New UM center to take medicine to personalized level
Don Levitt’s test results suggested for years he might have prostate cancer, but he decided to monitor his health and forgo a biopsy.
A few years ago, one of Levitt’s doctors told him about a more personalized test developed at the University of Michigan Comprehensive Cancer Center that could better detect cancer and assess whether he needed to have a biopsy.
The test — the Mi-Prostate Score, or MiPS — uses a urine sample and looks at PSA, or prostate-specific antigen, which is produced by the prostate. But the test also looks for the presence of two genes linked with prostate cancer, and helps men make choices in their care such as avoiding overtreatment with a biopsy.
Levitt’s results showed that he was low on the presence of the two genes, and it was probably not necessary to have a biopsy even though his levels of PSA had been elevated, which sometimes means prostate cancer.
“When someone has a mildly elevated PSA level, the question is whether or not to get a biopsy,” said Levitt, an Ann Arbor-based psychologist and consultant. “It helped to reassure me that I was making the right decision not to get a biopsy.”
MiPS has emerged in an era of advancing technology being used to battle diseases on a precise level in a burgeoning area known as personalized medicine — treatments tailored to individuals based on their genome, a complete set of DNA.
Central to the test is RNA (ribonucleic acid) — a powerful molecule that many scientists are beginning to better understand and has prompted UM to create the Center for RNA Biomedicine with academics across many disciplines being able to collaborate to treat a wide range of diseases.
An inaugural symposium with five prominent scientists and two Nobel laureates will launch the center at UM on Friday, along with new scientific endeavors aimed at better health care.
Besides the MiPS test, many studies are underway at UM to examine the role of RNA, and more are expected with the new center.
“Collaboration across disciplines is one of the hallmarks of the UM community and a key driver of creativity and impact our research,” said S. Jack Hu, vice president of research.
“The Center for RNA Biomedicine will build on this core strength to spur progress in medical sciences.”
A new era
Regarded as the next frontier in health care, personalized medicine has been emerging in recent years, but most of the discussion has been around the power of an individual’s DNA (deoxyribonucleic acid) to find precise treatments.
Turns out, it’s the RNA in an individual’s cells that is paving the way for that approach.
“One of the new aspects in medicine now compared to even as recently as five years ago is the growing idea that we should be engaged in personal medicine,” said Dr. Eva Feldman, a UM neurology professor and director of the A. Alfred Taubman Medical Research Institute, which is providing support for the center.
“RNA turns out to be pivotal in multiple disease processes and in personalized medicine.”
Mats Ljungman, one of the co-directors of the center, said the university has a tremendous research infrastructure in which complete analysis of the 3 billion base pairs that make up a person’s genome, and the expression levels of all RNAs copied from the genome, can be completed within a few days.
“This is the basis of ‘precision medicine’ that President Obama recently announced would be a national research focus,” Ljungman said. “Here at Michigan, these technologies are being used to guide cancer treatment on an individual basis, to capture disease-predictive RNA molecules in patient’s blood and to better understand the molecular underpinnings of ALS and autism.
“We are moving into a very promising time where major advances in technology together with tremendous breakthroughs in basic fundamental RNA biology is leading us into the exciting new era of RNA biomedicine.”
DNA vs. RNA
Most medical treatments were designed for an average person. So when patients get treated for diseases, therapies typically used are those that work on the most people.
But one person’s disease can differ from another person’s, so precision medicine aims to tailor a treatment for an individual with his or her DNA. DNA was sequenced in the Human Genome Project in 2003. The project was hailed as a milestone that many predicted would revolutionize how diseases are diagnosed and treated.
DNA is the blueprint of an individual, but in recent years scientists have better understood how RNA carries out the DNA’s directives.
Now, researchers across the spectrum of RNA and diseases — such as cancer, neurodegeneration and viral infection — are coming together at UM as more knowledge emerges about the various types of RNA and their connections to diseases.
Nils Walter, a co-director of the center, used a Henry Ford car factory as an analogy for understanding the roles of DNA and RNA in the human body: The factory director is the DNA, he said, but the workers are the RNA and the cars are proteins.
“The workers do a lot of important things,” said Walter, a UM professor of chemistry and biophysics. “The workers carry the blueprint of the car from the director’s office onto the warehouse floor, they assemble the car, and they also are responsible for bringing together all the parts of the car.
“They are the midlevel managers that make sure the right car is built at the right time. And they are also the market researchers trying to figure out whether the car is popular.”
In the human body, RNAs take cues from other cells in our body as well as the environment, Walter added.
“Thus, perhaps most strikingly, what RNA is doing also involves integrating all these outside cues, and then go back and modify the blueprint of the cell in Henry Ford’s office,” Walter said.
“Just like a factory, the human body is finely tuned to smoothly make all these ‘cars,’ but imagine if one of the RNAs stumbles and drops the blueprint, incorrectly reads the market research, or accidentally erases the wheels on the blueprint — chaos will reign and your body will develop cancer.
“The Center for RNA Biomedicine is set up to study and help prevent such RNA-caused diseases.”