VA Maryland Health Care System
Million Veteran Program
Veterans Affairs launches unprecedented research program to advance disease screening, diagnosis and prognosis, pointing the way toward more effective, personalized therapies.
With about 25,000 genes packed into a single cell, changes to genes are like spelling mistakes in an instruction manual: some mistakes can be more harmful than others, and some can cause more serious health problems than others. Yet if scientists compare any two individuals' genes, they'll see that those genes are 99 percent identical. Small changes within our genes give us our physical characteristics, determine susceptibility to disease, and influence our unique responses to medical treatments.
To understand how these small changes impact our health, researchers need to study the genes of a large pool of people, and according to Alan Shuldiner, MD, a physician and a longtime researcher at the Veterans Affairs (VA) Maryland Health Care System, associate dean for Personalized & Genomic Medicine; and head, Division of Endocrinology, Diabetes & Nutrition at the University of Maryland School of Medicine, this understanding represents the next logical step since the U.S. Department of Energy and the National Institutes of Health completed the Human Genome Project more than a decade ago.
By creating bio or DNA databases, researchers can study genomic materials to identify those minute differences that can explain why treatments, medicines and other prophylaxis prove successful in some people and unsuccessful in others.
"We live in a society where obesity is an epidemic, but not all obese people develop type 2 diabetes. Why is that? Veterans present a unique population because they are sometimes exposed to toxins and other environmental hazards while in service. Some do not react to the exposures; others' reactions may be minimal, while for still others, toxic exposure causes a maximum response and can turn out to be a life-altering event. Why does the same situation or stimuli cause different reactions in people?" say Shuldiner, which poses questions researchers want to answer.
To answer these questions and others, the VA has embarked on an unprecedented research program—the Million Veteran Program (MVP)—that promises to advance the sophisticated science of genomics with its trailblazing effort to consolidate genetic, military exposures, health and lifestyle information in one single database to be used by authorized researchers. VA aims to collect genetic and health information of a million or more Veterans across the nation to help lead new ways of preventing and treating illness. The goal of MVP is to better understand how genes affect health and illness in order to improve health care for Veterans. Participation in MVP is entirely voluntary and will not in any way affect a Veterans access to health care or benefits.
Currently underway at 40 VA medical centers, MVP hopes to collect the DNA of a million Veterans over the next few years throughout the country. The VA Maryland Health Care System is one of the 40 MVP sites, and Shuldiner--who is best known for his genetics research in the Old Order Amish and for his research findings that identify a genetic variant that predicts response to the widely used drug, Plavix--serves as the principle investigator for Maryland's segment of the program.
"By better understanding genomic materials, scientists and researchers can develop a better insight as to why people react differently. Such personalized medicine is the wave of the future, and the VA Maryland Health Care System want to be among the pioneers of this coming change in the way medical care is delivered," Shuldiner says.
Although a young concept, personalized medicine already offers a proven track record for its advantages to health care providers and patients battling cancer. Doctors now routinely measure for specific proteins in breast, colon, and lung cancer patients before choosing a proper treatment plan. As this new field advances, genomic information, combined with an individual's personal and family histories, imaging data and other tests, can help health care providers to develop more effective treatments for a wider variety of conditions in addition to cancer.
"A large DNA database—such as what the VA aims to create via the Million Veteran Program—could advance disease screening, diagnosis and prognosis, and point the way toward more effective, personalized therapies," Shuldiner says.
Veterans interested in learning more about the Million Veteran Program can call 866-441-6075 or visit www.research.va.gov/MVP for more information.