I wanted to mention this news, since it’s really the most wildly advanced form of “personalized medicine” that the world has yet seen. As detailed in this paper, Stanford professor Michael Snyder spent months taking multiple, powerful, wide-ranging looks at his own biochemistry: genomic sequences, metabolite levels, microRNAs, gene transcripts, pretty much the whole expensive high-tech kitchen sink. No one’s ever done this to one person over an extended period – heck, until the last few years, no one’s ever been able to do this – so Snyder and the team were interested to see what might come up. A number of odd things did:
Snyder had a cold at the first blood draw, which allowed the researchers to track how a rhinovirus infection alters the human body in perhaps more detail than ever before. The initial sequencing of his genome had also showed that he had an increased risk for type 2 diabetes, but he initially paid that little heed because he did not know anyone in his family who had had the disease and he himself was not overweight. Still he and his team decided to closely monitor biomarkers associated with the diabetes, including insulin and glucose pathways. The scientist later became infected with respiratory syncytial virus, and his group saw that a sharp rise in glucose levels followed almost immediately. “We weren’t expecting that,” Snyder says. “I went to get a very fancy glucose metabolism test at Stanford and the woman looked at me and said, ‘There’s no way you have diabetes.’ I said, ‘I know that’s true, but my genome says something funny here.’ ”
A physician later diagnosed Snyder with type 2 diabetes, leading him to change his diet and increase his exercise. It took 6 months for his glucose levels to return to normal. “My interpretation of this, which is not unreasonable, is that my genome has me predisposed to diabetes and the viral infection triggered it,” says Snyder, who acknowledges that no known link currently exists between type 2 diabetes and infection.
There may well be a link, but it may well also only be in Michael Snyder. Or perhaps in him and the (x) per cent of the population that share certain particular metabolic and genomic alignments with him. Since this is an N of 1 experiment if ever there was one, we really have no idea. It’s a safe bet, though, that as this sort of thing is repeated, that we’ll find all sorts of unsuspected connections. Some of these connections, I should add, will turn out to be spurious nonsense, noise and artifacts, but we won’t know which are which until a lot of people have been studied for a long time. By “lot” I really mean “many, many thousands” – think of how many people we need to establish significance in a clinical trial for something subtle. Now, what if you’re looking at a thousand subtle things all at once? The statistics on this stuff will eat you (and your budget) alive.
But all of these technologies are getting cheaper. It’s not around the corner, but I can imagine a day when people have continuous blood monitoring of this sort, a constant metabolic/genomic watchdog application that lets you know how things are going in there. Keep in mind, though, that I have a very lively imagination. I don’t expect this (for better or worse) in my own lifetime. The very first explorers are just hacking their way into thickets of biochemistry larger and more tangled than the Amazon jungle – it’s going to be a while before the shuttle vans start running.