Mayo Clinic’s Center for Individualized Medicine will play a key role in groundbreaking research funded by an award from the Advanced Research Projects Agency for Health (ARPA-H), part of the U.S. Department of Health and Human Services. The research will explore how environmental exposures interact with genetics to affect people's responses to medications — a field known as pharmacoexposomics. 

The five-year award, called IndiPHARM, aspires to develop and execute a state-of-the-art high-resolution, precision monitoring system that aims to evaluate how a large group of people varies in response to drugs for metabolic diseases. The prime research site will be Columbia University, with support from Mayo Clinic, Emory University, Harvard University, Brown University and the Jackson Laboratory in Connecticut.  

This collaboration aims to address why medicines for some metabolic diseases, such as obesity, work for some people and not others and will look at the role environmental exposures — such as chemicals, pollution, diet and lifestyle — may play in people's genetic response. 

Mayo Clinic will use its expertise in genomic research, a large exome dataset of more than 100,000 adult patients that includes all protein-coding genes, and comprehensive longitudinal phenotypes from electronic health records to identify unique patient populations and improve understanding of drug responses. Mayo will oversee the enrollment of study participants as well as the collection and processing of biospecimens to ensure the data meets high-quality standards for analysis.  

Importantly, Mayo investigators will interpret the metabolism of the chosen medications based on available exome sequencing testing of 4,000 participants with metabolic disease and how these observations relate to drug side effects and disease outcomes.  

Shared vision to transform medicine 

Mayo's role in the research will be important in uncovering the missing links in personalized medicine. 

"We've dedicated decades to studying the human genome and mapping its every twist and turn to understand health and disease, but it's only half the story," says Konstantinos Lazaridis, M.D., the Carlson and Nelson Endowed Executive Director for Mayo Clinic's Center for Individualized Medicine. "This ARPA-H award propels us into an uncharted frontier of medical science to explore the other half — the environmental exposures that interconnect with our genetics to drive therapeutic outcomes. Our goal is simple yet profound: to redefine medicine by creating truly personalized treatments that reflect the full picture of each person's health." 

The vision of IndiPHARM is inspired in part by shared goals of Dr. Lazaridis and Gary Miller, Ph.D., Vice Dean for Research Strategy and Innovation and Professor of Environmental Health Sciences at Columbia University Mailman School of Public Health.  

“Medications have the potential to reduce suffering, alleviate symptoms, prevent serious events and help people live longer and healthier lives. Unfortunately, there is a gap between what drugs are predicted to do and what they actually do in the real world,” says Dr. Miller, a globally recognized authority on the exposome. “IndiPHARM is marshaling the technology to bridge this gap.” 

For more on this research, read Columbia University’s news release. 

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