Summary of Genomics and Medicine: Role in Cardiovascular Diseases
Author: Larry H. Bernstein, MD, FCAP
- Genomics and Medicine
- Epigenetics – Modifyable Factors Causing CVD
- Determinants of CVD – Genetics, Heredity and Genomics Discoveries
- Individualized Medicine Guided by Genetics and Genomics Discoveries
- rapidly evolving science of genomics
- aided by analytical and computational tools for the identification of nucleotide substitutions, or combinations of them
- cardiovascular diseases,
- hypercoagulable state,
- atherosclerosis,
- microvascular disease,
- endothelial disruption, and
- type-2DM, to name a few.
- essentially because the involvement of the circulation is systemic in nature.
Part 1
- the necessity of a patient-centric approach to patient-care.
- the height of a series of discoveries elucidating key metabolic pathways.
- carbohydrate,
- protein, and
- lipid metabolism,
- Tay Sachs, or
- Transthyretin-Associated amyloidosis.
- multifactorial non-linear traits of great complexity and
- cardiovascular disease,
- cancer,
- microbial,
- plant,
- prion, and
- metabolic diseases.
- the identification of genomic targets
- that are either involved in transcription or
- are involved with cellular control mechanisms for targeted pharmaceutical development.
- codevelop with new drugs,
- biomarkers that are indicators of toxicity or
- of drug effectiveness.
- this portion of the genome is not identified in transcription of proteins.
- an essential role in the regulation of nuclear and cytoplasmic activities.
- changes in Van der Waal forces and internucleotide distances lead to
- conformational changes that could have an effect on cell activity.
Part 2
- the post-genomic modification of genetic expression
- by the substitution of nucleotides or by the attachment of carbohydrate residues, or
- by alterations in the hydrophobic forces between sequences that weaken or strengthen their expression.
- may be modifiable, and they
- may be highly influenced by environmental factors, such as
- smoking and environmental toxins,
- diet,
- physical activity, and
- neutraceuticals.
- the extraction of ancient herbal remedies of agricultural derivation
(which could be extended to digitalis and Foxglove; or to coumadin; and to penecillin, and to other drugs that are not neutraceuticals).
The best examples are the importance of
- n-3 fatty acids, and
- fiber
- dietary sulfur (in the source of methionine), folic acid, vitamin B12
- arginine combined with citrulline to drive eNOS
- and of iodine, which can’t be understated.
- the proinflammatory n-6 fatty acid.
The importance of the ratio of n-3/n-6 fatty acids in diet is not seriously discussed when
- we look at the association of fat intake and disease etiology.
- critical to understanding the inflammatory process, just as
- dietary factors tie in with a balance that is maintained by dietary intake,
- possibly gut bacteria utilization of delivered substrate, and
- proinflammatory factors in disaease.
- elucidated the relationship between platelet-endothelial interaction in the formation of vascular plaque.
- for identifying and classifying types of disease pathobiology, and
- for following treatment measures.
Part 3
Part 4
- the pursuit of cardiovascular disease prevention.
- in the pharmacogenomics for cardiovascular diseases, with
- volyage-gated calcium-channels, and
- ApoE in the statin response.
This volume is a splendid example representative of the entire collection on cardiovascular diseases.