Ellen BlaineAs CLP goes to press, the Genome Tri-Conference is taking place in Santa Clara, Calif., and announcements from this molecular medicine trade show are filtering into select mainstream media, if not your local paper. Developments in annotating the human genome, and the proteins that carry out its functions, promise to provide the road map for the next great wave of diagnostic and therapeutic advances in healthcare. The ability to determine what kinds of diseases are inherent to our individual genetic makeup, and the ability to predict what our metabolic responses will be to the drugs used for treatment, are already beginning to lead us toward what IVD manufacturers and others refer to as “personalized medicine.”

One area in which the results of genomic/proteomics studies will impact the clinical laboratory is in the discovery of better disease markers. As you read our Disease Management feature on cardiac markers (page 28 ), it is interesting to keep in mind that the future holds promise for an even greater understanding of markers that allow presymptomatic assessment of disease risk, and also closer monitoring of disease state. By increasing our power to predict susceptibility to disease, we should also be able to provide further impetus for healthy lifestyle changes, and when appropriate, treatment with preventive or disease-delaying medicine.

The future also is likely to see a movement of pre-disposition screening and disease monitoring tests to the physician’s office. This will require smaller devices capable of analyzing a broad panel of genetic information, but such advances are foreseeable technologically, just as we once imagined that we could have smaller, personal computers. Our Industry Overview on Physician’s Office Labs (page 20), looks at developments in the present and more immediate future, but the still unfolding long-term picture has interesting implications for us all.

Today, each of us fortunate enough to have health insurance carries around our coverage card. Will we one day be able to add on to the insurance ID number our complete genome and a catalogue of single base pair variations that will predict our response to the treatment we are about to receive?

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Ellen Blaine