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Genomics on Public Health Course

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Genomics on Public Health Course The impact of Genomics on public health course Why is this course necessary? Layla Jader Contents • Definitions • History of this field • The genomic impact on public health actions • The main determinants of health • Epigenetics • Final messages • “genetics” is the study of single genes & their effects • “genomics” is the study not just of single genes, but of the complete genetic material of an organism • also covers the development of genome- scale technologies and their application to ALL areas of biological investigations. Public Health Genomics (PHG) became a new public health field in 1997 “It is the responsible & effective integration of genome-based knowledge & technologies into public policy & health services for the benefit of population health” It combines & integrates insights from knowledge from population sciences genetic & & the humanities & molecular science social sciences to develop programmes & policies aimed at protecting & improving the health of the population National Office of Public Health phgfoundation Genomics 1997 1997 2005 2006 2010 2005 WHO-Collaborating Centre on Public Health Genomics So, what are the implications of genomics to Public Health? “Genomics is to the 21st century what infectious diseases were to the 20th century” Genomics is impacting the main pillars of public health Public health actions The impact of genomics 1. Health protection & . More accurate & quicker resilience diagnosis . Communicable diseases .Identifying new virulent variants . Tracking disease outbreaks . Identifying those more susceptible to infectious diseases leading to family clusters Public health The impact of genomics actions 1. Health . Biosensors to monitor protection & pollutants resilience . Biorobots to protect against • Environmental biological & chemical warfare health . Environmental clean up & land bioremediation using microbes to detoxify or remove pollutants . Biofuel production converting grasses & forest waste biomass into usable energy Public health actions The impact of genomics 2. Prevention of ill . Enhancing accuracy & health & early detection range of screening of diseases programmes . Developing screening programmes that stratify populations according to their genomic profile & only screening high risk people . Allowing earlier detection of common diseases (ca.) . In vaccine production Public health actions The impact of genomics 3. Health . Improving our improvement: understanding of biological positively promoting basis for addiction & healthy lifestyles substance dependence leading to better diagnosis & treatment . By providing targeted information to those at higher risk of diseases, based on their genetic profile Public health actions The impact of genomics 4. Tackling the wider . By building our determinants of ill understanding of gene- health environment interactions . By having greater insight into increased susceptibility . Epigenetics science: the environment, nutrition & psychosocial factors can alter gene expression & these changes can be transmitted to future generations raising their risk of chronic diseases Public health The impact of genomics actions 5. By improving . Better understanding of diseases healthcare (redefinition & reclassifications) services, . Earlier, more accurate diagnosis & healthy life accurate prognosis expectancy & preventable . Pharmacogenomics, selecting mortality treatments that a patient is more likely to respond to & developing rational drug design . Molecular testing of cancers to tailor the appropriate treatment to the individual cancer (personalised therapy) The main determinants of health (Dahlgren and Whitehead, 1991) The main determinants of health (Dahlgren and Whitehead, 1991) General socioeconomic conditions The wider environment Individual life style factors Genomics Epigenetics: The science that is starting to explain some of the reasons for complexities in many public health problems Epigenetics: Inheritance, but not as we know it! • It is the study of heritable changes in gene expression caused by mechanisms other than changes in the underlying DNA sequence • A key feature that distinguishes epigenetic modifications from genetic changes is their reversible nature • This provides exciting preventive & therapeutic opportunities Wider Psycho-social Economic environmental & behavioral factors factors factors Embryo Early childhood Pre-puberty Can alter the function of genes leading to an increase in chronic diseases These gene alterations can be inherited perpetuating the ill health cycle in future generations Why are gene-environment interactions so important to Public Health? • These interactions, together with genetic predisposition have likely produced most recent epidemics of chronic diseases. • Understanding the nature of these interactions may be the key in reversing their cause. • By suggesting approaches for modifying the effects of deleterious genes. • Future public health measures may focus on avoiding deleterious environmental exposure especially in genetically susceptible persons. Final messages • Genomics is NOW part of mainstream medicine • The NHS is NOW using new genetic technologies • Public health is using genomic technologies NOW especially in health protection & screening programmes • Pathways of diseases are being redrawn • But the process is fragmented & uncoordinated • We need only to fund validated services • Handle consumer expectations & demands • Guard against potential discrimination • Epigenetics is explaining interactions between genes & environment altering genome functions • These alterations can be inherited • An added urgency to tackle inequalities in health • We should adopt a public policy that prioritises children • We need to develop, analyse & disseminate a large body of scientific information that will guide our public health actions • We need to ensure NHS workforce is well educated in this field So, why is this course necessary? Public Health will simply not be able to contribute optimally to improving health in the twenty-first century unless it factors genomic science into its practice.
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