Lucio Miele, M.D./Ph.D.
Professor and Chair
Department of Genetics
Each individual is unique. Differences in lifestyle, environment and biology may account for different disease risk profiles and different responses to treatments. We base health decision on existing evidence, but we simply don’t have enough information on individual variability. The mission of precision medicine research is to dramatically increase the quantity and quality of individualized information that physicians and patients rely upon when making medical decisions. LSUHSC will play an important role in a historical precision medicine research program, the National Institutes of Health’s “All of Us” initiative (https://allofus.nih.gov/).
Advances in molecular biology and digital technology have given us an unprecedented ability to gather information about human biology and disease. Yet, to translate these advances into diagnostic and prognostic tools that patients and providers can use to make informed health decisions, we must identify variables associated with health outcomes. Conceptually, this is not different from existing medical tests. The “normal” ranges for plasma glucose, cholesterol, blood pressure and countless other tests were determined by testing thousands of patients and correlating the results to clinical phenotypes. What is different about precision medicine research is the unprecedented scale of the data it generates. Rather than one or a handful of variables, precision medicine research tests can return thousands to millions of data points. A simple SNP-chip test can probe hundreds of thousands of genomic variants. Proteomics or metabolomics can test thousands of analytes in a single blood sample. A whole genome sequence produces terabytes worth of information for each individual. To distinguish informative associations from random variability, we must study very large populations, representative of human diversity. This requires cutting edge “big data” approaches to build, curate and analyze datasets representing vast numbers of participants of all ancestries, from all walks of life.
The “All of Us” initiative will enroll one million or more active participants/partners and build long-lasting, mutually beneficial relationships. Participants will donate information about their health and lifestyle as well as physical measurements and biological fluids (blood and urine). The mission of “All of Us” is to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all of us. The program will be also seeking input and suggestions on research priorities from participant/partners and citizen scientists.
Data produced by this NIH-funded program will be shared with researchers and the community, so that new ideas can be explored, multiplying the potential impact. This will be a long-term, national team effort, which already includes over 1000 multi-disciplinary team members from centers throughout the country and approximately 14,000 participants who have completed enrollment at a handful of “pilot” locations.
Louisiana, with its disease burden and diverse population, has an especially important role to play in shaping a precision medicine approach that will serve everyone. LSUHSC New Orleans is part of the UAB-led Southern All of Us Consortium, affectionately called “Y’All of Us”. National launch will begin at 8 selected sites in the spring of this year. “Y’All of Us”, including LSUHSC, will be among them.
I have the honor of serving as the LSUHSC Principal Investigator, the “quarterback” of our highly dedicated LSU team. I will also enroll as a participant, and donate my data and biospecimens for the greater good. “All of Us” is a team of equals, and credit belongs to all. It will involve physicians, students, residents and fellows as ambassadors, and strengthen the bonds between LSUHSC and the community we serve.
“All of Us” will be much more than a giant data gathering effort. It will change the way participants and investigators cooperate as equals in medical research. In time, it will change medicine and prevention in ways yet unimagined. “All of Us” will be to health sciences what the Hubble Telescope is to astrophysics. Over the years, Hubble has revealed Earth-like exoplanets previously imagined only in science fiction, and has revealed facts about the Universe that ground-based telescopes simply couldn’t see.
“All of Us” will be just as transformative. It will take time, dedication and patience, and it will bear its fruits over decades. But it will open new frontiers of precision medicine for each and all of “Us”. LSUHSC will be among its pioneers. Stay tuned for news on national launch!