Global implementation of genomic medicine
Research Imagine a world where you go to the doctors not when you are sick, but when you are well and want to stay that way. That’s the vision one leading geneticist has for the future.
Professor Fahd Al-Mulla is Director of Genetic Medicine and Pathology at Kuwait University and Director of Genatak, a centre specialising in genomic medicine. Through his Kuwait-based centre, Genatak, Professor Al-Mulla is taking the knowledge and technology that has recently been developed in the field of genomics and making it available to the public. Here, anyone can have their genome sequenced to assist with diagnosis, prevention and personalisation of treatment.
Whilst Genatak is the only clinic of its kind within the Gulf region, Professor Al-Mulla is not alone in his push to make genomic medicine more widely available. As a member of the Global Leaders in Genomic Medicine group, he meets regularly with an international team of specialists to share research and look for greater opportunities to implement genomic medicine on a broader scale.
Just last year, more than 90 leaders in genomic medicine from the United States and 25 other countries on five continents convened for a Global Leaders in Genomic Medicine symposium. In response to these discussions and other meetings the group contributed an article in the prestigious Science Translational Journal to assess the current state of genomic medicine and suggest ways to accelerate responsible implementation in an effort to improve clinical care worldwide.
Professor Al Mulla’s passion to develop genomics has partially been spurred by his location in Kuwait. “In the Gulf, genetics play a stronger role than environment in determining if someone has a disease,” explains Professor Al-Mulla. “With a high percentage of inter-family marriage, inherited genetic diseases are much more common in this region than elsewhere. For example, Lynch Syndrome is a cancer with a genetic base that typically affects just 1 per cent of the population, in Kuwait, it affects 20 per cent.”
While extensive research continues to be carried out, Professor Al-Mulla is already putting knowledge into practice at Genatak. A lot of the clinic’s clients are couples seeking advice about their genetic heritage so they can make informed choices about the risks before starting a family.
Couples who choose to have their genomes sequenced undergo lengthy pre-test and post-test counseling as part of the process. They are made fully aware of the implications of having their genome sequenced and the additional concerns and anxieties that might come with such detailed knowledge. Once the results have been processed, they also receive a full break down of the findings and their practical applications.
Throughout everything Professor Al-Mulla ensures that his clients are aware that, relatively speaking, genomic medicine is still in its infancy. Knowledge is advancing at a rapid date and an unknown mutation today, may be identified as a key disease risk in a few months’ time. “We make it clear that in 50% of cases we don’t find anything that we can treat,” he asserts. “We don’t overestimate and we don’t underestimate.”
Another area that Professor Al-Mulla is pioneering is preventative medicine. Genomics is currently used most extensively in the diagnosis and treatment of disease. Whilst this is vital area of application, Professor Al-Mulla is keen to apply it even further, by using genomics to assess a healthy individual’s susceptibility to a particular disease or disorder so changes in lifestyle can be made.
“Genome sequencing could help to unearth predispositions to all sorts of issues such as cancer, heart disease, heart condition or a particular type of diet,” explains Professor Al-Mulla. “For example, for most of us a cup of coffee in the morning could be a good thing. However, if you carry a mutation in the CYP1A2 gene and have a slow metabolism of caffeine, then it could cause a heart attack. Genome sequencing can ensure we can respond early.”
Whilst Professor Al-Mulla and the Global Leaders in Genomic Medicine will continue to push for greater collaboration and application of genomic medicine worldwide, the team at Genatak is committed to taking the knowledge available right now and helping as many people as possible. “We can’t be certain how long it will take for change to happen on an international scale,” says Professor Al-Mulla. “But what we can be certain of is that there are individuals whose lives are being transformed, right now, as a result.”