home Page on Genomics. Pay special attention to the section on genomics testing and Integrating genetics applications into practice and programs.
Consider the problem of accessing and improving family histories to prevent chronic disease in future generations. Also review the weekly updates,,.also look at this report from CDC on Precision Public Health,

Look at the recommendations of the EGAPP working group. While looking at the EGAPP the site take a look at the working group link and the activities link, also look at some of the working recommendations and find out how genetics is becoming translated from the bench to clinical practice.Use the web to look for new advances in genetics application to health care. Can you find any examples where genetics has made a difference? Look at this article from the "Scientist" magazine, And this one from the journal Science. How about creating new limbs?

Rember to visit this topic again when you get to the health equity session hwo this reains a problem in the field of genetics?

Dr. Prom Wormley's PowerPoint

Additional Readings for this session

Dr. Prom recomands ths paper from APHA

Translating genomics into improved health care (view the video from Dr. Collins.)

This recent viewpoint from JAMA is fascinating as it relates to who owns human genes, the individual or some research company, or neither?

Is the public's understanding about genes skewed and do people take unnecessary actions based on reading about genetics and cancer in the news media, see this ethical concern viewpoint from JAMA.

Genomics & Perinatal care. Scan this artilce abou the importance for reducing the impact of chronic diseases? Note the Authors include the Dean of the VCU medical school and one of our MPH graduates, a consultant to the VDH.

Many of the chronic diseases that affect us are associated with autoimmunity, read this recent article from New England medical Journal.

Selected parts of this recent IOM report are worth reading in relation to genetics and translational research: Scan pages 21-24, 25, page 31 "implementing change", Table on Page 61.

This set of readings below are optional but cover some of the controversies in the current field of genetics:

Genome wide Association studies
Genes linked to low birth weight
Targeting DNA
The 1000 genome project
IOM Genetics Part1
IOM Genetics Pt II
Modeling human disease

Genomic prediction
The epigenome
Will the revolution in genetics improve healthcare
Roundtable on Translating Genomic-Based Research for Health
Recent Paper 23andMe NEJM March 2014