Institutional Profile: The Carney Centre for Pharmacogenomics: a New Zealand focus for Personalized Medicine Research

Abstract

The integration of genetics and genomics with pharmacology and clinical medicine has enriched our understanding of all of these disciplines and is steadily providing a more complete picture of the etiology, pathophysiology and treatment of disease. To capitalize on this new knowledge requires the ability to evaluate the underlying evidence base and to test the utility of any proposed pharmacogenetic or genomic approaches to personalized medicine, within local or regional healthcare structures. The Carney Centre for Pharmacogenomics is now in its eighth year of operation, and although small by international standards, it has proven to be a valuable focus for research, training and dissemination of such knowledge in New Zealand and beyond. By focusing predominantly on research and training, the center has raised awareness about the value and limitations of pharmacogenetics and pharmacogenomic approaches.

The Carney Centre for Pharmacogenomics (Christchurch, New Zealand) [101] was established in 2005 at the University of Otago, (Dunedin, New Zealand), supported by a grant from The Jim and Mary Carney Charitable Trust [102], with matching support from the government in a campaign known as ‘Partnerships for Excellence‘ [103]. The Centre brings together a group of collaborating researchers and clinicians from across the university campus and from further afield. The main base is at the Christchurch medical school campus of the University of Otago, and the key elements of the Centre are the Clinical Pharmacology Department (led by Evan J Begg) and the Gene Structure and Function Laboratory (led by Martin A Kennedy). Additional affiliated researchers are located throughout the University of Otago, and elsewhere in the country.

Although a small institution by international standards, we aspire to be a leading center for research into pharmacogenomics, and try to provide an Australasian focus for this discipline. To achieve this end, we have three main goals:

• ▪ To carry out high-quality research into pharmacogenomics, from molecule to bedside;

• ▪ To provide support for postgraduate and medical training in pharmacogenomic areas;

• ▪ To disseminate pharmacogenomics information in ways that inform and improve clinical practice.

Research

One of the key aspects of the Centre‘s operation has been core funding for the genetics laboratory. This allows rapid development of projects in the absence of additional specific research funding or while funding is being sought. This has proven to be a productive way for stimulating interest in pharmacogenomics research amongst clinical colleagues, and establishing research collaborations.

In the first years of operation, several research themes have predominated. Development of genetic [1,2] and pharmacological assays [3–5] has been a constant focus, enabling useful correlations to be made between the ‘pharmaco‘ and the ‘genomics‘. We have applied these methods to explore influences of pharmacogenetic variation in respiratory medicine (asthma) [2], psychiatry [1,6], gastroenterology (inflammatory bowel disease) [7,8] and rheumatology (rheumatoid arthritis) [9,10]. Beyond these predominantly clinical studies, we have carried out a range of laboratory pharmacogenomics studies [11–14]. We are also very aware that overenthusiasm for pharmacogenomics as the answer to personalized medicine may ultimately impair uptake. To this end, we continue to evaluate and discuss what is actually happening in the clinic [15,16].

New research directions include the application of genomic methods such as exome sequencing in cases of rare, serious adverse drug reactions, and studying the impact of personal genome knowledge on prescribing practices, as well as ensuring such data are optimally used. We are dependent for some of this work on the collaborative genomics and bioinformatics infrastructure provided by New Zealand Genomics Ltd (Dunedin, New Zealand) [104].

As an extension to these immediate research goals, the Centre strives to remain a driving force in the development and dissemination of pharmacogenomic knowledge, at both a national and international level. Our location within a research-active medical school, based in a major urban hospital center, provides good opportunities to achieve these goals.

Training

Most members of the Centre are active in the undergraduate medical and postgraduate teaching programs of the university, and are able to disseminate current knowledge of pharmacogenetics and genomics to a range of students at different stages of the curriculum. Beyond this immediate student base, occasional lectures are either electronically distributed around all three campuses of the university, or are given as guest lectures at different sites.

We offer pharmacogenomic and genetic research projects in many departments, including pathology, medicine, psychological medicine and clinical pharmacology. These projects include summer internships, registrar training, MD programs, and Honors and Masters projects.

Numerous PhD students and several postdoctoral fellows have trained within or have been affiliated with the center.

Dissemination

An annual scientific meeting (The Annual Carney Pharmacogenomics Symposium) has been run every year since inception of the Centre [105]. The meeting is generally held in the period August–October, and has proven to be an excellent way of raising awareness, creating networking opportunities, and educating students and colleagues alike. We have been fortunate to host invited overseas speakers each year, and attract delegates from around New Zealand and Australia. The 2010 and 2011 meetings were also held in conjunction with the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) New Zealand Branch annual meeting, raising pharmacogenomics awareness amongst a larger audience of pharmacologists and pharmacists [106]. Another important avenue for disseminating pharmacogenomic knowledge is by presentations at specialist clinical conferences. Key members of the Centre are active in their respective disciplines, and often present their research or provide overview talks at such meetings.

Conclusion

One lesson we have learnt well is that to be effective, pharmacogenetics and genomics must be an interdisciplinary activity. The continuous interactions of genetics researchers, pharmacologists and clinicians from many specialties, facilitated by the activities of the Carney Centre, have led to some very productive collaborations. Collectively, we have enhanced the practice of both pharmacology and genetics, as well as personalized medicine as a whole, in this part of the world. It is very rewarding seeing genetics researchers learning pharmacology, pharmacologists learning genetics and young clinicians gaining a balanced appreciation of both subjects. We often view the world from different angles, but it is very educational to understand more than one perspective. Many of our graduates and alumni are now working in different centers around the world, and we hope that they will contribute to the continual improvements in personalized medicine that are promised by the rational, evidence-based application of pharmacogenetics and genomics.

The last 18 months have been the most challenging the Centre has faced. During this period, Christchurch was severely damaged by a series of very large earthquakes, the most devastating and tragic of which, on 22 February 2011, led to closure of the main medical school building for repairs. Although the building is scheduled to re-open in late 2012, forced relocation of laboratory facilities and offices has caused significant disruption to our activities. However, new challenges and opportunities can arise from adversity, and we look forward to the future with optimism and enthusiasm.

Highlights

• ▪ The Carney Centre for Pharmacogenomics was established in 2005 at the University of Otago, New Zealand, with the main base at the Christchurch campus of the university.

• ▪ The Centre comprises a network of collaborating researchers and clinicians from across the university campus and from further a field.

• ▪ Activities of the Centre focus on three main objectives, which are:

  • – To carry out excellent research into pharmacogenomics, from molecule to bedside;

    – To provide high-quality postgraduate and medical training in pharmacogenomic areas;

    – To disseminate pharmacogenomics information in ways that inform and improve clinical practice.

• ▪ The Centre engages in a wide range of research activities touching on many medical areas, but with major themes in psychiatry, clinical pharmacology, gastroenterology, respiratory medicine and rheumatology.

• ▪ Members of the Centre are active in the undergraduate medical and postgraduate teaching programs of the university.

• ▪ The Annual Carney Pharmacogenomics Symposium provides a focus for research dissemination, networking and collaboration by interested professionals throughout New Zealand and further afield.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.