ABSTRACT
When the EU-Commission first proposed the Genome mapping project in 1988, the title of the proposal was ‘Predictive Medicine’. The initial paragraph of the proposal, the ‘Reasons for proposal’, went like this:
Fifty years ago the principal cause of morbidity and mortality was infectious disease but with the discovery of antibiotics, and improvements in hygiene and pest control, it is now a minor one in industrialised countries. Apart from the consequences of accident or war, much disease today has a genetic component which may be of greater or lesser importance. Over the past few years a great deal has been learned about those diseaeses which are due to the inheritance of a single defective gene, though in most cases we are still far from a remedy. However when it comes to the common diseases such as coronary heart disease, diabetes, cancer, autoimmune diseases, the major psychoses and other important diseases of Western society, the major position is far less clear. These conditions have a strong environmental component, and although genetic factors are undoubtedly involved, they do not follow any clear cut pattern of inheritance. Put another way, the disease results from the exposure of genetically susceptible individuals or populations to environmental causes; prevention will depend on reducing the levels of exposure, or more probably, those of susceptible individuals. As it is most unlikely that we will be able to remove completely the environmental risk factors, it is important that we learn as much as possible about the
genetically determined predisposing factors and hence identify high risk individuals. In summary, predictive medicine seeks to protect individuals from the kinds of illnesses to which they are genetically most vulnerable and, where appropriate, to prevent the transmission of genetic suscepti bilities to the next generation.
