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Programs to probe roots of common diseases


WASHINGTON -- To kick start the development of more successful treatments of common diseases, federal researchers announced at least $60 million in new initiatives yesterday designed to deepen understanding of the roles that genetics and environment play.

Dr. Elias A. Zerhouni, director of the National Institutes of Health, presented the programs as a significant step toward speeding up the advent of more personalized treatments for Alzheimer's, cancer, diabetes, heart disease and other major diseases.

He and other officials predicted breakthroughs in as little as two or three years, allowing researchers to rapidly move forward on new treatments and preventive measures.

"This is the engine that will transform medicine," said Dr. Francis S. Collins, director of the National Human Genome Research Institute, who will help lead the new efforts. "This will fuel an era of preventive, personalized, preemptive medicine."

While drug companies struggle to develop new drugs by the old methods of working with chemicals, public and private officials have begun eyeing advances in genetics to create new and faster methods.

In one initiative, NIH scientists will develop new technologies to measure environmental causes and determine the genetic changes that can give rise to diseases. In the other, researchers from pharmaceutical and biotechnology companies will study when the genetic changes actually result in illness.

Scientists have had trouble determining which of the 10 million slight alterations in DNA increase the risk of contracting a disease, as opposed to the many alterations that are meaningless.

At the same time, scientists have come to recognize that genetics isn't the sole cause of many common diseases. Other factors play a role, such as exercise, diet and exposure to toxic substances.

Timothy R. Rebbeck, a molecular epidemiologist at the University of Pennsylvania School of Medicine, said in an interview that the promise of the new programs lies in their comprehensiveness.

"None of the studies done to date have been done on a very large scale, and none have taken advantage of our understanding of the human genome," he said.

Another goal is to spur the creation of new technologies to measure how people react to the foods they eat, activity they undertake and environmental toxins they're exposed to.

Development of new technologies, such as wearable sensors, could pave the way for determining the impact of nongenetic factors and enable doctors to predict more easily who could be at the greatest risk for falling ill.

That new knowledge would have significant benefit for monitoring those most susceptible to developing diseases, said Dr. Georges C. Benjamin, executive director of the American Public Health Association.

"We can target who needs to be screened and how often based on that," Benjamin said an interview. "We can identify people who are extraordinarily high-risk to be tested more often."

The new initiatives by NIH, the federal government's medical research arm, are the latest it has undertaken to capitalize on the map of the human genome completed in 2003, data accumulated from DNA collected from numerous test subjects, and the rapidly falling cost of studying changes within human DNA.

Also distinguishing the two newest programs, NIH and private officials said, is the cooperation between medical researchers from the federal government and from private industry, who would publicly post their research for other scientists to use.

Pharmaceutical maker Pfizer Inc. is expected to donate $20 million to help start the program and investigate five diseases. Affymetrix Inc., a biotechnology company in Santa Clara, Calif., will contribute equipment to study two diseases.

Joint projects between the public and private sectors often raise concerns that companies will steer basic research toward subjects with the most profit potential, rather than those with the greatest impact on public health.

Hank Greely, director of the Stanford Center for Law and the Biosciences, said drug companies also may try to take advantage at the expense of rivals. Other problems could result if NIH, which has traditionally supported basic research, shifts its focus toward more drug development, he said.

"There are potential conflicts, but it sounds like there is real potential value to NIH, the drug companies and public health" by pursuing the work, said Greely.

NIH officials said a team of scientists from academia and industry would decide which diseases to study. Participating companies have pledged not to keep findings for themselves, but instead would join the NIH in making them immediately available via a public database.

"We see great needs out there," said Martin MacKay, a senior vice president for worldwide research and technology at Pfizer. "And we can't do it all ourselves."

NIH has allocated $40 million for the efforts, and it has asked Congress for an extra $28 million. A nonprofit foundation that raises money for NIH is seeking an additional $60 million from other companies, philanthropists and disease advocacy groups.

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