Page 53 - Genomic Medicine in Emerging Economies

42 CHAPTER 3: Genomics and Public Health: China’s Perspective

For both developing and developed countries, the integrative concept of
PPPM would enable clinicians and public health workers to predict an indi-
vidual’s predisposition in order to provide targeted preventive measures before
the actual onset of disease. By using innovative PPPM tools—such as the
SHSQ25—biomarkers (medical imaging or pathology-specific molecular pat-
terns, sub/cellular imaging, and omics), pharmacogenetics, disease and patient
modeling, individual patient profiles, and a combination of Western medicine
and TCM, the expected outcomes are conducive to more effective population
screening, prevention measures early in life, identification of persons who are
at risk, stratification of patients for optimal therapy planning and prediction,
and reduction of adverse drug-drug or drug-disease interactions. With the sup-
port of the rapid progress of biotechniques and the availability of large health
databases such as the Human Genome Project, health professionals are in a
good position to address the topics of genetics, environment, and behavior
and to motivate the introduction of PPPM into daily medical services.

Challenges and Opportunities
Our understanding of TCM has advanced greatly with data-intensive genom-
ics and omics biotechnologies. However, a number of critical challenges
remains ahead to fully articulate this vision and roadmap. First, it is difficult
to combine multidimensional omics data emerging from epigenomics, pro-
teomics, metabolomics, and clinical phenotype data in relation to TCM health
outcomes. Second, there are complicated exogenous components of TCM.
Potential personalized medicine could be found if we can utilize genomics and
metabolomics techniques for full spectrum of metabolites of TCM. Genomics,
together with metabolomics, transcriptomics, and proteomics, jointly inform
the “systems biology” approaches that are crucial for the integration of the
postgenomics knowledgebase with TCM.
Next-generation sequencing (NGS) and multi-omics integrative biology
research offer new opportunities into the way we research and understand an
illness like stroke. For example, the exploration of possible genetic factors in
the development of complex multigeneic ischemic stroke (IS) was first made
feasible by the advent of GWAS. One study utilized genomic data from a bio-
bank (Jiang et al., 2006) to explore IS stroke prevalence in China and found a
strong genetic predisposition to IS. The ability to process pedigree data could
also enable the use of classical linkage techniques for the analysis of NGS in
complex diseases such as IS. However, the type and amount of NGS data has
been increasing rapidly. To be able to store and analyze this increasing amount
of data, extremely high-performance computing and intensive bioinformat-
ics support must be available (Zhao et al., 2012). Therefore, the opening of
the CNGB, which is supported by the world’s most advanced and sophisti-
cated high-throughput sequencing and bioinformatics capacity, will provide
an unprecedented opportunity to conquer diseases through genomic tools.