ISSN0535-1405

公益財団法人

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INTERNATIONAL MEDICAL NEWSInternational Medical Society of Japan
Since 1925

第 62 回 国際治療談話会総会
がんと糖尿病のゲノム医学の進歩№ 515
2023.January

International Medical News

Page 1The 62nd International Congress on Therapy

Advances in Genomic Medicine for Cancer andDiabetes
Opening remarks:

Koichi Ito, MD, PhD (Managing director, IMSJ)Congratulatory remarks:
Kichiro Matsumoto, MD (President, Japan Medical Association)

Discourse Chair：Georg K. Löer (Advisory Board Member, IMSJ)
Discourse: Outlook G7: Japanese-German-partnership in terms of Global Health
Timotheus Felder-Roussety (Counsellor for Labour and Health Affairs, Embassy of theFederal Republic of Germany Tokyo)

Advances in Genomic Medicine for Cancer and Diabetes
Medical Lectures Chair：Koichi Ito, MD, PhD (Managing director, IMSJ)Taro Kondo, MD, PhD (Managing director, IMSJ)

Lecture I: Future perspectives on cancer genomic medicine
Hitoshi Nakagama M.D.,D.M.Sc（President, National Cancer Center Japan）

Lecture II: Progress in Genome Medicine in Diabetes
Takashi Kadowaki MD,PhD(President, Federation of National Public Service Personnel Mutual Aid Associations
TORANOMON HOSIPITAL)

Closing remarks:

Kenichi Ishibashi, MD, PhD (Chairman, Board of Directors, IMSJ)

ＩＳＳＮ

0535-1405

No. 515

INTERNATIONAL MEDICAL NEWSInternational Medical Society of Japan
Since 1925
January 31, 2023
Published by International Medical Society of Japan,
Chairman, Board of Directors: Kenichi Ishibashi, MD, PhD
Editors:

K. Ito, MD, PhD, T. Kondo, MD, PhD,

K. Ichihashi, MD, PhD, T. Murakami, PhD, R.Nagai, MD, PhD,
I. Taniguchi, MD, PhD, and T. Yamazaki, MD, PhD

1-11-9-3F Kamiuma, Setagaya-ku, Tokyo154-0011,
Japan.
TEL03(5486)0601

FAX03(5486)0599

E-mail: imsj@imsj.or.jp https://www.imsj.or.jp/

Opening Remarks
Koichi Ito MD, PhD
Managing director, IMSJCongratulatory message
Kichiro Matsumoto, MD
President,
Japan Medical Association
I would like to make a few remarks to congratulate the opening of the 62nd International Congress on
Therapy on behalf of the Japan Medical Association.
The COVID-19 that began about three years ago has spread throughout the world, and the situation still
remains unpredictable. However, countries are beginning to relax movement restrictions, and society is
gradually moving toward living with COVID.
Factors behind these changes include not only the thoroughness of infection prevention measures taken by the
public and the strenuous efforts of healthcare workers in the medical practice, but also the development,
transportation, and administration of vaccines on a global scale as well as the development and spreading oftreatment methods and therapeutic drugs. In other words, we are slowly regaining our daily lives because
countries of the world combined efforts in the face of the COVID disaster.

The Japan Medical Association keeps international contribution of medicine in mind, and works to promote
global health as the main axis of international activities by enhancing collaboration with the World Medical
Association (WMA), the Confederation of Medical Associations in Asia and Oceania (CMAAO), and national
medical associations as well as relevant ministries and agencies and international organizations.
In August of this year, we co-hosted the COVID-19 Symposium on Holistic Health Care in a New Era online
with the Korean Medical Association, the Indian Medical Association, and the Taiwan Medical Association. In
September, CMAAO held its general assembly as a hybrid meeting of both local and online, in which the
Takemi Memorial Oration on Healthcare in COVID-19 Pandemic was presented and the CMAAO Karachi
Statement on Health Care in COVID-19 Pandemic was adopted. In addition, in October, WMA held thegeneral assembly in Berlin, where the WMA International Code of Medical Ethics (Revised) was adopted.
The Japan Medical Association will continue to cooperate with other national medical associations andhealthcare professionals including physicians and work on global health activities including the COVID-19
response.
I believe that, by combining the wisdom of mankind, the day will come when we overcome pathogens including
COVID-19 as well as diseases such as cancer and diabetes that are the theme of today’s lectures. To realize it,
research on new medicine such as genome medicine is essential. The opportunity today to access the latest
research outcomes on medicine, medical practice, and public health will greatly contribute to the improvementand development of medical practice, healthcare, and welfare in Japan and overseas, and I hope such activities
will continue for years to come.
Last but not least, I would like to express my sincere wishes for the success of this congress, for continuing
growth of the International Medical Society of Japan, and for the good health of all attendees. Thank you.

