U-M to help White House, NIH advance precision medicine

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A tool that helps determine if someone with diabetes could manage it better with drugs or diet and exercise.

A 3-dimensional printer that created a personalized implantable tracheal splint for a baby who stopped breathing every day.

Massive genetics studies to better understand diseases like diabetes, obesity and macular degeneration that involve the coordination of hundreds of scientists and 10s-of-thousands of participants across the globe.

These are among the lifesaving and life-changing contributions by University of Michigan scientists that demonstrate U-M’s leadership in a growing field known as precision medicine.

Using data about lifestyle, medical history, environment and genetics, precision medicine essentially works to prevent and treat disease one person at a time.

A national Precision Medicine Initiative announced in January 2015 by President Barack Obama and funded last week by the National Institutes of Health, dedicates $55 million to create four program areas: a Data and Research Support Center, Participant Technologies Centers, a Healthcare Provider Organizations network, and a Biobank.

The U-M School of Public Health was named one of four sub-awardees that will work with the Data and Research Support Center at Vanderbilt University to mine and organize data, and create the tools to analyze it, while protecting those who share it.  

The nationwide goal is to obtain the DNA and relevant health information from one million people.

At present, a few major academic medical centers, including U-M, gather this information from patients who consent to share it for research. Michigan currently has a bank of information from about 35,000 people collected through its Michigan Genomics Initiative, which asks patients in the U-M Health System to provide data on their health. Part of the national plan is to get more institutions to follow suit.

“The goal is to make sure scientists can ask questions about the role of particular genes,” said Goncalo Abecasis, the Felix E. Moore Collegiate Professor of Biostatistics and director of the Biostatistics Department in the School of Public Health. “We are going to create tools to make it easy for them to ask those questions and get answers from the data, while keeping patient records safe.”

The NIH announcement comes as U-M is developing its own strategy around how to advance precision medicine work across its campuses.  President Mark Schlissel has asked a number of U-M scientists to take a look at how the various schools and colleges currently doing this work might collaborate and expand precision medicine at U-M.

Dr. Sachin Kheterpal, associate professor of anesthesiology whose research focuses on medical informatics, was appointed by NIH Director Dr. Francis Collins to the NIH Precision Medicine Initiative Advisory Panel. This group created the strategy for the program announced last week.

Among Kheterpal’s contributions to the group was sharing what U-M has been doing for 3-4 years in precision medicine. 

“As a public institution U-M is uniquely positioned to have public health as its priority and that’s the foundation of precision medicine — putting participants at the center. So this initiative is completely in line with U-M’s approach,” Kheterpal said.

Michigan’s current areas of expertise include precision oncology, drug development and targeted therapies, obesity research, health outcomes research and analysis, social research and new approaches to big data.

Abecasis, his lab and other faculty in SPH and across U-M, have been involved with hundreds of genetic studies — either directly or as researchers have used the software and other tools for genetic analysis that were developed here.  He has made contributions to better understanding conditions such as heart disease, diabetes, psoriasis and macular degeneration.

Abecasis was a leader of the well-known 1000 Genomes Project, an international effort to catalogue human genetic variation. Two years ago he also established Genes for Good, a public data bank of genetic and health information, which to date has enrolled 13,000 individuals across the country.

Announcing the awards last week, NIH Director Collins said: “Over time, data provided by participants will help us answer important health questions, such as why some people with elevated genetic and environmental risk factors for disease still manage to maintain good health, and how people suffering from a chronic illness can maintain the highest possible quality of life. The more we understand about individual differences, the better able we will be to effectively prevent and treat illness.”

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