In part three of our three-part ‘Personalized Medicine World Conference’ interview series we talked with Dr. Leroy Hood about his exciting ‘100K Wellness’ project and how it will transform the healthcare industry. Dr. Hood’s research has focused on fundamental biology (immunity, evolution, genomics) and on bringing engineering to biology through the development of five instruments; the DNA and protein sequencers and synthesizers and the ink-jet oligonucleotide synthesizer (making DNA arrays) for deciphering the various types of biological information (DNA, RNA, proteins and systems). These instruments constitute the technological foundation for modern molecular biology and genomics. He has applied these technologies to diverse fields including immunology, neurobiology, cancer biology, molecular evolution and systems medicine. Dr. Hood is a member of the National Academy of Sciences, the American Philosophical Society, the American Association of Arts and Sciences, the Institute of Medicine and the National Academy of Engineering. Dr. Hood is one of only 7 (of more than 6000 members) scientists elected to all three academies (NAS, NAE and IOM). Dr. Hood has also played a role in founding more than 14 biotechnology companies, including Amgen, Applied Biosystems, Systemix, Darwin and Rosetta. He is currently pioneering systems medicine and the systems approach to disease and has recently cofounded the company Integrated Diagnostics—that hopefully will become a platform company for P4 medicine.
AllSeq – NGS is starting to be adopted in the clinic, with NIPT, cancer, and rare childhood diseases being the first examples. Where do you think we’ll start seeing NGS adopted next?
Dr. Hood – “Next” is difficult to say as there are so many applications. The many versions of cancer will be prime candidates. But the application I’m excited about concerns wellness. We’re exploring this with the ‘100K Wellness’ project. As a start 100 individuals, we call them “pioneers”, have volunteered to have us examine their genome, transcriptome, gut microbiome (once every three months), metabalome, and clinical chemistry. We also monitor other attributes like weight, blood pressure, and overall activity (via Fitbit). To optimize wellness, we must think about genetic defects. Se we collected three different tranches of data. The data we collected shows that even people who are well have opportunities to optimize their health. Genome sequencing is a fundamental tool here – it can identify gene defects for nutritional or metabolic pathway, check for diabetes, inflammation, etc. This information provides an opportunity for optimizing wellness. With the right kind of information, we could maximize our health potential. We found that each of the 100 pioneers had multiple opportunities for maximizing their health – they all found predispositions for health issues. So now we want to scale up the project to 100k people. We’ll integrate data and create models for each person – give them a prioritized list of how they should manage their health treatment. This is the beginning of a fundamental change in medicine – looking at people while they’re still healthy, before they get sick. This gives us the opportunity to see the transitions from wellness into disease. This will transform the disease industry. In 10 to 15 years we will see two industries – a wellness industry and a disease industry, and the wellness industry will be bigger. We’re just beginning to see this power. The biggest challenge will be how to introduce this concept into the current health system.
AllSeq – How far along the clinical adoption curve do you think we are?
Dr. Hood – The wellness approach will happen 3-5 years – it’s already helping the pioneers. Next year (2015) we’re looking to expand this to 1000 people, and that’s going to start putting pressure on the system. We’re looking into getting federal funding to help push this forward. We feel it will be more useful than the genome project in terms of transforming health. As this transformation takes place, we’ll be creating databases with lots of information. Companies will be spun off to help drive this new industry.
AllSeq – Is the technology today good enough for this transformation, or does something else have to happen first?
Dr. Hood – It’s already good enough, but it’s still too expensive. It needs to be much cheaper. We anticipate that in 5 to 8 years all of the sequencing could be done by a smartphone – using a drop of blood, saliva or whatever – for $100 for a human genome. So what we’ll need is miniaturization of the instrumentation and advancements on the analytics side. And the other assays (metabolomics, proteomics, etc) will have to come down in cost by a similar magnitude. What we’ll also need are ‘wellness coaches’ who can help patients manage all of this data and know what to do with it. Nurses would be ideal to fill this role.
AllSeq – Do you think the use of NGS will take off in the ‘direct to consumer’ space?
Dr. Hood – Physicians are utterly incapable of interpreting the genome – they have not been educated to do this. It will be some time before the typical physician can handle this. They’ll need new training involving nutrition, inflammation and much more, but medical schools are pretty conservative, so the change may come slowly. Once we reach the 100k participant level, the consumer mode becomes a possibility as that many people could put a lot of pressure on the medical care system. Most of the pioneers are already disappointed with their current doctors, and they’re looking for new ones who are willing and able to approach health care management from this new angle.
AllSeq – Most researchers who incorporate sequencing into their research focus on one thing: DNA, RNA, ChIP, etc. But very few seem to combine multiple results together. What’s preventing most researchers from adopting a more holistic approach?
Dr. Hood – The first thing is that most researchers don’t have the skills for creating models from multiple types of data sets. The second thing is that this is a systems approach, and most researchers simply haven’t thought about their research in this way; they haven’t thought through what it takes. This kind of approach is vital for wellness. There’s a tremendous amount of complexity and it will take dense data clouds, integrated data sets and models to achieve a path forward.
AllSeq readers receive $100 off registration by entering promo code: AllSeq_100