When Gualberto Ruano ’81, MD, PhD, arrived at Hopkins as a college freshman from his native Puerto Rico in 1977, the young man was almost singularly focused on academics and biophysics.
“The [pharmacogenetics movement] comes out of a concern about drug safety and side effects. We need to make sure
we are looking at the whole person when we are treating them.”“I was just very, very driven,” says the 47-year-old Ruano today. That effort paid off: Ruano graduated with a 4.0 grade-point average, Phi Beta Kappa, top of his class.
Today Ruano is a leading authority in the emerging field of pharmacogenetics, an approach in which doctors consider a person’s individual genome, or genetic makeup, to guide them in deciding what drugs to prescribe and at what dosages.
He is president and chief executive officer of Genomas Inc., a Hartford, Connecticut, biotech company he founded in 2003. The company has teamed up with Hartford Hospital and The Hospital of Central Connecticut to develop and use a proprietary DNA-based test, called the Phyzio Type medical management system, to customize treatment of certain metabolic conditions such as obesity, cardiovascular disease, diabetes, and psychiatric disorders, by considering an individual’s unique DNA fingerprint.
In addition, Ruano has been instrumental in founding the Personalized Medicine Coalition, a Washington-based think tank launched to promote pharmacogenetics. The hope: Doctors eventually will query a patient’s genome to best understand which drugs, in which doses or combinations, will be most effective.
“As doctors, I don’t think any of us were ever comfortable with the idea of mass [prescribing] of drugs as if they were candy,” Ruano says. “The [pharmacogenetics movement] comes out of a concern about drug safety and side effects. We need to make sure we are looking at the whole person when we are treating them.”
Consider the case of the drug warfarin, sold as Coumadin, which is taken by roughly 2 million Americans with a clot-triggering heart rhythm called atrial fibrillation. But depending on how people metabolize the drug, they are at risk of serious side effects. If some people don’t absorb enough of the drug, they can suffer from a stroke; too much, and some people are at risk of life-threatening bleeding. In January, the Mayo Clinic began a project to look at the genetic fingerprint of 1,000 patients on Coumadin to see whose bodies break down the drug faster or slower than normal. Based on a patient’s genetic makeup, the doctors hope to adjust dosage to avoid serious complications.
Ruano, who went on to Yale to earn his PhD and MD, credits his wide-ranging undergraduate experience at the Krieger School with giving him a strong intellectual foundation—and the propensity to think creatively.
“The introduction to literature from a practicing author, Stephen Dixon, was very significant to me,” says Ruano, “It allowed me to begin appreciating the creation of art, and the universal creative spark that is fundamental to literature, art, and science.”