Dr. Robert Marion on Complex Genetic Diseases

by Dr. Hsien-Hsien Lei
Posted August 25, 2009 in Books About DNA, Personalities with DNA

Part 3 of my interview with clinical geneticist and author Dr. Robert Marion. His latest book, Genetic Rounds, will be published in October. (See part 1 and part 2 of the interview.)

In Genetic Rounds, the patients you focus on have devastating diseases caused by mutations in single genes. What is your perspective on genetic medicine as it applies to complex diseases and traits caused by a multitude of gene variants?

Dr. Marion: As time passes, it becomes more and more clear that everything is genetic (or at least has a genetic component)! I’ve taught this lesson to my colleagues in other specialties; through the years, most of them have come around to accept my view (it’s funny to hear these words come from the mouth of a pediatric cardiologist who deals with congenital heart disease, but our work together has more than convinced her).  In the past, the tools haven’t been able to tease out the genetic factors from the environmental ones, but with advances in technology, it won’t be long until the genetic basis of common diseases. such as diabetes, asthma, schizophrenia, etc. will all be known.

And when the technology allows this to happen, it will change all of medicine.  Rather than being a field that waits for individuals to develop symptoms and signs of disease and then treats those symptoms and signs, analysis of polymorphisms and mutations throughout the genome will allow us to predict who will develop diseases, and even when they are likely to develop them.  Medicine will focus more on prevention than treatment.  I’m convinced that with the way technology is progressing, this will happen within the next two decades.

Unfortunately, medical schools are not geared for training future doctors in thinking in this way.  The genetic revolution will force a revolution in medical education.  As geneticists, I think it’s important to begin to get this message to the people responsible for developing the curriculum at our medical schools.

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