[Human genome and made-to-order health care system]

Common diseases of adulthood are caused by interplay between environmental and genetic factors. Essential hypertension, diabetes mellitus, and coronary heart disease are the representative diseases, being the major cause of disability in aged population. The molecular pathogenesis of the most common forms of the diseases is still poorly understood. However, thanks to the rapid progress of "Human Genome Project", susceptibility genes of common diseases are expected to be isolated in the near future. At present, the word, "made-to-order medicine", means personalized medication in terms of doses or drug groups determined by genotypes of drug metabolizing genes. However, if knowledge about susceptibility genes and specific mutations for common diseases is available, made-to-order health care would be feasible. Before attainment of made-to-order health care system, we have to reach social agreement in usage of genetic informations. Genetic information can be used to prevent the onset of diseases, to assure early detection and treatment. This information can be used by probands and their relatives, but also by third parties such as insurers and employers. There are concerns that this information could lead to discrimination and social exclusion.