Watch City of Tampa TV show on Genomics at USF Health 

Genomics, the study of genes and their function, is a burgeoning field that is changing the face of medicine and other health professions as it gives practitioners, and even patients, unprecedented detail about diseases, conditions and even levels of health risk.

Beginning fall semester, USF Health will offer its first course in human genomics designed specifically for health professionals without advanced research training, including those in medicine, nursing, public health, pharmacy and physical therapy.

Human Genomics in Medicine and Public Health (PHC 6943/GMS 7930) will introduce genomics and modern genetic technologies to master’s-level and senior undergraduate health students with limited training in molecular biology and biochemistry.  The course, taught by genomics experts from the colleges of Medicine and Public Health, will integrate these rapidly developing technologies into the real-world practice of personal health decisions and public health initiatives encompassing population health.

The curriculum will cover information needed to meet nursing as well as public health competencies in genomics.

Michael White, PhD, professor of global health and technical director of the new course, says the human genome is an instruction manual for building and maintaining a human being.

Michael White, PhD

“Only very recently has medicine had the tools to translate the DNA language of the complete instruction manual. The manual for each of us has unique pages that together make up our individual book of life.  Today, understanding each book of life is within our grasp, and this has profound implications for our health,” said Dr. White, a practitioner of genomics and bioinformatics in research.

“It will fall to health professionals at all levels to help us navigate this new world of genomics and teach us to confidently read and understand our own book of life.”

Dr. White designed the curriculum with course clinical director Judith Ranells, MD, chief of the Division of Genetics and Metabolism in the USF Health Morsani College of Medicine and a practitioner of clinical genetics.

Judith Ranells, MD

“In this course we will train front-line health professionals how the new DNA decoding tools work and how genome-based knowledge will impact the future of individual health decisions, including the diagnosis, treatment and prevention of disease,” Dr. Ranells said. “We will also consider strategies for preventing the potential misuse of genomic information and ensuring patient confidentiality.”

Registration in currently open for Human Genomics in Medicine and Public Health, which will be held 5 to 7:45 p.m. on Wednesdays at the Interdisciplinary Research Building in the USF Research Park.  For more information, please contact either of the course directors: Dr. White at mwhite3@health.usf.edu or Dr. Ranells at juranell@health.usf.edu

Personalized medicine research at University of South Florida strikes early for heart genes 

Tampa, FL (Oct. 16, 2012) — A landmark paper identifying genetic signatures that predict which patients will respond to a life-saving drug for treating congestive heart failure has been published by a research team co-led by Stephen B. Liggett, MD, of the University of South Florida.

The study, drawing upon a randomized placebo-controlled trial for the beta blocker bucindolol, appears this month in the  international online journal PLoS ONE.  In addition to Dr. Liggett, whose laboratory discovered and characterized the two genetic variations, Christopher O’Connor, MD, of Duke University Medical Center, and Michael Bristow, MD, PhD, of ARCA biopharma and the University of Colorado Anschutz Medical Campus, were leading members of the research team.

Dr. Stephen Liggett, who joined USF just four months ago to lead the University’s Center for Personalized Medicine and Genomics, was a senior author of the landmark paper.

The analysis led to a “genetic scorecard” for patients with congestive heart failure, a serious condition in which the heart can’t pump enough blood to meet the body’s needs, said Dr. Liggett, the study’s co-principal investigator and the new vice dean for research and vice dean for personalized medicine and genomics at the USF Morsani College of Medicine.

“We have been studying the molecular basis of heart failure in the laboratory with a goal of finding genetic variations in a patient’s DNA that alter how drugs work,” Dr. Liggett said.  “We took this knowledge from the lab to patients and found that we can indeed, using a two-gene test, identify individuals with heart failure who will not respond to bucindolol and those who have an especially favorable treatment response. We also identified those who will have an intermediate level of response.” The research has implications for clinical practice, because the genetic test could theoretically be used to target the beta blocker to patients the drug is likely to help. Equally important, its use could be avoided in patients with no likelihood of benefit, who could then be spared potential drug side effects.  Prospective studies are needed to confirm that bucindolol would be a better treatment than other classes of beta blockers for a subset of patients with health failure.

Dr. Liggett collaborated with medical centers across the United States, including the NASDAq-listed biotech company ARCA biopharma, which he co-founded in Denver, CO.   This genetic sub-study involved 1,040 patients who participated in the Beta-Blocker Evaluation of Survival Trial (BEST).  The researchers analyzed mortality, hospital admissions for heart failure exacerbations and other clinical outcome indicators of drug performance.

