Regional One Health and University of Tennessee Health Science Center have partnered to create the Biorepository and Integrative Genomics Initiative, or the BIG Initiative.
The BIG Initiative will create a database of DNA samples that researchers can use to study how a patient’s genes impact which diseases they get and how well they respond to treatment.
The goal is to create new treatments and cures that are targeted toward a patient’s individual genetics and needs, leading to a more personalized, effective style of care.
Regional One Health is helping shape the future of medicine into a more personalized, effective style of care in which treatment is targeted to each patient’s unique genetic makeup and lifestyle.
The Regional One Health Research Institute, LLC and University of Tennessee Health Science Center have partnered to launch the Biorepository and Integrative Genomics (BIG) Initiative.
The project started under the leadership of Dr. Jon McCullers and has rapidly grown under the guidance and support of Dean Scott Strome. Day-to-day activities are overseen by a group of researchers and scientists including Drs. Robert Davis, Chester Brown, Robert Williams, Robert Rooney and Kito Lord.
The project will create a collection of DNA samples that researchers can use to study how a person’s genes impact which diseases they get and how they will respond to treatment. The DNA will be extracted with patients’ permission from leftover blood samples from their care at Regional One Health. Personal information will be fully protected and participation is completely voluntary.
Kito Lord, MD, MBA, Medical Director of Regional One Health’s Department of Emergency Medicine, said BIG combines the strengths of Regional One Health and UTHSC while keeping the focus on improving outcomes and experiences.
“This is an exciting opportunity to move forward as an academic medical center and combine excellent clinical care with cutting-edge research to improve patient care,” Dr. Lord said. “We have a shared vision and shared goal to keep patients at the center of everything we do.”
The BIG Initiative will support research that could lead to improved treatments or even cures for everything from cancer to hypertension to diabetes – and beyond.
“With almost any condition you receive treatment for, there is a genetic component to how you respond to that treatment. Because of that, we’re moving away from a one-size-fits-all approach and looking at how individual patients respond based on their lifestyle and genetics,” Dr. Lord said. “Instead of treating the group, we will treat the individual using precision medicine, and that’s really important.”
A common example is blood pressure medication.
“Some patients respond very well to blood pressure medications, while others don’t respond at all. What is even scarier is some patients can develop a life-threatening reaction to their blood pressure medication called angioedema,” Dr. Lord explained. “What if we could figure out ahead of time who these drugs will benefit and who they will hurt?”
That would help physicians target the prescriptions they provide. Patients would experience faster relief, avoid setbacks, and even save money since they wouldn’t have to take additional medications to offset side effects from prescriptions that aren’t ideal for their genetic makeup. Physicians would also be able to gauge when a patient is at risk for a certain disease and deliver more effective, preventative medicine.
It’s exciting news for all patients, Dr. Lord said, including those who are part of groups that have suffered from disparity in access to health care. Regional One Health’s patient population includes underserved communities, so DNA from those groups will be included in the repository.
“There’s a paucity of genetic information from historically underrepresented groups, and we can help bridge that gap,” he said. “It’s a chance to address health disparities and be at the forefront of advocating for our patients and community by making sure no one is left behind.”
Dr. Lord explained how the BIG Initiative works:
Typically, patients at Regional One Health have blood drawn as a routine part of their medical care. Doctors and nurses draw only the blood they need, but if there is any left over, patients can consent to have it saved for the repository rather than discarded.
If a patient does not want to take part, their blood sample is simply discarded.
For those who do grant permission, several steps are taken to protect privacy. “Confidentiality is extremely important, so we take a lot of precautions,” Dr. Lord said. “We make sure private information is safe, and even a court order can’t force researchers to reveal private information.”
Each participant’s medical record is coded so they cannot be identified and linked to their blood sample. Their name and any other information that could identify them is removed and replaced with a number. DNA extracted from their sample is linked only to that number. Researchers only see a number and a de-identified medical history.
However, that history is precisely what they need to make a sample useful.
For example, if researchers are studying DNA as it relates to diabetes, they would want to use samples of patients with diabetes. That would allow them to understand how genes impact the health and treatment options for patients with diabetes.
“It’s a huge opportunity for researchers going forward,” Dr. Lord said. “Finding out how genes impact a patient’s health and how they respond to treatment is crucial to improving outcomes and health care delivery. It’s precision medicine, and we’re excited to be at the forefront of this new initiative.”