Pillars of Personalized Medicine

National Jewish Health Health has launched three ground-breaking initiatives that will support its pioneering efforts to develop preventive and personalized medicine programs. They give us the potential to transform the practice of medicine from a reactive model to a proactive one. These initiatives also will allow us to provide care based on the unique characteristics of each patient.

 

Integrated Bioinformation and Specimen Center

The Integrated Bioinformation and Specimen Center is a centralized repository of tissue samples from throughout the institution. The samples are anonymous to protect patient privacy. However, the tissue samples are linked to information about the patient who donated them, including diagnosis, CT scans, X-rays, genetics and more. They offer a tremendous resource for researchers seeking biomarkers that can help predict if a person will get a disease, the likely course of that disease, and what medications will work for patients with that specific biomarker.

  • In practice: Drs. Russ Bowler and Raul Torres recently took advantage of a repository of tissue samples to identify a protein, Arhgef1, which appears to play a role in the development of chronic obstructive pulmonary disease (COPD).

 

Integrated Center for Genes, Environment and Health

The Integrated Center for Genes, Environment and Health is dedicated to understanding the genetics of complex lung and immune-related conditions. The Center builds on the scientific and clinical strengths at National Jewish Health by developing programs to understand how genes work in biological systems, how genetic variants contribute to the development of disease, and why individuals with the same disease have very different results due to the treatment. These approaches will enable clinicians to develop innovative approaches to disease prevention, early diagnosis and personalized therapeutic intervention.

  • In practice: National Jewish Health researchers recently identified a genetic mutation that alters the response of asthma patients to the medication albuterol. Advanced diagnostics will help determine which patients have that mutation so that physicians will know who should and should not receive that medication.

 

Advanced Diagnostics Programs

Our advanced diagnostics programs include the Institute for Advanced Biomedical Imaging®, Advanced Diagnostic Laboratories and Minimally Invasive Diagnostic Center.

The Institute for Advanced Biomedical Imaging offers cutting edge-technology, including a dual-source 128-slice CT scanner, PET/CT scanner, and 1.5 Tesla MRI, in combination with some of the best chest radiologists in the world to provide the advanced diagnostics that are central to personalized medicine. National Jewish Health Health and Siemens Healthcare, manufacturer of the most advanced imaging equipment in the world, have partnered in the institute to advance their shared vision of personalized medicine. They will work together to optimize the function of the existing imaging technology and collaborate on research to improve imaging in the future.

  • In practice: The combined PET/CT scanner shows chemical processes occurring inside cells as well as displays three-dimensional anatomy that can pinpoint where they are occurring.

The Advanced Diagnostic Laboratories (ADx) - featuring the new Molecular Diagnostics Laboratory - is essential in providing personalized laboratory diagnostic tests for the delivery of personalized medicine. This facility, often working with other diagnostic arms of National Jewish Health Health, is able to develop and make available tests that provide patients with individualized information on disease risk, drug responsiveness, and health prognosis. These “companion diagnostic” tests can be performed on samples as simple as a cheek swab or blood draw.

  • In Practice: Recently, ADx launched a genetic test for filaggrin genotyping. Loss-of-function mutations in the filaggrin gene reduce the expression of the filaggrin protein in the skin and have been strongly associated with atopic dermatitis, ichthyosis vulgaris and asthma. This test is especially useful for early clinical intervention and enhanced clinical management of asthma and atopic dermatitis patients at risk for moderate-to-severe disease. In conjunction with the filaggrin genotyping test, ADx has developed a skin disease testing menu that enables diagnosis, early clinical intervention, and management of immunologic and allergic skin diseases.

The Minimally Invasive Diagnostic Center (MIDC) provides a variety of diagnostic, therapeutic and palliative pulmonary procedures as well as gastroenterology and otolaryngology services. Recent advancements in technology have made it possible for pulmonologists, gastroenterologists and others to perform in an outpatient setting a variety of diagnostic and therapeutic procedures that previously required invasive surgery and a stay in the hospital. In late 2007, Ali Musani, MD, FCCP, joined the faculty to bring those advanced technologies to National Jewish Health in the MIDC.

  • In Practice: Dr. Musani performs early diagnosis and staging of lung cancer in patients who would otherwise wait months for a diagnosis. He places stents to open airways closed by cancer and other disorders. He frequently removes foreign bodies, from earrings to fish bones, that people have inhaled into their airways. 
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