In the latest episode of The Genetics Podcast, host and Sano Genetics CEO Patrick Short explores the evolving landscape of personalized medicine with Dr. Scott Weiss, a Professor of Medicine at Harvard Medical School and Associate Director of the Channing Division of Network Medicine (CDNM) at Brigham and Women's Hospital (BWH).
The discussion starts with an overview of Dr. Weiss’s career journey; he began in epidemiology with a focus on asthma and COPD before he transitioned into genetics just as the Human Genome Project gained momentum. This change was a pivotal moment in his career, leading him to spearhead large-scale research efforts in the genetics of asthma and COPD, and eventually taking on leadership roles in personalized medicine initiatives at Mass General Brigham.
Reflecting on his career journey, Dr. Weiss highlights the importance of embracing new scientific frontiers. His early work in epidemiology laid a foundation, but the sequencing of the human genome opened up new avenues, allowing him to expand his research into the genetic underpinnings of these diseases. This shift not only supported his career progression but also positioned him at the forefront of a rapidly-advancing field.
Dr. Weiss goes on to provide a detailed overview of the significant strides made in understanding the genetics of asthma. He identifies chromosome 17q21 as the most critical locus associated with the disease, among 88 replicated loci. He also discusses his research, which has revealed that asthma is primarily a developmental disease, with origins in utero, and suggests that vitamin D deficiency during pregnancy could be a significant contributing factor. This discovery opens up potential preventive strategies, such as supplementing vitamin D during pregnancy to reduce the incidence of childhood asthma.
One of the central themes of the conversation is the challenge of translating genetic and multi-omic research into clinical practice. Dr. Weiss emphasizes that no innovation will be widely adopted unless it meets the stringent value proposition required by healthcare systems, particularly in terms of cost-effectiveness and reimbursement. He notes that while genomics has the potential to transform healthcare, demonstrating its economic viability is key for widespread implementation.
Dr. Weiss also discusses the slow but promising progress in areas like whole-genome sequencing for newborn health, which has started to gain traction due to its clear cost-benefit ratio in diagnosing and managing rare genetic disorders. However, he acknowledges that other areas, like multi-omics for complex traits, face steeper challenges in proving their value.
Looking ahead, Dr. Weiss predicts that longitudinal multi-omic profiling will become increasingly important in clinical practice within the next 10 to 15 years. He also suggests that there will be significant advancements in areas like liquid biopsy for early cancer detection, metabolic health monitoring, and even mental health, driven by the integration of genomics and other omics data.
At the same time, he notes the critical role of large-scale biobanks in driving these innovations, emphasizing the need for both massive prospective cohorts like the UK Biobank and more targeted efforts within healthcare systems. The potential to combine this data with AI models could also unlock new predictive tools, making personalized medicine better and more accessible.
Despite stepping back from some leadership roles, Dr. Weiss remains actively engaged in research. His current projects include a comprehensive paper on the role of vitamin D in preventing asthma, as well as collaborations on network medicine exploring the links between pregnancy complications and long-term health outcomes. At 78, Dr. Weiss continues to contribute to the field, driven by a passion for discovery and a commitment to improving patient care.