Abstract
Clinical genomics is now a reality and lies at the heart of individualized medicine efforts. The success of these approaches is evidenced by the increasing volume of publications that report causal links between genomic variants and disease. In spite of early success, clinical genomics currently faces significant challenges in establishing the relevance of the majority of variants identified by next generation sequencing tests. Indeed, the majority of mutations identified are harbored by proteins whose functions remain elusive. Herein we describe the current scenario in genomic testing and in particular the burden of variants of uncertain significance (VUSs). We highlight a role for molecular modeling and molecular dynamic simulations as tools that can significantly increase the yield of information to aid in the evaluation of pathogenicity. Though the application of these methodologies to the interpretation of variants identified by genomic testing is not yet widespread, we predict that an increase in their use will significantly benefit the mission of clinical genomics for individualized medicine.
Highlights
Clinical genomics is a reality and lies at the heart of individualized medicine efforts
Limiting clinical interrogation of a patient genome to a coding subset may seem counterintuitive in the era of whole-genome sequencing, but the reality is that our understanding of non-coding genomic variation and its role in disease remains in its infancy, with regard to clinical actionability
The explosion of genomics research has increased our understanding of the human genome and the wide-ranging functions it encodes, most regions of the genome remain uncharacterized and poorly understood
Summary
Clinical genomics is a reality and lies at the heart of individualized medicine efforts. Keywords Individualized Medicine , Clinical Genomics , Diagnostic Odyssey , Oncology , Molecular Modeling , Molecular Dynamics , Variants of Unknown Significance
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