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What Is Pharmacogenetics, Pharmacogenomics and Clinical Evaluation?

 WolfgangSade
 

 

Dr. Wolfgang Sadee
The Ohio State University
 

 

Questions:
 

1) If you had to explain your fields of pharmacogenetics, pharmacogenomics and clinical evaluation to a 4th grade science class, what would you say? 

2) What is the overall goal of your field?  

3) What are some of the landmark achievements in pharmacogenetics and pharmacogenomics to this date?  

4) What is a typical day like for you?  

5) What part of your job do you like best? 

 5b) What is the most challenging?  

6) What achievement at work are you most proud of? 

7) What type of educational background does your field require?  

8) How would you direct someone into your line of work? 

8b) Any tips to help them get their foot in the door?  

9) Is there anything you wish you would have known about your field prior to choosing it as your career? 

 

Q 1) If you had to explain your fields of pharmacogenetics, pharmacogenomics and clinical evaluation to a 4th grade science class, what would you say? 

A) “We know that everyone is an individual and each one is different. These differences come about at least in part through genetics. The genetic information that is contained in the DNA in every cell determines how you look like, what you do, how you feel, and so on. The fields of pharmacogenetics and pharmacogenomics explore how this difference in genetics affects your risk of actually getting a disease later in life and how it affect your response to drugs. People respond differently to the drugs they take. Take aspirin, for example. While it does its job well for most people, some cannot tolerate it and get stomach bleeding. We would like to find out why responses differ and utilize this information to optimize drug therapy for each patient individually. We think people all need to get somewhat different medication in order to be helped optimally.

Pharmacogenetics is a discipline that is already about 50 years old. Back then we usually looked at a single gene that could be defective in how it metabolizes a drug in the body. But now we know about all genes in the body and we understand that each drug interacts with numerous proteins in each gene. This means that genetic variations in a very large number of genes can affect the body’s response to the drug, so that is why we now look at all genes at the same time. This field of study is called genomics.”

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Q 2) What is the overall goal of your field? 

A) “What we hope to achieve at least in part with pharmacogenomics is to have effective drug therapies for all the major diseases. Some diseases that happen later in life are very complex and difficult to treat. Current medications do not work all that well. So there is a great deal to be done. The field of pharmacogenomics will help overcome current limitation and optimize therapies. Furthermore, we would like to be able to predict the risk of disease. I personally think this is the most important aspect. If you know ahead of time that you are likely to get a disease, such as hypertension for example, you can provide treatment at a much earlier stage. When treatment is provided sooner, the currently available drugs may be very effective. Our ultimate goal must be to not only treat the disease as early as possible, but to prevent it entirely, if possible. If we have a pretty good indication that the individual is at high risk, we can come in with mild medication early and therefore potentially prevent disease altogether.”

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Q 3) What are some of the landmark achievements in pharmacogenetics and pharmacogenomics to this date? 

A) “The number one landmark achievement is that we now fully recognize that genetic factors play an important role in drug response. Over the past decades we have been mapping many of the human genetic variations that affect disease and its treatments, and there are already several examples where determining the genetic makeup of the patients is part of therapy. For example, this is being done in cancer chemotherapy with certain anticancer agents. So while this field is ever evolving and has a great deal of growth potential, we’ve identified the importance of genetics in drug therapy. We can now implement that knowledge into providing proper treatment to patients. The biggest achievements in the field are right around the corner, like being able to sequence the entire human gene in each individual which has not been accomplished yet. Therefore, our goals change and expand all the time.”

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Q 4) What is a typical day like for you? 

A) “One of my typical days probably looks very similar to that of any other scientist or business person. I start my morning with going through my email because this is an extraordinarily fast-paced field where you continuously have to be aware of the newest developments. Reading the literature that I receive via email is very important. I particularly spend a lot of time every day looking at the rapidly evolving technology for pursuing pharmacogenomics. Then I meet with my clinical collaborators to discuss what is happening in clinical trials, which is an ongoing process. I also meet with my lab staff to discuss ongoing research projects with them.”

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Q 5) What part of your job do you like best? 

A) “The best part is the interaction with the collaborators, the research staff, and seeing new research findings coming out of my own lab. Obviously, nothing beats the excitement we all feel when new findings are discovered which one has to interpret.”

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Q 5b) What is the most challenging? 

A) “The most challenging aspect in research is setting goals and choosing the right type of approach for achieving those goals. If one does that well, the lab will do well. In a very fluid environment where everything changes around you--the techniques, technologies, goals, expectations, and the impact on society—keeping your eye on the goal and not straying from the course can be quite challenging. Also, keeping the administrative responsibilities from taking over is an endless struggle.”

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Q 6) What achievement at work are you most proud of? 

A) “Having helped to establish an interactive research environment that can actually be productive in such a complex field as pharmacogenomics certainly feels like an achievement. In addition, we have research results coming out all the time that are very exciting and important to me and my staff, but no one else would necessarily recognize their importance at this time. Reaching these milestones is very fulfilling for all the researchers working on the project.”

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Q 7) What type of educational background does your field require? 

A) “Since this field is so diverse, there is room for all kinds of folks. They could be coming in at a B.S., M.S. or Ph.D. level. Because this is such a new field, it offers great opportunities even for someone with only a B.S. degree to take on a leadership role or tackle new technologies. It is a wide-open field right now because it is so interdisciplinary. The best way though is to look for relevant Ph.D. programs, which are still quite limited at this time. Many students who are attracted to pharmacogenomics come from mathematics and statistics. Moreover, the field is attractive to clinical scientists, including clinical pharmacists, physicians, cardiologists, and others. Lastly, students of molecular biology, biomedical engineering, genomics, and medical technologies are all needed.”

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Q 8) How would you direct someone into your line of work? 

A) “I have seen small start-up biotechnology companies hire high school students to do some of their programming. For those who are interested in the field at a young age, those opportunities are priceless. Once you get to the university level, you need to look for the emerging genomics programs and try to get involved as soon as possible, to help you get practical experience. Increasingly, Departments of Pharmacology, Pharmaceutics, Genetics, and more will provide formal teaching in pharmacogenomics without making it the primary focus of their programs. Eventually, pharmacogenomics will be integrated into many disciplines.”

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Q 8b) Any tips to help them get their foot in the door? 

A) “One could look into all universities and colleges - and their Websites - to see which ones offer programs related to pharmacogenetics and pharmacogenomics programs, and then contact the department head or faculty to see what these opportunities are. There is nothing systematic about it yet.”

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Q 9) Is there anything you wish you would have known about your field prior to choosing it as your career? 

A) “No. The only problem I see is that this is a new field and there are many expectations. In looking into genomics and understanding the complexity of what we are dealing with we have to understand that progress will be incremental. There will be many breakthroughs that at first may look like giant steps in therapy, but invariably, we might find the issue to be much more complex than originally thought. It will be a long struggle until the research will have real impact on health in this country and around the world. The more I study pharmacogenomics, the more I realize this is a very difficult task that lies ahead. Even if we find solutions that can significantly improve health care, these will need to fit into a health care system that is as of yet unprepared to incorporate genetic information. Education of health care providers and patients is going to be critical as well. Yet, the very complexity and magnitude of the task ahead make this a most exciting endeavor.”

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