Grußbotschaft

Jürgen Kessing
Oberbürgermeister der Stadt Bietigheim-Bissingen
Sehr geehrte Damen und Herren,dem 62. Internationalen Therapiekongress der Internationalen Medizinischen Gesellschaft sende ich im Namen
der Stadt Bietigheim-Bissingen, ihrer Bürgerschaft wie auch persönlich die besten Grüße. Die Vorträge werden
auch in diesem Jahr wieder zu wegweisenden Erkenntnissen der Medizin und Wissenschaft in Praxis und Lehreder japanischen Heilkunst beitragen und für einen erfolgreichen Erfahrungsaustausch sorgen.

Als Partnerstadt von Kusatsu in Japan sind wir der Internationalen Medizinischen
Gesellschaft Japans über ihren ehemaligen Präsidenten, Professor Dr. Choei Ishibashi, wie auch über Ihren
heutigen Vorsitzenden, Dr. Kenichi Ishibashi, sehr herzlich verbunden. Die Partnerschaft geht zurück auf Dr.
Erwin von Bälz, der sich als Arzt, Kunstfreund und Liebhaber der japanischen Kultur im ausgehenden 19.
Jahrhundert und zu Beginn des 20. Jahrhunderts in Japan wie in Deutschland einen großen Namen gemacht
hat.

Die freundschaftlichen Beziehungen wurden maßgeblich angeregt und in ihren Anfangsjahren getragen

von Professor Dr. Choei Ishibashi, der für seine Verdienste im Jahre 1962 zum geehrten Bürger unserer Stadt
Bietigheim-Bissingen ernannt wurde. Die Partnerschaft besteht seit nunmehr 60 Jahren und leistet auch heutenoch einen wichtigen Beitrag zur Vermittlung der Kulturen unserer beiden Nationen an die Jugend sowie zum
Aufbau beiderseitiger Freundschaften und zur Stärkung des Verständnisses für die japanischdeutschen
Interessen. Bis heute fühlen sich die Partnerstädte Kusatsu und Bietigheim-Bissingen dem Erbe von Dr. Erwin
von Bälz verpflichtet, dem es vor allem am Herzen lag, die Menschen, unabhängig von ihrem Stand, ihrer
Herkunft, ihrer Religion oder Nationalität zu verstehen, zu helfen und zu stärken. Erwin von Bälz hat vor allem
auf dem Gebiet der Medizin Brücken geschlagen zwischen Japan und Deutschland, aber auch zwischen der
Kunst und Kultur beider Völker.
Heute gibt es enge Kooperationen zwischen unseren Ländern, sowohl im wissenschaftlichen Austausch wie auch
auf der Ebene von Studenten und natürlich im wirtschaftlichen Bereich.
Unser großer Sohn, Erwin von Bälz, hat uns gezeigt, welcher Fortschritt mit einem offenen Blick auf die
Menschen und die Verhältnisse, in denen sie leben, erzielt werden kann. Wir können ähnliches erreichen, wenn
wir weiterhin offen an die Dinge herangehen, wenn wir uns damit auseinandersetzen, wie der Alltag in anderen
Ländern bewältigt wird. Deshalb ist es auch wichtig, dass wir die Begegnungen zwischen den Bürgern unserer
Stadt fördern, der jungen Generation die Aufgabe der Völkerverständigung vermitteln und damit einen Beitragfür den Frieden in der Welt leisten.
In diesem Sinne wünsche ich der Internationalen Medizinischen Gesellschaft Japans weiterhin erfolgreiches
Wirken und einen guten Verlauf der diesjährigen Tagung. Die Stadt Bietigheim-Bissingen wird ihren Freundenin Japan stets eng verbunden bleiben.
Mit freundlichen Grüßen

