Next Doors: “We Have the Ability; Therefore We Have the Responsibility”

One year ago, I wrote a column about the work that the Translational Genomics Research Institute (TGen) was doing to combat the COVID-19 pandemic. Everything was big and scary at the time. But here we are today, with hopefully some light at the end of the tunnel.

So, I thought it would be a good time to check back in with TGen and see how the pandemic has unfolded from their perspective — but also how they’ve been able to continue to focus on other diseases and research as well.

The first person I talked with was Dr. David Engelthaler, an associate professor at Northern Arizona University and the co-director of TGen’s Pathogen and Microbiome Division. I couldn’t help but think that for someone like Engelthaler, the past year has been the equivalent of the Super Bowl of epidemiology.

“That’s probably a good way to put it,” he said. “We had been purposefully building up this capacity to more effectively use this 21st-century technology in a public health setting so that we can track the normal pathogens we have, and we know we can do that. It was kind of a timing thing — we had the ability, and then the pandemic happened. There wasn’t any way we’re not going to jump in for the public good.”

TGen started the pandemic with a focus on developing diagnostic testing, but as other labs gained widespread testing capabilities, the organization’s focus shifted.

“We knew that our mission needed to be a public health mission, so we focused our time and attention on providing services for the local and tribal health departments and those populations that don’t typically get tested for infectious diseases,” he said. “So not so much the hospitals, but the prisons, the shelters, the long-term care facilities, inpatient psychiatric facilities, tribes in rural Arizona — places that would need this resource, but typically wouldn’t have an infectious disease lab at their fingertips.”

TGen also focused on the genomics of the virus and genetic sequencing, doing almost all of the work in this area over the first eight or nine months of the pandemic. As a result, they now understand the virus much better than a year ago. But there have been surprises along the way.

“I think we understood that the first wave was the virus settling in and starting to hit the individuals that were most likely to share the virus with one another,” Engelthaler said. “But by the time we came out of the summer surge, we were concerned there would be a winter surge … I don’t think we properly understood how quickly and easily this virus moves and how devastating the winter surge would be.

“It goes to show that this is not going to be just a disease for people who are reckless. The vast majority of cases were people that wore masks and were trying to make sure they did not get infected. So it became difficult to predict how devastating this virus would be,” he said.

Engelthaler is optimistic about the next few months and thinks we will reach the anticipated herd immunity needed to stop the virus’ spread sooner rather than later.

“Most states are starting to see immunity not only from vaccines but also aided by all the previous cases,” he said. “Some states are having a tough time right now but they didn’t have a lot of cases before and were behind on getting the vaccines out. I don’t think we’ll see another major surge because we have so much built-up immunity in the community. It’s becoming harder and harder for the virus to find the next person.”

In the meantime, TGen has continued to focus on other fronts. Dr. Jeffrey Trent, president and research director of TGen, said that some significant strides have been made in several different areas.

For example, TGen recently announced that they have identified a gene that could help prevent or delay the onset of Alzheimer’s disease, a huge breakthrough that could change how the sixth most-deadly disease in America is treated.

“What we know about this disease after decades of work is that there’s a plaque-forming protein called an Abeta that accumulates these plaques and tangles that are hallmarks of the disease,” Trent said. “The research that TGen did found there’s a gene called ABCC1 that not only helps take this Abeta out of the brain but also helps reduce the production of that Abeta. So it’s helpful in two different ways.”

“What this really provides is another avenue of research into this elusive disorder, and to some extent, it’s the start of a journey, but you can imagine the focus of the world research community is picking up to take advantage of this information,” he said.

Despite all of the successes, Trent said that the last year has been challenging for logistical reasons but also a drain on researchers who were already working long hours before the pandemic. However, he said the organization has been working past those issues to continue to make progress.

In particular, TGen is doing amazing work in the early detection of cancers. It recently inked a partnership with Exact Sciences, one of the leading companies focused on tests that can help with early detection. They are working on a test that can detect colon cancer without a colonoscopy and a test to find out if cancer surgeries have left behind any residual cancer cells.

“This is extraordinarily important for patients who are asking, ‘Did you get it all?’ after surgery,” Trent said. “We do know that if we can’t find anything in your blood, most patients live a lot longer.”

TGen is also about to fill its newly-endowed chair in memory of the late Senator John McCain to study brain cancers. And they’re even helping veterinarians diagnose and treat cancer in dogs.

“What’s interesting about dogs is that many of the cancers they get are rare in humans,” Trent said. “Bone cancer, for example. So if you can show value in treating those cancers, it can give you a pathway to treatment, especially in children.”

Engelthaler summed up TGen’s approach nicely, by sharing a quote on the wall of the Northern Arizona facility.

“We have the ability; therefore, we have the responsibility,” he said. “That’s been our mission for 10-plus years. We have the ability to use this technology to make a difference in the world, and we’re going to do it.”

To learn more, go to tgen.org.