National Geographic : 2019 Jan
variant that produces a defective form of an enzyme needed to activate the drug. Alan Shul- diner, a professor of medicine and a genetics researcher at the University of Maryland, found that when those people are prescribed the drug, they are twice as likely to have a repeat attack or die within a year of the first, compared with patients who don’t have the variant. Some major medical centers now screen heart attack patients for the variant, but the test is far from routine. Many experts say that a decade from now, a DNA profile will be part of everyone’s med- ical record. Geisinger, a large health system in Pennsylvania and New Jersey, recently began offering genome sequencing as a routine part of preventive care, along with mammograms and colonoscopies. Like advances in computer chips, which liber- ated us from desks and then tethered us to smart- phones, the shift to genomics and data-driven medicine will be disruptive in unpredictable— and perhaps distressing—ways. We soon will have at our fingertips extensive data about diseases we may develop over the course of our lifetimes. T OGLIMPSE what that future might look like, meet geneticist Michael Snyder. He directs Stanford University’s Center for Genomics and Personalized Medicine, and for the past nine years he has been tracking molec- ular and physiological markers in his body. The result is a high-definition depiction of his inner workings that registers fluctuations that may sig- nal problems. It’s like a weather map, charting shifts in the atmosphere to predict storms. Snyder and the team in his lab take his DNA sequence into account as they analyze a continu- ous data stream. It includes measurements from blood, urine, and stool specimens he routinely provides and readings from bio-sensors he wears on both wrists, his ring finger, and his right arm. His team tracks his gene expression, proteins and metabolites, and physiological measures such as his exercise activity, heart rate, skin temperature, and blood oxygen. He undergoes MRIs, echocar- diograms, and other scans to detect changes in his organs, muscles, and bone density. Snyder is not a hypochondriac. At 63, he’s lean, and if not for his receding hairline, he Monitoring Risk assessments Data portal CONTINUOUSLY MONITORING THE HUMAN MACHINE While precision medicine tailors treatment to one person, precision health uses detailed data to help people adapt their behavior and make healthy lifestyle choices. The goal: to avoid the need for treatment in the first place by passively collecting, transmitting, and storing health infor- mation as an individual goes about daily life. While sleeping Advances in electrodes small and flexible enough to fit in textiles could lead to pillowcases and sheets able to moni- tor brain waves and sleep patterns. In the kitchen Smart refrigerators might soon monitor the food stored and record its nutri- tional information. Food quality and freshness would be tracked, along with dietary habits. Upon waking Toilets that check urine and stool for disease are being developed. In the future, smart mirrors could measure vital signs with radar, and toothbrushes might analyze saliva. Plugged in Smartphones could analyze patterns that might indicate depression—such as a drop-off in social communication—and alert the user to address poten- tial mental health issues.