By Tom Still
MARSHFIELD – At last week’s launch of the Wisconsin Genomics Initiative, U.S. Rep. David Obey, the veteran Democrat from Wausau, told a story that illustrated the Marshfield Clinic’s historic penchant for keeping medical records. At one point as a young adult, Obey recalled, he showed up to the clinic for treatment and was asked if he had been a patient there before. “Gee, I think so but I’m not sure,” Obey replied. The doctor promptly found a record of Obey being treated there as a 2-year-old in 1940.
Keeping track of patients over time has been a hallmark of the Marshfield Clinic, which was one of the first clinics of its size to convert those records to electronic form for ease of retrieval by its physicians and other medical staff throughout northern and western Wisconsin.
Today, the Marshfield Clinic is home to the largest “bio-bank” in the United States, boasting DNA samples from 20,000 people who have agreed to take part in a personalized medicine project. That project taps into medical data that dates back at an average of 29 years per patient, electronic medical records and the power of “bioinformatics,” which is the science of using computers to analyze data and samples.
Combine the Marshfield Clinic’s database and bioinformatics expertise with the UW-Madison’s expertise in regenerative medicine, stem-cell biology and “super-computing,” the Medical College of Wisconsin’s ability to analyze individual samples for specific disease traits, and the UW-Milwaukee’s ability to reach a large urban population, and the result is the Wisconsin Genomics Initiative. It marks the first time the state’s four largest research institutions have worked together on a project of this size – and a unique opportunity to put Wisconsin at the forefront of the emerging field of personalized medicine.
What is personalized medicine? It is a phrase that describes the ability of scientists to predict an individual’s risk for developing a disease, to precisely target a treatment that fits that person, and to ultimately prevent some diseases before they ever occur.
So far, personalized medicine has been more theory than practice, but the work of the Wisconsin Genomics Initiative aims to make individualized health care a reality.
During the project’s first phase, researchers will build a scientific model that will predict susceptibility to certain diseases – cardiovascular disease, diabetes and obesity are examples – and responses to treatments. In its second phase, the model will be applied to a wider variety of people and different diseases. The process will begin with the 20,000 people in the Marshfield Clinic database, breaking down up to 1 million genetic “markers” for each. It will expand to include people rolled into the database through the other institutions, including more children and people from different racial backgrounds.
For Obey, it’s a chance to put Wisconsin at the forefront of a movement that federal researchers predict will revolutionize medicine in the years and decades ahead.
“Medical experts have testified before my committee (which handles the budget for the National Institutes of Health) that the future of medicine is that we will be able to look at individuals and how what diseases they will get, how best to treat them, and what we can do to keep them from getting sick in the first place,” Obey said. “The Wisconsin Genomics Institute is all about getting us to that future.”
It is a project that expects to compete for large federal grants that will fund the research and its applications. The outgoing director of the NIH, Dr. Elias Zerhouni, attended the Oct. 10 announcement as well as the dedication of the Marshfield Clinic’s Laird Center for Medical Research. Zerhouni described the initiative’s proposal to NIH as “one of the very best in the world,” and stressed that personalized medicine is essential to improving the human condition in the United States and beyond.
“There is no way, 20 years from now, that we can practice medicine as we do today and be a successful nation,” Zerhouni said.
The promise of personalized medicine emerged with the race to map the human genome, a project that was completed in 2003 with the sequencing all the genes in human DNA. Today, a unique combination of Wisconsin resources promises to move that promise to the next level. For outside observers, Marshfield, Wis., may seem an unlikely location for medical breakthroughs. But a long history of record-keeping and innovation has made the unlikely possible.
Still is president of the Wisconsin Technology Council. He is the former associate editor of the Wisconsin State Journal in Madison.