• Tiny variations in each person's genes will be recorded in a simple binary "bar code." Physicians will be able to choose the medication most likely to work best and have the fewest side effects by matching it to the patient's personal code.
  
  
• In the near future, individuals will be able to have their genetic profile checked at the doctor's office as easily as blood pressure is done today. The information will help predict disease years in advance, so that prevention or treatment can begin at the earliest stages.
  
  
• "Biologic" therapy -- whether gene- or antibody-based -- will kill diseases like cancer through new strategies that help the body recognize a tumor as something abnormal, something the immune system should attack.

"Knowing the human genome is really going to help us," University of Cincinnati medical researcher Stephen Liggett says. "We can go find the gene we're interested in, and then look at the diversity there, the ways it varies from one person to another.

"Previously, what we really failed to realize -- or refused to realize," the physician maintains, "is that key proteins (directed by genes) that make your heart, lungs and the rest of your organs work are different from one person to another. This was not well appreciated in science or medicine, perhaps because we just didn't want to believe it, or perhaps because the pharmaceutical firms might then have to consider that one medicine does not fit all."

Liggett's research team, working mainly with asthma and congestive heart failure, began to show in 1992 that variations in a person's response to a medication could be influenced by genetics, rather than their environment or the severity of their disease. The College of Medicine researchers were the first to demonstrate that a drug response could be predicted using genomic markers from an individual's DNA.

"For example, there are five different classes of drugs that we use for treating asthma, and within each class there are three or four brands of drugs, so the doctor has 15 different things to choose from and no way to know which one is going to work," he says. "For the patient, that trial-and-error process means multiple visits and lots of frustration."

If a person were to be tested for a panel of "polymorphisms" or gene variations at the time a health problem is identified, more effective remedies might be prescribed. Liggett, honored by the university as the 2001 Distinguished Research Professor, envisions being able to provide doctors with a three-tiered report on pharmacological options: drugs most likely to work, those least likely to help and those apt to cause side effects.

Could this kind of gene screening actually predict a person's susceptibility to a serious condition like congestive heart failure? Liggett believes it could, but the caution will be phrased in percentages of risk, rather than in absolutes. Knowing that they have a "predisposing gene" for cardiovascular disease probably would make patients take diet and exercise more seriously.

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