Clinical challenges posed by new biotechnology

• biotechnology
• nutrigenomics

If all goes as planned, the world in which we can obtain an inexpensive, easy to produce digital data version of our personal genome is not far in the future.1 The idea of possessing genetic self knowledge is intriguing. Imagine holding an optical storage disk encoded with your genome, a disk whose contents can reveal a staggering amount about your genetic identity, past, present, and future. Having genetic self knowledge is also empowering. The disk containing your personalised genomic knowledge could enable you to make informed choices and take life transforming steps to prevent or mitigate disease.

If complete genome DVDs sound futuristic, it is because data collection and encoding issues stand in the way. Technical problems will undoubtedly be finessed. When they are, we will realise that beneath the initial allure of improved individual access to genetic information lies a more interesting phenomenon. We are witnessing the rapid movement of genomic science and technology into the commercial sector, fuelled by the progress being made in the elucidation of the identity, function, variants, and interaction of our 30 000 genes. Perhaps the most significant outcome of the published draft sequences2,3 of the human genome was the nearly fourfold reduction in the predicted number of human genes. Once one gene-one effect determinism was decisively overthrown, pleiotropy, polygenic effects, and gene-environment complexities suddenly became the orthodoxy in biology. Genomics, once ridiculed by Syndey Brenner as work so boring that inmates should do it, has produced very complex results. Uptake of genomics into medical genetics likewise reflects the subtlety and variety of the science under girding predictions about disease susceptibility,4,5 behavioural dispositions,6 and heterogeneous response to drugs.7 Intensive diversification is the hallmark of genomics science and technology, and tremendous opportunity exists for …