When the Doctor Becomes the Patient

Church: We’ve been using sequencing to help us discover some of the blockbuster new drugs, protein drugs, antibiotic drugs and so forth.  But it’s transitioning to a time where it becomes an important component of personalization and preventative medicine. 

I’m George Church, Professor of Genetics at Harvard Medical School.

Question: How will DNA sequencing change healthcare?

Church: The test, it’s kind of like insurance against floods or fires or something, you don’t say, 'I don’t need any insurance,' you just buy it and you hope you never need it.

Question: Why are electronic medical records important?

Church:    Electronic medical records are incredibly important. We have a very mobile population and so they need to be able to easily get all new physicians in their life up to speed, that’s one utility.  They might actually help with research in the sense that if people, the small set of the population that wants to participate in that, they can easily share their electronic medical records, that could help inform research of all types, noninvasive as well as drug-related.  Electronic medical records could reduce errors in principal, you have to have great software and you have to have good training but if it’s coupled with devices and good practices, it can allow a very strong accountability and strong quality assurance procedures. 

Question: How have electronic medical records helped you personally?

Church:   Around 1999, very early on, they gave me full access to my medical records and I put all my medical records up on the internet and interestingly a hematologist contacted me and noticed from my medical records that I was overdue for a cholesterol test, having picked up a cholesterol drug, Lovastatin.  And sure enough, I tested it out and it was having no effect; it was an inadequate dose and so that resulted in getting the right dose and the right diet and may have added many quality years of life in my case.

Question: How else is technology helping reinvent the healthcare industry?

Church:    A huge one is really bringing the knowledge to the individual via the internet.  It allows people to do social networking and so if they have a fairly specialized form of a disease, it could be a very common disease but if they have something that’s idiosyncratic, they’re no longer limited to their family, they can find other families that are similar to them.  So that’s a potential use of technology, it’s actually quite simple and quite accessible. 

Question: How can we improve access to healthcare?

Church:    Access is a huge problem, not just to insurance, the 45 million that aren’t covered well, it has to do with long waits, it has to do with the inconvenience of traveling, and you can see the beginnings of revolutions around the edges, you can see more home test kits, more information available on the internet, more reliable information, ways of determining what’s reliable or not and so patients are coming in, when they come in, much more well-informed.  Again, there are issues about false positives that you might get or false alarms by becoming, maybe, what people might think that’s too well-informed.  But I think as a whole, as a population becomes more well-informed, has greater access to self-testing, we might consider that better access and it will lead to possibly reduced hospital visits, possibly reduced clinic visits.

Question:    How can we improve integrative medicine?

Church:    So, to make the transition to patient care of highly integrative technologies requires, along with the technologies, requires a lot of computer software and it requires computer interfaces so that to some extent, people can be directly educated and to some extent physicians can be educated because for example, genetics is new to almost all physicians, even in very sophisticated countries and so a huge component is software that does the integration. It used to be that a family doctor could do all these integrations, they could keep everything that they needed to know except for various specialized operations in their head and they could deliver the advice directly there during a house call.  But now that the opportunity has been for years and is now becoming more realistic, is that far more information than a single individual or even a team could integrate requires prior development of software and constant vetting and updating of that software in collaboration with patient groups and physicians.

Question: What is the future of genomic medicine?

Church:    The generic human genome is complete but we need to have this information for each individual because it’s very clear that we don’t all share the same genome. What’s very important is the differences from person to person, both genomic and their environmental differences and the integration of those.  So some of the next big breakthroughs are going to have to do with how we obtain this information for each of the individuals at low cost and high quality and how they share it. 

Genomics pioneer George Church found that cutting-edge medical technology added years to his own life.

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An organism found in dirt may lead to an anxiety vaccine, say scientists

Can dirt help us fight off stress? Groundbreaking new research shows how.

University of Colorado Boulder
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  • New research identifies a bacterium that helps block anxiety.
  • Scientists say this can lead to drugs for first responders and soldiers, preventing PTSD and other mental issues.
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Are modern societies trying too hard to be clean, at the detriment to public health? Scientists discovered that a microorganism living in dirt can actually be good for us, potentially helping the body to fight off stress. Harnessing its powers can lead to a "stress vaccine".

Researchers at the University of Colorado Boulder found that the fatty 10(Z)-hexadecenoic acid from the soil-residing bacterium Mycobacterium vaccae aids immune cells in blocking pathways that increase inflammation and the ability to combat stress.

The study's senior author and Integrative Physiology Professor Christopher Lowry described this fat as "one of the main ingredients" in the "special sauce" that causes the beneficial effects of the bacterium.

The finding goes hand in hand with the "hygiene hypothesis," initially proposed in 1989 by the British scientist David Strachan. He maintained that our generally sterile modern world prevents children from being exposed to certain microorganisms, resulting in compromised immune systems and greater incidences of asthma and allergies.

Contemporary research fine-tuned the hypothesis, finding that not interacting with so-called "old friends" or helpful microbes in the soil and the environment, rather than the ones that cause illnesses, is what's detrimental. In particular, our mental health could be at stake.

"The idea is that as humans have moved away from farms and an agricultural or hunter-gatherer existence into cities, we have lost contact with organisms that served to regulate our immune system and suppress inappropriate inflammation," explained Lowry. "That has put us at higher risk for inflammatory disease and stress-related psychiatric disorders."

University of Colorado Boulder

Christopher Lowry

This is not the first study on the subject from Lowry, who published previous work showing the connection between being exposed to healthy bacteria and mental health. He found that being raised with animals and dust in a rural environment helps children develop more stress-proof immune systems. Such kids were also likely to be less at risk for mental illnesses than people living in the city without pets.

Lowry's other work also pointed out that the soil-based bacterium Mycobacterium vaccae acts like an antidepressant when injected into rodents. It alters their behavior and has lasting anti-inflammatory effects on the brain, according to the press release from the University of Colorado Boulder. Prolonged inflammation can lead to such stress-related disorders as PTSD.

The new study from Lowry and his team identified why that worked by pinpointing the specific fatty acid responsible. They showed that when the 10(Z)-hexadecenoic acid gets into cells, it works like a lock, attaching itself to the peroxisome proliferator-activated receptor (PPAR). This allows it to block a number of key pathways responsible for inflammation. Pre-treating the cells with the acid (or lipid) made them withstand inflammation better.

Lowry thinks this understanding can lead to creating a "stress vaccine" that can be given to people in high-stress jobs, like first responders or soldiers. The vaccine can prevent the psychological effects of stress.

What's more, this friendly bacterium is not the only potentially helpful organism we can find in soil.

"This is just one strain of one species of one type of bacterium that is found in the soil but there are millions of other strains in soils," said Lowry. "We are just beginning to see the tip of the iceberg in terms of identifying the mechanisms through which they have evolved to keep us healthy. It should inspire awe in all of us."

Check out the study published in the journal Psychopharmacology.