2012 09 medicine x

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description

Atul Butte's slides from Medicine X at Stanford September 30, 2012

Transcript of 2012 09 medicine x

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Total 1 million microarrays available

ncbi.nlm.nih.gov

www.ebi.ac.uk

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Type 2 Diabetes Mellitus

• Affects 20 million in US, 170 million world-wide

• Leading cause of kidney failure, blindness, amputation

• Major risk factor for heart disease, stroke, birth defects

• 12% of all US health-care dollars

• Prevalence in children born after the year 2000 expected to reach 30%

• Many drugs available to boost insulin secretion, improve insulin response, lower glucagon secretion

• New drugs still needed and used: DPP-4 inhibitors (2008)

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Perc

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Number of positive experiments (out of 130)

Intersect 130 experiments

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Intersect 130 experiments

Most of the 25000 genes in the genome are positive in very few diabetes experiments

Perc

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Number of positive experiments (out of 130)

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Our best known 186 genes are positive in more experiments!

LEPR

Perc

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Number of positive experiments (out of 130)

TCF7L2 PPARG

Intersect 130 experiments

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A

Perc

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gen

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Number of positive experiments (out of 130)

Intersect 130 experiments

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Gene A is expressed in mouse fat tissue Gene A is higher in high fat diet

Gene A

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Gene A knockout mouse has fewer inflammatory cells in the fat

• Stain for inflammatory cells (macrophages)

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Humans have inflammatory cells in their fat too, with Gene A!

• Paraffin-embedded omental fat tissue from an obese 57 year woman, BMI 36.9 kg/m2

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Humans even have Gene A in the blood! It correlates with our average blood sugar (HbA1c)

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Therapeutic antibody against Gene A reduces sugar in mice!

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• Gene A is CD44 (Hyaluronic Acid Receptor)

• Anti-CD44 in development for multiple cancers

• CD44 is a complicated receptor

Kodama K, Horikoshi M, ..., Maeda S, Kadowaki T, Butte AJ. PNAS, 2012.

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Four Lessons Learned

• Sufficient data already exists to impact medicine

– Diagnostics and drugs from public big data

– More data is better, but we see no reason to wait

– Data over dogma

– “Retroactive crowdsourcing”

• Public molecular data is extremely high quality

– Should never wait for perfect data, experiment, conditions

• Sticks seem to work better than carrots for sharing

– Continue exponential growth, more transparency

• Need to train students to initiate science with data

– High school higher education career changers

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Collaborators

• Keiichi Kodama

• Rong Chen, Alex Morgan, Marina Sirota

• Takashi Kadowaki, Momoko Horikoshi, Kazuo Hara, Hiroshi Ohtsu / University of Tokyo

• Kyoko Toda, Satoru Yamada, Junichiro Irie / Kitasato University and Hospital

• Junichiro Irie / Keio University

• Shiro Maeda / RIKEN

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Support • Lucile Packard Foundation for Children's Health

• National Institutes of Health

• March of Dimes

• Hewlett Packard

• Howard Hughes Medical Institute

• California Institute for Regenerative Medicine

• Scleroderma Research Foundation

• Clayville Research Fund

• PhRMA Foundation

• Stanford Cancer Center, Bio-X

• … and you, the taxpayer who supports and pays for science