Jürgen Kessing
Oberbürgermeister

Grußbotschaft

Markus Baier
Bürgermeister der Alten Hansestadt Lemgo

Sehr geehrter Herr Dr. Kenichi Ishibashi,sehr geehrte Damen und Herren der Internationalen
Medizinischen Gesellschaft Japans,dem 62. Internationalen Therapiekongress der Internationalen Medizinischen Gesellschaft Japans sende ich
auch im Namen von Rat und Verwaltung der Alten Hansestadt Lemgo meine herzlichsten Grüße. Außerdem
wünsche ich dem Kongress "Fortschritte der Genommedizin für Krebs und Diabetes" im Online-Format
einen guten Verlauf.
Die Verbundenheit mit Japan ist uns sehr wichtig! Engelbert Kaempfer hat einst die Länder
zusammengeführt und mit Stolz kann ich berichten, dass in einem Ortsteil von Lemgo ein Gedenkstein
eingeweiht worden ist, der an den Geburtsort von Engelbert Kaempfer erinnert. Weiterhin hatte ich die
große Ehre den japanischen Generalkonsul, Herrn Kiminori Iwama im Rathaus der Alten Hansestadt Lemgo
begrüßen zu dürfen.
Unsere Länder vereint ein großer kultureller Reichtum aber vor allem gemeinsame demokratische Werte. In
einer von Krisen geplagten Welt sind diese sehr bedeutend. Die Freiheit der Wissenschaft und die
Völkerverständigung gehören besonders dazu.
Es wäre uns daher eine große Freude, Sie Herr Dr. Ishibashi und eine Delegation der Internationalen
Medizinischen Gesellschaft Japans in naher Zukunft in unserer schönen Stadt begrüßen zu dürfen.
Mit freundlichen Grüßen

Markus Baier
Bürgermeister der Alten Hansestadt Lemgo

Grußbotschaft

Dr.Frank Mentrup
Oberbürgermeister der Stadt Karlsruhe
Der Internationalen Medizinischen Gesellschaft Japans übermittle ich zu ihrem 62. Internationalen
Therapiekongress im Namen der Stadt Karlsruhe, ihres Gemeinderats und ihrer Bürgerinnen und Bürger undauch ganz persönlich die besten Wünsche. Ein weiteres Mal wird in diesem Jahr der Kongress als reine
Onlineveranstaltung mit Web-Vorträgen aus Japan und Deutschland stattfinden. Das Thema desTherapiekongresses in diesem Jahr lautet „Fortschritte der Genommedizin für Krebs und Diabetes“ – widmet
sich also der Bekämpfung der verbreitetsten Krankheiten auf unserer Welt.
Ihre intensiven Beziehungen zur Stadt Karlsruhe freuen mich ebenso wie die engen Bande, die es zwischen derdeutschen und der japanischen Medizin seit langem gibt. Dafür stehen namhafte Ärzte wie Dr. Erwin von Bälz
und Dr. Engelbert Kämpfer. Der ehemalige Präsident der Internationalen Medizinischen Gesellschaft Japans,
Professor Dr. Choei Ishibashi, hat sich, ebenso wie später sein Sohn Chosei und heute sein Enkel Dr. Kenichi
Ishibashi, stets aktiv für die guten Beziehungen zwischen den Medizinerinnen und Medizinern Japans unddenen der Fächerstadt eingesetzt. Ich wünsche mir daher sehr, dass diese Tradition wieder fortgesetzt werdenkann.
Denn hier bei uns in Karlsruhe sind japanische Lebensart und Kultur in vielfacher Weise präsent. Dies ist vor
allem das Verdienst der sehr engagierten Deutsch-Japanischen Gesellschaft in der Fächerstadt, die sich mit
großem Erfolg für Verständnis und Freundschaft zwischen Deutschland und Japan sowie für die Förderung
kultureller und wissenschaftlicher Beziehungen einsetzt. Seit 1994 ist die Deutsch-Japanische Gesellschaft
Patin des Japangartens im Karlsruher Zoologischen Stadtgarten, dessen Geschichte auf das Jahr 1914
zurückgeht, als ein Karlsruher Arzt eine Steinleuchte und verschiedene Samen aus Japan mitgebracht hatte.
Mit seiner Pagode, seinem Steinlöwen, dem Shinto-Schrein und vor allem dem im Jahr 2018 neu erbauten
Teehaus verströmt der Garten das Flair des - für uns – „Exotischen“. Der Gang durch das rote „Torii“ führt mit
einem Schritt in eine andere Welt. Gleichzeitig ist der Japanische Garten für die Karlsruherinnen und
Karlsruher – fast wie selbstverständlich – ein Stück Ur-Karlsruhe. Dieser unaufgeregte Umgang mit dem
Anderen, diese harmonische Integration des vermeintlich Fremden spiegeln die weltoffene Atmosphäre wider
und die Neugier auf Neues, die unsere Stadt seit jeher auszeichnet.
Ich wünsche der Internationalen Medizinischen Gesellschaft Japans für die Zukunft viel Erfolg und dem 62.
Internationalen Therapiekongress einen erfolgreichen Verlauf und gute Ergebnisse.

