In the September 2009 issue of the Current Pharmacogenomics and Personalized Medicine (CPPM), Dr. Khoury shares his thoughts and immediate and long term vision on public health genomics, and why this new field of investigation is important for personalized medicine and global health. He is interviewed by a multidisciplinary team of researchers and educators: Abdallah S. Daar (McLaughlin-Rotman Centre for Global Health and School of Public Health Sciences, University of Toronto), Serge Dubé (Department of Surgery and Faculty of Medicine, University of Montreal) and Vural Ozdemir (Editor, CPPM, and Department of Social and Preventive Medicine, Faculty of Medicine, University of Montreal). Khoury received his BS degree in biology/chemistry from the American University of Beirut, Lebanon, and his medical degree and pediatric training from the same institution. He received a PhD in human genetics/genetic epidemiology and training in medical genetics from The Johns Hopkins University. Khoury is board-certified in medical genetics. Obesity and associated diseases such as diabetes have become an epidemic that represents a major threat to global public health. In the last two decades, an explosive increase in the number of persons diagnosed with diabetes has been observed worldwide. The global figure of affected individuals is expected to increase from currently 150 million to 300 million in 2025. The obesity spectrum diseases also impact individuals at a young age, posing a tremendous burden on the global public health system. Dietary interventions and pharmacological strategies have so far failed to deliver appreciable success in the fight against obesity. This paper examines the emerging role of metabonomic-based gut microbiome biomarkers for personalized interventions against obesity. We also highlight that chronobiology is a potentially relevant consideration for systems biology research in obesity. Mechanism-oriented molecular diagnostics for obesity offer the promise to substantively influence the long term trajectory of obesity related diseases and create a space whereby preventive public health interventions can be designed effectively. Human gut and microbiome warrant attention in future research efforts for personalized medicine, and rational therapeutics for obesity and the associated continuum of diseases. Even though many pharmacogenomic tests are available, these test have not yet been recommended for most drugs, and large-scale trials are needed to show that routine testing could improve patient outcomes in pharmacotherapy, such as CYPD6 polymorphism on tamoxifen treatment (Lee et al. Probably the best examples of pharmacogenomic applications in routine practice are HER2 testing for breast cancer treatment (Phillips 2008 ), UGT1A1 variant associated with Gilbert's disease in patient receiving irinotecan (Palomaki et al. 2009 Marsh and Hoskins 2010 Evrard and Mbatchi 2012 ), HLA testing for Abacavir for HIV management (Goldman and Faruki 2008 Faruki et al.
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