Translational genomics in medical genetics

Personalized medicine for individuals with Down syndrome

As the cost of whole genome analysis decreases, we have the opportunity to explore the interactions of various gene changes in an individual that lead to their particular phenotype. This will provide the ability to move from the epidemiologic study of groups, in which, the individuals are treated collectively and homogenously, to personalized medicine, and a model in which the individual is recognized and treated as a distinct entity. We will be applying personalized medicine to individuals with Down syndrome in order to understand and develop biomarkers for increased risk of co-morbidities. Personalized medicine will change the "culture of intractability" of Down syndrome.

Nanopediatrics: enabling personalized medicine for children

The topic of the special series of reviews in this issue will be nanobiology and nanomedicine, with a focus on the impact of nanotechnology on children and their health; hence, the title of this collection and this introduction, Nanopediatrics: Enabling Personalized Medicine for Children. We will address what is meant when we discuss these nanodisciplines and why we developed a NanoPediatrics Program at University of California, Los Angeles. We will consider the implications of these nanodisciplines for individuals and society. The nature of research, diagnosis, and screening in nanomedicine and nanopediatrics will be illustrated by selected projects in nanodiagnostics and nanotherapeutics by our group and our collaborators, and the combined use of diagnostics and therapeutics in a single nanodevice referred to as "theranostics." We will conclude this introductory review with a summary of the reasons for developing the discipline of nanopediatrics.

Genetic screening: carriers and affected individuals

Genetic screening utilizes analytical approaches adapted for high throughput to identify carrier and affected individuals in a targeted population. Currently, genetic screening focuses on carrier screening, prenatal screening, and newborn screening. Newborn screening should serve as a model for all genetic screening, with more than forty years of experience and numerous lessons learned. As with all genetic screening, there are policy concerns in newborn screening regarding which disorders and technologies should be selected, and how centralized or decentralized the process to set policy should be. The need to share experiences and develop databases transcends all other policy considerations in genetic screening. The future will see population-based screening for adult-onset disorders. However, there needs to be extensive research to define predictive risk for various ethnocultural groups and to determine effective interventions. Ethical concerns regarding the timing of population screening, as well as the scope of use of information, will need to be resolved if genomic medicine will achieve its promise of a predictive, preventive, and personalized medicine.