Consistent with a current, worldwide move towards a new era in medicines, Australia, as reflected in a project initiated by the state of Victoria and some medical research institutes, is trying to ensure personalised medical care by means of a research platform making data accessible to researchers at multiple sites.

Called the Bio21:Molecular Medicine Informatics Model (MMIM), it has been formed through collaborative efforts by Victoria's second largest health service Melbourne Health, Melbourne University and Bio 21 Australia, the country's largest biotechnology foundation.

It is aimed at dismantling the barriers to pharmacogenetic research by allowing a mix of scientific, clinical, medical and genomic research data maintained by different institutions and research teams. Pharmacogenetics is the study of individual variations in a DNA sequence related to drug responses.

The enterprise seeks to enable doctors and researchers to find bio-technical and clinical information in multiple databases and to combine it in a virtual repository with publicly available research and genetic profiling data.

Security of the clinical research records and genetic data is foolproof; no one's privacy is eroded; moral matters are never lost sight of.

"In the 1800s, the medical world's focus was on nutrition; in the 1900s, immunisation was its chief concern. The contemporary emphasis is on improved medicines and attention," said Michael Georgeff, principal of Precedence Research Institute and professor in Monash University's information technology faculty in Melbourne.

To prevent avoidable deaths - and many occur every year - the project tries to have knowledge shared by several institutions so each of these can treat its patients better than before. "We'll do the pilot and then expand. That's important," he said.

Robert Merriel, chairman of the MMIM and business development manager of Melbourne Health, a major public health provider in Victoria, said that Bio21 currently supported research into the treatment of such chronic diseases as cancer, epilepsy, a disorder of the central nervous system characterised by a loss of consciousness, and of course, diabetes. There are five hospitals, a university and two research institutes involved in the project, with Western Hospital, Austin Hospital, Peter MacCallum Cancer Institute, Alfred Hospital and Ludwig Institute for Cancer Research included.

Since each of these institutions possesses its own database related to diseases, the project has successfully integrated clinical research findings, tissue banks and genetic information on colorectal cancer, epilepsy and diabetes.

Merriel said that each institute held its specific data in its own local research repository, and it is the repositories that are linked to what is called a "federated data integrator" to enable authorised researchers in hospitals and institutes to download data for analyses.

It is expected to lead to the development of pharmaco-genomics: the study of how an individual's genetic inheritance affects his body's response to drugs. It is a combination of pharmacology - the study of drugs, inclusive of how they are made and how they work - and genomics, the branch of genetics dealing with organisms in terms of their genomes. It holds the promise that drugs might one day be tailor-made for individuals and adapted to each person's own genetic make-up.

Environment, diet, age, lifestyle and the state of health influence a person's response to medicines but understanding an individual's genetic make-up is thought to be the key to creating personalised drugs for greater efficacy and safety. Leaving today's trial-and-error method behind, doctors will in the future be able to analyse a patient's genetic profile and prescribe the best available drug.

Richard Hill, partner for Healthcare and Business Consulting Services at IBM Australia, spoke of a "translational medicine" where genetic predisposition testing and molecular medicine are playing an important role, before moving forward to personalised medicine in which pre-symptomatic treatment and lifetime treatment will be available.

suchalee @nationgroup.com

Suchalee Pongprasert

The Nation

Melbourne