New LA BioMed team takes on glaucoma in African-Americans

Sandy Mazza, Daily Breeze

A team of genomics researchers recently left Cedars-Sinai Medical Center to join LA BioMed, where it has embarked on the largest-ever study of the genetics responsible for glaucoma among African-Americans.The team hopes its research will pave the way for medical care so precise that doctors will, one day, be able to know a person’s disease risks and successful treatment options even before an office visit.Such personalized medicine is the goal of genomics — the study of someone’s entire genetic history encoded on 23 pairs of chromosomes encased inside the nucleus of human cells.

“The best way to treat disease is to understand its genetic underpinnings,” said David I. Meyer, president and CEO of LA BioMed. “Different people respond differently to different drugs. What’s the difference? Genetics. We want to be on the cutting edge of genetics to put tools in doctors’ hands to better treat their patients.”

The team at the new Institute for Translational Genomics and Population Sciences at Los Angeles Biomedical Research Institute at County Harbor-UCLA Medical Center near Torrance has a specialized focus. Its researchers want to understand how predominant diseases among blacks, Asians and Latinos occur. Genetic testing of minority groups is still in its infancy, said the team’s director, Dr. Jerome Rotter.

“It’s great if we have pharmacogenetics for Europeans but what about Hispanics? African-Americans? Asians? That’s what we’re looking at,” Rotter said. “If you’re studying the cause of disease, then you need to study it in each ethnic group. Among the genomic efforts in this country, only a modest number have emphasized minority populations.”

The researchers currently have 19 grants to study the genetic underpinnings of diabetes, hypertension, eye and heart diseases and other conditions common among minority groups. They chose to do their work at LA BioMed because it’s on the campus of Harbor-UCLA, which treats one of the most diverse populations in the state.

Glaucoma, most devastating among African-Americans, is believed to be caused by pressure on the optic nerve that can result in decreased vision and, potentially, blindness. But once researchers identify the genetic abnormalities that cause glaucoma, Rotter said, the existing understanding of how the disease progresses could change dramatically.

“Understanding the true cause of the disease is the goal,” Rotter said. “The power of what we do is to get the real cause. Genetics hits you in the face with the cause.”

Every human has 3 billion DNA base pairs and, of those, there are about 10 million instances where one person differs from another. Rotter’s team will analyze 2,500 glaucoma patients in San Diego, the Los Angeles Harbor Area and at two other sites in other states. They will detail 2.5 million genetic markers within each patient over a five-year period. The data hopefully will result in identification of the genes that cause glaucoma, Rotter said.

Pinpointing the problematic DNA is only the beginning, however.

All disease is caused by a combination of genetics and a person’s interaction with his or her environment, Rotter said. Without knowing a person’s genotype, doctors are dependent only on family medical histories and his or her physical appearance.

“The mutation in the gene can tell you someone’s predisposition, but to determine how drugs will react with that person is more complicated,” Rotter said. “We will be able to evaluate at-risk patients earlier, but new therapies will have to be developed.”

The goal of personalized medicine is often described as “providing the right patient with the right drug and the right dose at the right time.”

Such ideas were the stuff of science-fiction stories until the Human Genome Project outlined the complete genetic blueprint of one human being in 2003. Subsequent genome studies such as the International HapMap (haplotype map) project, and technological innovation from companies like Illumina, have resulted in making genotyping much more affordable. This affordability is what made it possible to launch the glaucoma study, Rotter said.

“Ten years ago I studied one gene at a time and it cost me $2 or so per gene,” Rotter said, adding that the team is looking at 2.5 million genes per person in this study. “Rather than $5 million per person, I can do it now for $250 per person because of new technology and knowledge.”

As it is, medical treatment is often predicated on trial-and-error processes in which doctors test drugs on patients to see which works the best. Rotter calls this system a “tragedy.”

“This exposes them to side effects or drugs with no therapeutic effects and we need to do better than that,” he said. “The goal of our therapy is to know how to treat a patient before they even walk in the door.”

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