Government genetic research may completely transform medicine

You want cutting edge? Try this: in the health care world of tomorrow, simple blood tests accurately forecast a person's life long predisposition to disease. Doctors are able to custom fit medicines to a person's genes, eliminating the chances that drug treatments will prove dangerous or ineffective. It will also be possible to substitute healthy genes for defective ones, a procedure that spares people the horrible suffering and devastating expense of catastrophic illness.

All of this could be in store for twenty-first century medicine say National Institutes of Health (NIH) scientists. In fact, federal researchers are so encouraged, NIH recently held its very first Consumer Day to inform the public about its strides in genetic research. A big reason for the excitement: the progress of the Human Genome Project (HGP), a decade-long effort to characterize--for the first time ever--the complete set of genetic instructions encoded in the 3 billion base pairs of human DNA. Scientists expect the project to yield a bountiful harvest of new cures and preventions of disease, including genetic treatments for illnesses such as prostate cancer, diabetes, and neurodegenerative disorders .

"We're approaching a historic point," Dr. Francis Collins, director of NIH's National Human Genome Research Institute (NHGRI) declared, noting that mapping of nearly all of the genetic instructions in DNA could be completed as early as the spring of 2000. That achievement, according to Dr. Collins, "will divide biology between what we knew before and what we will know after" the mapping is completed.

Cell bosses. Genes tell cells how to behave. They influence everything from what you look like to what diseases you get. Problems arise when genes are wrongly formed. For example, defective genes play a role in the development of cancer, diabetes, and many other illnesses. However, the cause of an illness is usually attributable to the interaction of genetic predisposition and environmental factors such as diet and lifestyle.

So why the buzz over genetic research? Because in years to come, the science is expected to revolutionize medicine by giving health care providers much more precise diagnostic, therapeutic, and prevention tools. If the information at NIH's Consumer Day bears out, you'll live in a world where doctors can correct flaws in a person's genetic makeup by replacing abnormal genes with normal ones. You'll have access to medicines that are fit to your particular body system, and drugs which attack the cause of an illness instead of its symptoms. Adverse reactions and superficial drug therapies will be passe. Another bonus: "crystal ball" blood tests that will reveal your chances of getting a disease long before the onset of symptoms. What will be the advantage there? Early detection will sharply increase the odds of successful preventative care.

Consult your physician. In fact, genetic medicine is already advanced enough to enable doctors to do a genetic test for some disease. Consult your physician if you wish to be screened because of your family's medical history or other factors. Given the potential for a positive test result, it's a good idea if you also seek out the services of a genetic therapist, a professional trained to counsel people who wish to test their predisposition for illness.

Difficulties, Though The Path Is Right. Advances in genetic medicine are stirring up their share of controversy. Deaths have occurred in some gene therapy cases, prompting calls for more federal oversight of the fledging science. Also, some observers fear privacy violations or discriminatory employment and insurance practices will befall persons diagnosed with predispositions to disease. Others say the benefits of pharmaco-genomics--customizing medicines to a person's genes--still remain too far off. Recently Business Week reported the new technology to be "at an awkward, adolescent stage" that could turn off impatient investors.

At NIH's Consumer Day, such subjects were greeted with sensitivity, awareness, and the notation that the field of genetic medicine is so new, a certain degree of trial and error is unavoidable. "We can't say there won't be difficulties," Dr. Collins noted. "But we think we're on the right path" toward life enhancing scientific discovery. The HGP has already prompted the identification of the gene involved in cystic fibrosis and a hereditary form of colon cancer. Furthermore, since its inception, the project has devoted about five percent of its budget to research into the ethical, legal, and social issues revolving around gene therapy.