“The results showed that the choice of the best drug for a given patient, made the first time without a trial-and-error period, can be accomplished using this two-gene test,” Dr. Liggett said.

The genetic test discovered by the Liggett team requires less than 1/100^th of a teaspoon of blood drawn from a patient, from which DNA is isolated.  DNA is highly stable when frozen, so a single blood draw will suffice for many decades, Dr. Liggett said. And since a patient’s DNA does not change over their lifetime, as new discoveries are made and other tests need to be run, it would not be necessary to give another blood sample, he added.

This is part of the strategy for the USF Center for Personalized Medicine and Genomics. The discovery of genetic variations in diseases can be targeted to predict three new types of information: who will get a disease, how the disease will progress, and the best drug to use for treatment.

“In the not too distant future, such tests will become routine, and patient outcomes, and the efficiency and cost of medical care will be impacted in positive ways.  We also will move toward an era where we embrace the fact that one drug does not fit all,” Dr. Liggett said.  “If we can identify by straightforward tests which drug is best for which patient, drugs that work with certain smaller populations can be brought to the market, filling a somewhat empty pipeline of new drugs.”

This approach is applicable to most diseases, Dr. Liggett said, but the USF Center has initially concentrated on heart disease, because it is a leading cause of deaths, hospitalizations and lost productivity in the Tampa Bay region and Florida.  Dr. Liggett is a recent recruit to the USF Health Morsani College of Medicine, coming from the University of Maryland School of Medicine.  His work at USF has been supported by several National Institutes of Health grants and $2 million in funding from Hillsborough County.

Heart failure is characterized by an inability of the heart muscle to pump blood, resulting in dysfunction of multiple organs caused by poor blood and oxygen flow throughout the body.  An estimated 6 million Americans are living with heart failure, and more than half a million new cases are diagnosed each year.  About 50 percent of patients diagnosed with heart failure die within five years.  The economic burden of heart failure in the United States is estimated at $40 billion a year.

Article citation:
Christopher M. O’Connor, Mona Fiuzat, Peter E. Carson, Inder S. Anand, Jonathan F. Plehn, Stephen S. Gottlieb, Marc A. Silver, JoAnn Lindenfeld, Alan B. Miller, Michel White, Ryan Walsh, Penny Nelson, Allen Medway, Gordon Davis, Alastair D. Robertson, J. David Port, James Carr, Guinevere A. Murphy, Laura C. Lazzeroni, William T. Abraham, Stephen B. Liggett and Michael Bristow, “Combinatorial Pharmacogenetic Interactions of Bucindolol and β₁, α_2C Adrenergic Receptor Polymorphisms,” PLoS ONE   7(10): e44324. doi:10.1371/journal.pone.0044324

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Media contact:
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu

Tampa, FL (June 13, 2012)  — Stephen B. Liggett, MD, a pioneer in the emerging field of personalized medicine, will help USF Health build an interdisciplinary center that will be a national leader in driving research needed to tap patients’ unique DNA profiles to tailor their medical care.

Dr. Liggett, who will direct the USF Center for Personalized Medicine and Genomics, joined the University of South Florida June 11.  He is vice dean for personalized medicine and genomics at the Morsani College of Medicine, USF Health associate vice president for personalized medicine, and professor in the Department of Internal Medicine. He will hold a joint appointment in the Department of Molecular Pharmacology and Physiology.

Dr. Stephen Liggett brings to USF Health a multi-million dollar NIH portfolio.

Dr. Liggett came to USF from the University of  Maryland School of Medicine in Baltimore, where he was associate dean for interdisciplinary research and professor of medicine and physiology. Supported by a multi-million dollar portfolio of NIH grants, he studies genetic variations in people and pathogens, with a focus on signaling genes relevant to heart and lung diseases.

“We are very fortunate to have recruited Dr. Liggett; he was highly sought after by other universities both in Florida and across the country,” said Stephen K. Klasko, MD, MBA, CEO of USF Health and dean of the Morsani College of Medicine. “Dr. Liggett’s leadership and expertise will be critical in helping USF Health, the Tampa Bay region and the state of Florida advance in genomics-based personalized medicine for heart and other diseases. This is the future of medicine – another terrific opportunity for us to be at the forefront of transforming how health care is provided to patients.”

