NIH director: Emerging biomedical research ‘breathtaking’

NIH director Francis Collins, MD, PhD, spoke to the audience at TEDMED 2014 about the advances in biomedical research on the horizon.

“I have this amazing opportunity to look over this whole landscape of biomedical research and see what is emerging, and it is breathtaking — things that I never dreamed would happen in my lifespan,” Collins said.

Personalized medicine

Personalized medicine is an area of interest to Collins. He said the first genome sequenced in the Human Genome Project cost around $400 million to complete, but as of this year, it only costs about $1,000. The cost reduction, combined with mobile technology and advances in the understanding of genetic links to disease, will enable physicians to make better decisions about diagnoses, treatment options and dosing to accommodate an individual’s genetic makeup.

“We’ve been doing one-size-fits-all medicine, and it’s time to get personalized about it,” Collins said.

Treatment of cancer, in particular, will change as this body of information grows, he added.

“We’re reaching a point very soon where, if you have cancer, you should have that cancer completely analyzed at the DNA level to see what mistakes are driving those cells to grow when they aren’t supposed to, and then how to link that up with targeted therapy instead of one-size-fits-all approaches,” Collins said. “We are learning a prodigious amount about that, and it is going to be mainstream medical care quite soon.”

Role of the microbiome

Collins said the same approach to genetic sequencing could be used to better understand the effects of the human microbiome.

“What we increasingly are seeing is we’re kind of a super-organism,” he said. “Those microbes have a lot to do with your heath, and if we understood that better, we could perhaps modify them in ways that would help us lose weight, avoid diabetes, avoid infectious diseases — all of those things coming within our grasp.”

Brain research

Collins is also enthusiastic about research that is currently being conducted on the workings of the human brain. Last year, President Obama introduced a 10- to 12-year initiative to better understand how brain circuitry works. Modern computational abilities will play a large part in unraveling that information, according to Collins.

“We are going to figure out how those circuits in the human brain do what they do — those incredibly complicated processing steps — and how that plays out in things like autism, schizophrenia or Alzheimer’s disease, because we need that foundation of information. That’s pretty bold,” Collins explained. “You’ve got 86 billion neurons up here, and you have to figure out how those interact with each other, each of them having maybe a thousand connections.”

Biotechnology

The landscape of biotechnology will dramatically alter the way medicine can be delivered or monitored, according to Collins. He said biochips are being developed that will allow physicians to understand what is happening to a patient internally, without putting the patient at risk.

“We’re turning you into a chip, taking all of those cell types, putting them on a biochip and then testing. If you were going to try this drug, would that actually help you, or might it make you sick?” Collins asked, as an example of what will be possible. “This is not science fiction anymore.”

Funding for research

When asked about declines in funding for medical research and development, Collins said continued loss of funding will hinder research and the ability to attract promising scientists. Funding loss could also have negative impacts on the US economic system, he added — it is well-established that biomedical research is “one of the best drivers of the economy” and has a role in advancing in disease control.

“Over the last 10 years, the NIH has lost more than 20% of its purchasing power for research,” Collins said. “Young scientists are getting discouraged looking at that landscape.”

However, he is encouraged by the increase in nations that are getting involved in biomedical research. He cited a need for collaboration, but argued that momentum has been lost in the US.

“Let’s speak up about that,” Collins said. “Let’s figure out all sorts of ways to bring other resources together to make this kind of enterprise go forward. This is a grand adventure. It is also a great way to build the economy. We should not rest if we’re going slower than we could be, and right now I can’t tell you that we’re doing everything that we can.”

For more information:

Collins F. Presented at: TEDMED 2014; Sept. 10-12, San Francisco.