Dr. Frank Mentrup
Oberbürgermeister

Congratulatory Telegram
Kenro Hori MD
President, Japan Dentist Association
Please accept our sincere congratulations on the success of the 62nd International Congress on Therapy.
We truly wish further development of your Society and the health of your members.

Nobuo Yamamoto MD
President, Japan Pharmaceutical Association
I'm delighted that the 62nd International Congress on Therapy is such a grand event.
Through events and lectures such as these, your association contributes to both the improvement of health carein Japan and the development of international medical exchange as well. I truly respect everything you do.
I hope your association will continue to prosper and grow.

Introduction of speaker of discourse
Georg K. Löer
Advisory Board Member, IMSJ

Discourse
Outlook G7: Japanese-German-partnership in terms of Global Health
Timotheus Felder-Roussety
Counsellor for Labour and Health Affairs
Embassy of the Federal Republic of Germany Tokyo

Global health from the perspective of the German Federal Government
The right of every human being to the highest attainable standard of physical and mental health is a corehuman right. Health is one of the greatest goods of all people and an essential prerequisite for individual,social, economic and political development and stability.
In a globally networked world, the effects of health – both positive and negative – are amplified even more.
Health must therefore be thought of globally and can only be ensured and improved through joint global
action.

The topic of global health has become increasingly important both in Germany and internationally in recent
years. Global health and its security are part of the global order. The COVID-19 pandemic has once again
highlighted the many ramifications associated with a global health crisis.
The health and resulting humanitarian and socio-economic consequences affect all areas of life. Health is not
only a prerequisite for prosperity, social cohesion and participation in society, but also the result andindicator of the social, economic and ecological dimensions of sustainable development.
Almost all of the agreed sustainability goals of the 2030 Agenda have an important connection to health.
Global health is an example of the need for multi-stakeholder and multi-sectoral approaches, as well asinternational and multilateral collaboration.
Promoting and protecting the health of the population are central tasks for governments, both in their own
country and as part of their international commitments.
The Global Health Strategy is a commitment by the Federal Government to global health policy and toachieving the health-related sustainability goals and in particular SDG 3: "To ensure a healthy life for all
people of all ages and to promote their well-being". On the 7th of October 2020, the German Federal
Government adopted the German Strategy for Global Health. Under the leadership of the Federal Ministry of
Health, the strategy was developed in consultation with all federal ministries and in dialogue with nongovernmental actors. "Responsibility - Innovation - Partnership: Shaping Global Health Together" is themotto of the strategy as the challenges of global health require political leadership, new approaches andcooperation at all levels. The strategy is not about repositioning Germany in global health policy. It is about
focusing our long-standing commitment against the backdrop of new challenges. The implementation of thisstrategy will fit into the budgetary and financial policy guidelines of the federal government.
The federal government's priorities in terms of global health include:- Promote health and prevention- mitigate the health impacts of climate change- Strengthen health systems and enable universal health coverage with non-discriminatory access for all- Ensure health protection, including protection against epidemics and pandemics, and continued
engagement in humanitarian health assistance- Advance research and innovation for global healthActing in partnership and strengthening alliances and forums at national, international and multilaterallevel is essential.
The aim here is to strengthen multilateralism and further develop the global health architecture with the
WHO playing a central leading and coordinating role
Developing regional partnerships plays an important role. The global health architecture Germany envisions
should beobetter coordinated,obased on clear mandates of global actors,oavoiding duplication,obased on a strengthened coordination through an enabled WHO,oensuring efficiency, transparency, inclusivity, coherence and equity,As an influential member of the European Union and the G-formats, Germany can help shape global
processes for the benefit of global health and the global health architecture. Health is a central theme of theGerman G7 Presidency this year. In the health track, the focus is on protecting people from future
pandemics, antibiotic resistance and climate change.
The guiding principles of people, planet, prosperity, peace and partnership (People, Planet, Prosperity, Peace,
Partnership – “5 Ps”) and the premise “Leave no one behind” precede the goals of the 2030 Agenda.
