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AACC Annual Meeting Covers Genomics, Proteomics, and Diagnostics

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At the American Association for Clinical Chemistry annual meeting held in Washington, DC, at the end of July, it was the changing role of clinical laboratory medicine in improving healthcare that garnered the most attention. In one of the first plenary sessions, Roy Vagelos, retired chairman and CEO of Merck, talked about the changing pharmaceutical industry and its evolving role in providing healthcare. One symposium followed up on that with a look at evidence-based medicine, while another delved into the challenges facing clinical laboratory testing in the developing world.

James Hughes, director of Emory University's program in global infectious diseases, took on some of the challenges and opportunities in creating diagnostics for the developing world. Those included managing the global burden of infectious disease, dealing with emerging microbial and vector-borne threats that have cropped up in the past decade, and implementing disease control efforts. Some of the most devastating diseases globally in terms of mortality are HIV/AIDS, tuberculosis, and malaria, Hughes said, citing data from a 2003 World Health Organization study. "What you don't hear much is that, actually, the leading infectious disease killer worldwide is lower respiratory tract infections, primarily pneumonia and influenza, and that coming in third is diarrheal disease," he added.

At the other end of the Walter E. Washington Convention Center, Donald Baldwin, director of the microarray facility at the University of Pennsylvania School of Medicine, spoke about the use of standard genomics and proteomics tools for molecular diagnostics and high-throughput genotyping, especially for cancer. While his talk focused on miRNAs, he touched on many up-and-coming research tools that could be utilized for functional genomics, including alternative RNA splice arrays, tissue microarrays, cell transfection microarrays, and "next-next-gen" sequencing, which uses nanotechnology to get down to the single-molecule level. "Functional genomics has long way to go," he said, citing headway made in proteomic technologies as just the start. "We need good ways of looking at protein-protein interactions and sub-cellular localization to really understand in this entire model, what's happening to the whole genome context."

A debate on whether warfarin testing was ready for primetime was also the subject of a full-day symposium, with a series of experts in the field giving both supporting and opposing arguments. While some say using genetic tests to determine warfarin dosing is ready to lead the way for more pharmacogenomic tests, others say the data is not yet available and that testing could increase costs while not offering any real benefits. Inside the exhibit hall, ParagonDx paired with DNA Genotek to offer a warfarin demo to conference attendees, including a test for CYP2C9 and VKORC1, the two variants that determine warfarin sensitivity. The simple procedure consisted of signing a few consent forms, spitting into a tube, and then going to a designated website where the results were posted.

Finally, to put it all in perspective, veteran broadcast journalist and political commentator for ABC News, Cokie Roberts, gave a lively plenary on the healthcare debate — what the US presidential election will bring in terms of the candidates' ideas for healthcare reform. "It is definitely going to be robustly debated in this election campaign," she said. "It's a different debate from what it used to be." She contended that this election will see people demanding healthcare reform, and the statistics are enough to explain why: from 2001 to 2007, worker earnings in the US went up 18 percent, while the cost of health insurance premiums increased by 78 percent, Roberts said. More than 25 percent of people say they have trouble paying for healthcare and insurance and "with serious illness, it makes it considerably worse," said Roberts. "For those who are fighting cancer, which now is one in three of us, 25 percent … said the disease had used up much or all of their savings. I think that the pressure on the national government to act is going to be very strong."

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