New genetics division aims to transform pediatric patient care

Jonathan D. Gitlin, M.D., director of the new Division of Genetics and Genomic Medicine in the Department of Pediatrics, analyzes zebrafish embryos, which offer a great model for investigating human development and genetics because of their transparent st
Jonathan D. Gitlin, M.D., director of the new Division of Genetics and Genomic Medicine in the Department of Pediatrics, analyzes zebrafish embryos, which offer a great model for investigating human development and genetics because of their transparent state.

The separate worlds of patient care and genomic science will be brought together in the new Division of Genetics and Genomic Medicine in the Department of Pediatrics at Washington University School of Medicine in St. Louis. Plans for the division map out a model of individualized medical care in which physicians look to their patients’ genetic makeup to determine the most effective treatment.

“We’ve unraveled the human genome, and in that genetic blueprint are answers to medical problems,” says Jonathan D. Gitlin, M.D., the Helene B. Roberson Professor of Pediatrics, professor of genetics and director of the new division. “Right now it isn’t possible to get all the answers we need and apply them to patients, but this division will establish a structure with which to begin that effort.”

The division will receive research grants and support from Washington University School of Medicine and St. Louis Children’s Hospital.

“St. Louis Children’s Hospital has made a unique commitment by pledging financial support to the University for the new division as part of a new research collaboration to be announced later this year,” says Alan L. Schwartz, Ph.D., M.D., the Harriet B. Spoehrer Professor, head of the Department of Pediatrics and pediatrician-in-chief at St. Louis Children’s Hospital. “Hospital president Lee Fetter recognizes that an investment in the research programs stimulated by the Division of Genetics and Genomic Medicine will bring a strong return in the form of innovative care and new therapies.”

The new division’s goals mesh perfectly with Washington University’s strategic research initiative BioMed 21, which aims to translate basic genetic data into new therapies and includes faculty from the schools of Medicine, Engineering & Applied Science and Arts & Sciences.

Gitlin foresees the change to genetically based medicine as the inevitable next step in medical care. This shift is as ambitious as the U.S. decision to enter the space race in the 1960s, Gitlin asserts, and will produce a new approach to patient care that brings information from disparate fields together.

In effect it will bring to the bedside of each patient dozens of research specialists — from genomic scientists to developmental biologists as well as medical specialists from a wide variety of fields, such as oncology, cardiovascular disease and psychiatry.

As a result, patients will receive more effective care. Instead of hit-or-miss treatments that work for some patients, but not others, genomic medicine will one day offer precise treatments that work with the unique physiology of individual patients.

“For example, the most important advance in asthma care in the next decade will come out of understanding the genetics of asthma,” Gitlin says. “Why are certain children susceptible to asthma? Why do certain children respond to asthma medications and others don’t? At the core, those answers come from each child’s genetics.”

To understand the genetic basis for diseases requires researchers to compare genes from thousands of people. The sheer amount of information is massive, and translating that data to medical treatments will necessitate cooperation and collaboration.

“We’re starting this at Washington University because of the breadth of talent here, including of course, the Genome Sequencing Center and the Center for Genome Sciences, and the strong support of the medical school leadership, especially Dean Larry Shapiro, who believes it is important for us to take medicine in this direction,” Schwartz says.

Because many of the antecedents to adult diseases such as type 2 diabetes and cardiovascular disease begin early in childhood, Gitlin and Schwartz say they believe Washington University’s Department of Pediatrics — which ranks fourth nationally in research funding by the National Institutes of Health — provides an ideal foundation from which to launch the new division and to emphasize prevention as a cornerstone of medicine. Understanding the interaction of genetics and environment that leads to disease gives pediatricians the opportunity to prevent the onset of diseases in children for which there is currently little hope for treatment.

The new division is gearing up to double its number of faculty by hiring six new members who will occupy offices and laboratories in the McDonnell Pediatric Research Building, which is situated amidst the school and the hospital in Washington University Medical Center.

Some faculty members will have interdisciplinary appointments, in genetics and genome sciences, for example, as well as in pediatrics. Gitlin believes the goals of the division will quickly attract seasoned collaborators as well as young physicians and researchers who want to be part of this new direction for medicine and who will be attracted to St. Louis Children’s Hospital’s close affiliation with Washington University School of Medicine.

“With this new division, we want to be able to bring everyone together — it’s a division without walls — and see if we can develop very far-reaching programs,” Gitlin says.

Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.