Global protection and promotion of human rights is the guiding ideaand these, including the right to thehighest attainable standard of health, must be protected. And the aim of the Federal Government's work in
the field of global health is to ensure that the human right to the highest possible level of health can berealized more and more effectively. As with all other economic, social and cultural rights, states are obliged topromote the full realization of the law (principle of progression). This should also be done throughinternational aid and cooperation.
-Particular attention is paid to promoting gender equality, supporting women and girls, protecting sexual andreproductive health and rights and combating physical, psychological and sexualized violence, as well as
reducing stigma, moral judgments or even criminalization affecting the safe Making protection against
diseases more difficult for particularly vulnerable groups. The Federal Government is also committed to an
approach based on human rights when it comes to global health protection.
This includes a commitment to protecting humanitarian workers and healthcare workers. Because of theindivisibility and interdependence of human rights, a holistic approach must be taken. Health, social andeconomic development, security and stability are inextricably linked. The interactions between different policy
areas and sectors need to be actively addressed and managed across the board with a “Health in All Policies”
approach. Care is taken to ensure that no unwanted side effects arise (“do no harm”) and that structures are
created and maintained that are resilient and can withstand the demands of the future.
The "One Health" approach is the appropriate approach here, as it pursues a cross-sectoral, integrative
management of health risks. The focus here is on the complex relationships between the health of humans andanimals and the protection of the environment, which are viewed from an interdisciplinary perspective.
Considering the human-animal-environment interface is particularly important to understand the causes ofhealth risks and the health impacts of climate change and to take effective measures to prevent pandemics,
prevent antimicrobial resistance (AMR), contain neglected and poverty-related tropical diseases and improve
food safety develop.

Introductory Message from the Chair
Taro Kondo MD, PhD
Managing director, IMSJ
ectures on Medicine

Lecture Ⅰ
Future Perspectives for Cancer Genomic Medicine in Japan
Hitoshi Nakagama M.D.,D.M.Sc
President
National Cancer Center Japan

Cancer is now considered a national disease, and currently 65.0% of men and 50.2% of women of the Japanesepeople will develop cancer in their lifetime. The 5-year relative survival rate for cancer has been improving year
by year, and the latest data show that the 5-year survival rate for all cancers is 64.1%. However, some types ofcancer such as pancreato-biliary tract cancer, still have insufficient survival rate. To solve this problem, it isimportant to develop effective and efficient therapies based on an understanding of the biological nature of cancer.
Cancer is considered to develop by the multistep accumulation of multiple genomic mutations. In the 2000s,
the development of cancer drugs has been driven by the development of molecular-targeted drugs that suppress
the function of proteins encoded by such mutated genes. The National Cancer Center has conducted two projects
since 2013 toward the realization of cancer genomic medicine. The SCRUM-Japan project was launched toaccelerate clinical trials in collaboration with pharmaceutical companies and more than 200 medical institutions,and the TOP-GEAR project to prove the feasibility of cancer genomic medicine at the hospital levels. The TOPGEAR project developed the first approved cancer gene panel (CGP) test in Japan and the CGP test was decided
to be covered by the national health insurance in June, 2019.
Currently, three CGP tests are approved and covered by national health insurance in Japan, and more than
40,000 cases of genomic data have already been accumulated at the C-CAT (Center for Cancer Genomics andAdvanced Therapeutics) along with clinical data, and more than 30 research groups, including pharmaceuticalcompanies, have started using the data for the purpose of academic research and development of drugs, medical
equipment and so forth. The activation of the use of C-CAT data is expected to further deepen basic research anddevelop variety of medical seeds. In addition, an attempt to expand this genome medical system to an international
collaborative framework has recently been initiated with Southeast Asian countries. With the support of the
AMED, our Center has launched the Asian Clinical Trials Network for Cancer (ATLAS) project since September,
2000.
Finally, I would like to mention the future development of whole genome cancer medicine. By promoting
whole genome sequence analysis for cancer cases, a high-quality and versatile genome information
database will be constructed. The further development of cancer genomic medicine will lead to thedevelopment of a new medical platform for cancer treatment. We look forward to the establishmentof a new medical care delivery system in Japan through the further development of cancer genomic
medicine.

