Orchestrating an Era of Genomic Medicine

“I’m a big science sort of guy,” says Eric Green, MD ’87, PhD ’87, HS ’91. “I like large-scale experiments, large-scale organization.”

In the late 1980s, Green found the perfect match for his big-science passion: the Human Genome Project. The Human Genome Project was then a new initiative with an ambitious goal: to put into proper sequence the more than 3 billion pairs of molecules that make up human DNA, and to identify the more than 20,000 genes written in those molecules. Together our genes make up our genome — the genetic blueprint that encodes everything from what color hair we’re born with to which diseases we’re susceptible to throughout our lives. “I got involved [with the project] on the ground level,” Green says. “Genomics fit my personality so well.” And he’s been a part of genomics ever since.

“It’s about building partnerships, coalitions and collaborations, and it’s about figuring out priorities,” Green says. “I like speaking about genomics, and not just to the experts. I like communicating very broadly.”

In December 2009, Green was named director of the National Human Genome Research Institute (NHGRI), which is about as big picture a role as one can imagine. As a part of the National Institutes of Health, NHGRI (http://genome.gov/) is the largest funder of human genome research; as such, it supports experiments both on-site and at research institutions throughout the world. Green sees his role at NHGRI as akin to conducting an orchestra. “It’s incredibly gratifying to see everyone engaged in his or her solo roles, yet be part of a larger unit — and knowing as a funding agency you’re a part of that,” he says. Green adds that he and the institute essentially serve as overseers and as catalysts — they encourage research, search for new avenues to pursue, and work to get researchers from disparate areas talking to one another to come up with new ideas.

As director, Green also serves as NHGRI’s spokesperson, regularly talking to everyone from lay audiences to members of Congress and the press. “It’s about building partnerships, coalitions and collaborations, and it’s about figuring out priorities,” he says. “I like speaking about genomics, and not just to the experts. I like communicating very broadly.”

Part of worldwide team of scientists

Green’s work on the Human Genome Project began shortly after he earned joint medical and doctoral degrees from Washington University. He’d already begun a residency in clinical pathology at the School of Medicine, and he was searching for a research laboratory to work in as well. Green visited the lab of Maynard Olson, PhD, an early leader in genomic research. “Within 20 minutes, I knew I was going to work for him,” says Green, who describes Olson as one of his science heroes. “Genomics married my clinical side with the sort of scientific research mind I have.” Green was excited, too, about the possibility that one day genomics might bring his research and medical backgrounds together, as well as new ways to detect and treat disease.

In 1992, after finishing his residency and postdoctoral research, Green was appointed assistant professor of pathology, genetics and internal medicine at the School of Medicine, as well as a co-investigator in the university’s then-new Human Genome Center. “It was an awesomely fantastic place,” Green says of his time at the medical school. “Washington University was and is a mecca for genomic science. I felt well supported and nurtured there.”

“It was an awesomely fantastic place,” Green says of his time at the medical school. “Washington University was and is a mecca for genomic science. I felt well supported and nurtured there.”

At the university, Olson introduced Green to someone who became another of his science heroes: Francis Collins, who shortly thereafter would become NHGRI’s director. In 1994, Collins recruited Green to join NHGRI. In 2002, he appointed Green the institute’s scientific director, and in 2009, after Collins was appointed director of the NIH, he named Green his successor as director of NHGRI.

In 2003, the human genome was fully sequenced, two years ahead of schedule and under budget, and the Human Genome Project was officially concluded. With the sequence in hand for the first time, the hard work of understanding it began. For many years after, Green ran a sequencing center that made major contributions to genomics. He says he’s enjoyed “working shoulder to shoulder with hundreds of scientists around the world, knowing I was part of that team.” Green conducted other research, as well — one of his lab’s major successes was finding the gene associated with the most common form of inherited human deafness.

All told, Green has authored and co-authored more than 250 papers as a result of his work. He’s been honored by induction into the American Society for Clinical Investigation and the American Association of Physicians. In 2005, he received an Alumni Achievement Award from the university’s School of Medicine, and in November 2010, he was honored with a Founders Day Distinguished Alumni Award.

Green phased out his laboratory research at NHGRI in late 2010 in order to focus on his role as NHGRI director. “It’s a huge job and a huge responsibility. I wanted to give it my undivided attention,” Green explains.

He also wanted to assure he had time to focus on his family, especially his two children, a son and a daughter. Green enjoys coaching his son’s baseball team and both children’s summer swim teams, as well as helping with his son’s rock band. He squeezes two other obsessions into his busy schedule: digital photography and an unflagging dedication to the St. Louis Cardinals. He shares that dedication not only with his wife and children, but with his father, who also is a researcher, and his brother, Michael Green, MD ’81, PhD ’81. Michael graduated from Washington University’s joint medical and doctoral program the same year that Eric began studying there.

A patient’s genetic makeup key to care

With the human genome fully sequenced, NHGRI’s focus has turned more strongly to human disease applications that helped draw Green to the field. He sees medical science as moving toward an era of “genomic medicine,” where knowing a patient’s genetic makeup will be central to the person’s care.

“Our institute is about developing the routine use of genomic information for medical care,” he says. “It’s not going to happen overnight, but we’re finally within striking distance. By knowing the unique makeup of individuals, we can create smarter, better ways to treat people.”

“You really wouldn’t want a mechanic working on your car who doesn’t understand the blueprint of how the car was put together,” Green explains. “Yet right now we’re treating patients without fully understanding their genetic blueprint.”

Green cites current breast cancer research as one example of how this might change. Two breast cancer patients will often have tumors that look identical when examined with a microscope but are quite different when their genes are examined — differences that suggest alternative therapies. Genomics can improve preventive care as well: a patient with, say, a genetic predisposition to colon cancer should begin screening for the disease sooner than someone without such a predisposition.

“I believe the best way to treat cancer is to understand the genetic makeup of that cancer. And that the best way to treat heart disease is to understand the genetic makeup associated with each individual’s heart disease,” Green explains.

“Our institute is about developing the routine use of genomic information for medical care,” he says. “It’s not going to happen overnight, but we’re finally within striking distance. By knowing the unique makeup of individuals, we can create smarter, better ways to treat people.”

For more information, visit http://www.genome.gov/27535200.

Janni L. Simner, AB ’89, AB ’89, is a freelance writer based in Tucson, Ariz.