March 21, 2002
ATLANTA, Georgia (ACC) -- Cardiology has not seen much success in gene therapy yet, but
just you wait. When the breakthroughs come—and they will come
soon—they will surpass all of the achievements in the discipline
of the past 50 years and the 2,000 years before that, said
Robert Roberts, MD, who delivered the annual Simon Dack Lecture
on Monday, March 18, 2002.
“Cardiology is clearly on the verge of its most golden era,” Dr.
Roberts said.
Dr. Roberts, chief of Cardiology at the Baylor College of
Medicine, Houston, spoke on “Cardiovascular Genetics and the
21st Century.”
The past 50 years, with its multitude of advances, has already
been dubbed the “golden age of cardiology.” None of the
therapies common today were available 60 years ago, Dr. Roberts
noted, from open-heart surgery and cardiac catheterization to
ablation and antibiotics.
Cardiology advanced more in the past 50 years than in the
previous 2,000, he said, and the next 50 years will surpass even
that.
The completion of the Human Genome Project—the $3 billion effort
to map the human genome—Dr. Roberts believes, “will usher in the
next marvelous era of cardiovascular medicine.”
Personalized medicine
Mastery of the human genome will present physicians with a new
perspective on medicine, Dr. Roberts said, that of using
multiple etiologies—genes—to look for a disease in a specific
individual.
“This will be a totally different picture,” he said. “Within 10
years we will have sequenced 30,000 to 40,000 genes related to
human disease. A single blood sample will contain 40,000
etiologies.”
The Human Genome Project is about 88 percent complete, Dr.
Roberts noted, and should be completed within a year. So far,
only about 1,000 genes in the gene bank have been associated
with disease, and 18 percent of those are related to
cardiovascular disease.
But daily advances in computational biology and bioinformatics
point to a time in the next five to 10 years when an individual
will have his or her entire genome available for risk
assessment, treatment selection, and prognosis.
The average lifespan more than doubled over the past century,
from 36 years in 1900 to 80 years in 2000. Personalized medicine
based on gene therapy, Dr. Roberts predicted, will play an
essential role in doubling that again by the year 2100.
“Embrace the techniques and be patient,” he said. There will be
failures along the way, he concluded, “but the next things that
happen for all of us will be beyond our imagination at this
time.” |