If the promise of personalized medicine is realized, physicians could mine a person’s genetic code, or genome, for information to predict the individual’s disease risk, disease progression, or severity, and response to treatment.  They would take into account the patient’s unique genetic profile and physiology, including an individual’s ability to metabolize particular drugs, to select the best treatment and determine the right dosage.

Dr. Liggett describes genomics-based personalized medicine as a powerful, targeted approach that could achieve a level of optimal care surpassing current outcomes.

“Using a person’s genetic code to tailor their treatments eliminates the ‘trial-and-error’ approach, which is the way medicine is practiced now,” Dr. Liggett said. “We need to use the most sophisticated information we can to give patients receiving a diagnosis their best medication options right away, particularly for aggressive diseases where time is of the essence.”

At USF, Dr. Liggett will work with faculty members across multiple disciplines, incorporating personalized medicine in varying degrees into the research and practice of medicine.  The research will emphasize finding links between differences in genes sequences and responses to treatment, so that eventually genetic tests can be developed to help improve the safety and effectiveness of therapy and to lower costs.

Dr. Liggett’s initial collaborations will include Leslie Miller, MD, chair of cardiovascular sciences at the Morsani College of Medicine and leader of  the USF Health Heart Institute.  In April, the Heart Institute received a combined $8.9 million in state and county funding, which will allow USF Health to join with industry and academic partners to begin developing new genomics-based personalized approaches to health.

“There is a pressing need to bring to bear all our tools, including personalized medicine, to prevent and treat cardiovascular disease, the most common cause of death in the U.S., Florida and the Tampa Bay region,” Dr. Liggett said. “USF has already invested substantially in laying a foundation for personalized medicine in heart disease. So, to leverage this effort, one of the first group of diseases we target will be cardiovascular.”

Advances in the field of personalized medicine are expected to multiply over the next decade with strides in the clinical interpretation of genome sequencing and increases in the number of diseases that can be precisely diagnosed and then treated with a highly targeted therapy. Work by Dr. Liggett’s laboratory’s has led to greater understanding of how variations of genes and families of genes affect the disease processes of congestive heart failure and asthma and how a patient’s genetic makeup can be used to tailor drug treatment.

Among his accomplishments:

• At the University of Maryland, Dr. Liggett and colleagues identified a gene variation that appears to help determine which patients with heart failure will benefit from a beta-blocker drug commonly used to treat the chronic disease. That is important because it often takes several months to determine if a specific beta blocker is working for a patient.
• Dr. Liggett’s genomic investigations in heart failure have generated $6.1 million in National Institutes of Health grants, 10 new patents and resulted in the creation of two biotechnology companies.

•  Dr. Liggett’s University of Maryland team, working with colleagues at the University of Wisconsin-Madison, for the first time mapped out the entire genome of nearly 100 different strains of the common cold virus.  The work, published in the journal Science, may provide a powerful tool leading to the first effective treatments for the common cold.

•  Dr Liggettt’s team used a genomics-based drug discovery method that he pioneered to discover taste receptors in the lung and found a new target for treating asthma. This work, published in Nature Medicine, has stirred renewed interest internationally on development of new drugs for asthma and emphysema.

Dr. Liggett received an MD degree from the University of Miami School of Medicine.  He completed his residency in internal medicine and a fellowship in pulmonary and critical care medicine at Washington University School of Medicine and Barnes Hospital in St. Louis. Following a laboratory-based postdoctoral fellowship at the Howard Hughes Medical Institute at Duke University, he joined the faculty at Duke and then the University of Cincinnati College of Medicine.

At the University of Cincinnati, Dr. Liggett was the Taylor Endowed Professor of Medicine, Pharmacology and Molecular Genetics, and served as chief of the Pulmonary and Critical Care Division.  He moved to the University of Maryland in 2005.

Dr. Liggett has served on numerous NIH study sections and committees of the American Lung Association. He is a member of the Personalized Medicine Coalition’s Clinical Science Committee, working to advance the understanding and adoption of personalized medicine to benefit patients. He is an editorial board member for several high-impact journals and has authored more than 200 publications, including papers in peer-reviewed journals, book chapters and reviews.

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Photos by Eric Younghans, USF Health Communications

Media contact:
Anne DeLotto Baier, USF Health Communications, (813) 974-3303 or abaier@health.usf.edu