We are on the verge of tailoring treatment for heart disease and diabetes that works for each individual.
Professor Marwick began working at the Baker Institute over six years ago and brings with him more than 30 years of experience as a cardiologist and clinical researcher. He considers both these aspects vital to his understanding of cardiovascular disease, and the chance to continue working in both branches underpins his commitment to the Baker Institute.
'We go all the way from very basic science, genetics, lab work, individual cells, to new molecules, clinical trials, imaging and population health', he explains. 'That cross-fertilisation is unique about the Baker Institute, and a great strength.'
It is this collaborative approach that Professor Marwick is harnessing for the Institute’s current goal: to make the Baker Institute a world leader in personalised medicine for heart disease and diabetes.
Personalised medicine uses a person’s individual genetic profile to guide tailored decisions on diagnosis and treatment. It is a revolutionary approach that became possible after the discovery of the human genome around 20 years ago.
Assessing a person’s unique genetics can provide invaluable medical insights that were previously unknown. 'We now have the ability to measure thousands of genes that identify the level of risk', explains Professor Marwick. 'That gives a personalised level of risk assessment that has not been available before.'
The benefits of personalised medicine have been witnessed in other fields of medicine. 'It has had a huge impact in cancer treatment, for example', he says, 'because the genetic disturbances that drive cancers are usually quite straightforward'. However, the story is much more complex with diabetes and cardiovascular disease. “These diseases are influenced by genes, as well as by the environment. But it’s become apparent that the response to the environment is itself genetically determined.”
While great advances have been made in treatment of cardiovascular disease and diabetes, personalised medicine takes a proactive approach that aims straight for the holy grail of medicine: prevention. This is something Professor Marwick is particularly passionate about.
'Every time I see somebody who’s had a heart attack or heart failure, I think, "This is a failure of prevention",' he explains. 'We have the ability to stop these things. We’ve got much sharper tools now, and we need to press them into action.'
In preparing for the personalised medicine revolution, the Baker Institute began investing in bioinformatics (which combines software and other methods to better understand biological data) several years ago. The Baker Institute also formed a joint department with the University of Cambridge. Known as the Cambridge Baker Systems Genomics Initiative, the collaboration has seen the development of the Polygenic Risk Score, a genetic score that predicts a person’s risk of heart attack.
An initial round of funding from the Baker Institute’s board enabled the investment in bioinformatics and the crucial Cambridge partnership, something Professor Marwick labels as 'transformational'. But much more is needed. 'We need to have a means of making the work sustainable', he says.
That’s why the Baker Institute set an ambitious, $100 million dollar goal — with $50 million being sought in philanthropic contributions, we are now at a stage where we are seeking the final $5 million to reach our target. This will supercharge our vision of becoming a centre of excellence in personalised medicine for heart disease and diabetes.
With greater long-term stability, the Institute can attract and support top, talented scientists, as well as further invest in the technology and partnerships needed to make its personalised medicine goals a reality.
Professor Marwick hopes that testing can also be developed for younger people, to prevent disease well before it develops. If we had a means of genetic and metabolic testing for people aged 20, or even for those in their teens, we would be able to identify people at risk much earlier in their disease course, and we’d be able to change the trajectory,” he explains. This would completely transform the way we look at and understand heart disease and diabetes in the 21st century.
For more information, please visit you.baker.edu.au
