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Unfulfilled Promise in Mapped Genome

Unfulfilled Promise in Mapped Genome
Donald Kennedy discusses �The Bumpy Road to Personalized Medicine� at his lecture.

Donald Kennedy, the Bing Professor of Environmental Science and President Emeritus at Stanford University, spoke on Jan. 29 about the promise of — and the problems associated with — the human genome map and society’s use of it, both for medical and forensic uses.

Held in the Aresty Conference Center on the Health Sciences campus, the lecture offered a nuanced view of the value of genetic information for both scientists and society. His presentation was the first in a planned seminar series on translational medicine organized by Carmen A. Puliafito, dean of the Keck School of Medicine of USC.

Jon Samet, chair of the Department of Preventive Medicine at the Keck School, introduced Kennedy as someone who “has made the right enemies and therefore must be doing the right things,” a reference to Kennedy’s position as editor of the journal Science from 2000-2008, where he became a lightning rod for criticism for his willingness to speak out about the intersection of science and politics.

In his presentation, Kennedy said the complete mapping of the human genome, first announced in 2000, held much promise for scientists, researchers and physicians.

Labeled the “blueprint of life” by leading scientists, the human genome sequence was going to usher in a new age of truly personalized medicine, such as preventive therapies to preclude diseases predicted by the presence of certain genes.

However, Kennedy noted, the promise has not yet been fulfilled, due in large part to the lack of understanding of the epigenome, which can control the expression of genes. The discovery of the epigenome has added another layer of variability into the process of managing and preventing disease on a genetic basis.

“It’s not the case that all of us, eventually, will have bar codes that we can take to our doctor that will induce him or her to write prescriptions that will immunize us against the health risks that our genome is suggesting,” Kennedy said. “We don’t know anything, automatically, based on the genetic sequence, about the expression level of that particular gene. It’s a very difficult business.”

While he did not dismiss the possibility of utilizing genetic information to better understand and treat disease, Kennedy told the audience that it would require a more sophisticated understanding of both genetics and epigenetics. “And then we’ll know how much use this whole area of investigation will be to clinicians who are trying to help other human beings,” he said.

Kennedy’s questioning of the value of genetic information continued with an examination of the usage of DNA evidence in the prosecution of criminal cases.

According to his presentation, the criteria by which law enforcement officials may declare that an individual’s DNA matches that present at a crime scene appears to be too broad. However, federal law enforcement agencies have decided not to allow scientific access to state and national DNA databases.

“Scientific enterprise can surely tolerate strong differences of view if there is good access to the content of the argument,” Kennedy said. “But it’s a different matter when an important part of the judicial system simply walks away and refuses to permit analysis of the data. It is employed to make vital judgments about the fate of human lives … I think that’s a bad system.”

A Webcast of the seminar can be found at http://tinyurl.com/ydoxuxd

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