Genomics

Laying the Foundation

With the recent completion of the Human Genome Project and other gene-mapping efforts, researchers have a detailed map of humans' genetic structure. Research is now focused on translating this knowledge into improved medical care customized to an individual patient's health care needs. The next step in genomics research is to learn which genetic variations are associated with a particular disease, condition, or health characteristic. To do this, researchers must analyze and compare DNA from a huge number of participants—some with the disease or condition, others without.

Rich Array of Studies

New discoveries in genomics—accelerated by the Million Veteran Program, as well as by sophisticated robots and other automated systems for analysis—could improve screening and diagnosis and point toward more effective treatments. Such information could enhance care by revealing ways to quiet cancer-causing genes, for example, or activating genes to defeat cancer. Genomics-based approaches already in use at the VA include genetic tests to help diagnose breast, colon, and other cancers and to confirm the diagnosis of hemochromatosis, a hereditary condition in which iron builds up in the body.

Among the areas of ongoing VA research:

• Amyotrophic Lateral Sclerosis
  One VA study is looking at which genes may contribute to the risk of amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease. DNA from Veterans with ALS who agreed to be part of a registry is being compared with DNA from patients without the disease. VA researchers are also looking at other possible triggers for ALS, such as family and medical history, diet, medications, and exposure to toxins. This is the first study of its kind to look at the interaction of genes and environment in susceptibility to ALS.
• Bipolar Disorder and Schizophrenia
  A VA study that aims to identify genes associated with these chronic and debilitating mental health disorders stands to be one of the largest studies of its kind. In addition to identifying genes associated with these conditions, genetic studies in this area aim to help researchers find new treatments and treat people before their diseases become more severe.
• Posttraumatic Stress Disorder
  VA researchers are working to identify genes that affect a person's response to the experience of deployment, and especially combat exposure. By conducting careful clinical assessments in those affected by combat-related PTSD and analyzing their DNA samples with Veterans' consent, researchers hope to pinpoint genetic variants that contribute to PTSD and other post-deployment adjustment disorders, such as depression. This may result in more effective treatments, and perhaps even preventive measures.

Veterans' Privacy as Paramount

As in all VA research efforts, protection of Veterans' information is the highest priority in genomic medicine research. Various safeguards have been established to protect Veterans' privacy and safeguard the confidentiality of their genetic information. Among them: strict rules for collection of DNA samples for VA research studies. To maintain privacy, Veterans' samples are labeled with a code that does not contain any personal information (such as name, address, or Social Security number) before they are stored for analysis. Researchers who are granted access to Veterans' samples for analysis are not given any information that would identify who donated them. A "key" that links the code to the Veteran's identity is maintained in an encrypted file that only a limited number of authorized staff can access.

Advisory Committee

A Genomic Medicine Program Advisory Committee, which advises the Secretary of Veterans Affairs, lays the groundwork for the VA Research Genomic Medicine Program. Members include leaders in the public and private sectors and academia in the fields of genetics research and medical genetics; genomic technology; health information technology; and health care delivery, policy, and program administration. The committee also includes a Veterans Service Organization representative.