Lecture Ⅱ
A Review of Advances in Genomic Medicine for Diabetes
Takashi Kadowaki MD
TORANOMON HOSIPITALType 2 diabetes is a disease characterized by chronic persistent hyperglycemia, which is not only likely to lead to theonset of specific complications, i.e., retinopathy, nephropathy, and neuropathy, but to promote atherosclerosis
accounting for sequelae such as stroke and myocardial infarction. In this regard, a better understanding of the genetic
factors involved in type 2 diabetes is thought likely to lead to an elucidation of its mechanisms of onset thereby
contributing to the development of its preventive or therapeutic modalities.
1. Etiology of type 2 diabetes—characteristics of type 2 diabetes in Japanese and Asians
Genetic factors are assumed to be responsible for the onset of diabetes in 50% of the cases, and environmental
factors are also assumed to be responsible for its onset in another 50%, with the main thing being obesity
associated with overeating, high-fat diet, and lack of exercise. On the other hand, type 2 diabetes is shown todevelop only in Westerners with marked obesity but to develop in Japanese or Asians with mild obesity. While thedisease onset in the latter has thus been explained in terms of a genetic disposition among these populations
toward lower pancreatic β-cell insulin secretion, the genetic factors involved had remained largely unclear until
recently.
2. Identification of type 2 diabetes susceptibility gene loci in Japanese and Asians
Since the human genome sequencing in 2001, genome-wide association studies (GWAS) in type 2 diabetes have
led to numerous type 2 diabetes susceptibility gene loci being identified not only in Westerners but in Japaneseand Asians. However, many of these loci were found to be common across various ethnic groups, the reason being
that, of the close to 30 million human single nucleotide polymorphisms (SNPs), those made available for analysis
then remained limited to those common to diverse ethnic groups. Against a background of rapid advances ingenome research, however, the author and colleagues successfully identified a total of 20 type 2 susceptibility geneloci specific to the Japanese population in 2019 by analyzing the 12 million SNPs made available, including many
specific to Japanese and Asians, in a study of 36,614 patients with type 2 diabetes and 155,150 control subjects,
in collaboration with researchers from BioBank Japan, Tohoku Medical MegaBank Organization, and the JPHC
and J-MICC studies. The 20 gene loci thus identified included those involved in pancreatic β-cell gene expression
as well as in the regulation of insulin secretion (1). In 2020, as part of an international study, the author andcolleagues conducted a meta-analysis of pooled data from 23 GWASs conducted to date in East Asian populations
including Japanese, accounting for a total of 77,418 type 2 diabetic patients and 356,122 control subjects. Of note,
this led to a total of 61 novel gene loci associated with diabetes being identified as being common to East Asians(2), including fibroblast growth factor receptor 2 (FGFR2) and nidogen 2 (NIDS2) associated with lipodystrophyand body fat distribution, among those found correlated with type 2 diabetes in East Asians but not in Westerners,
suggesting that they may be associated, via visceral fact accumulation, with increased risk of type 2 diabetes in
East Asians. Additionally, aldehyde dehydrogenase 2 (ALDH2) was shown in this study to be a major locus
strongly associated with the onset of type 2 diabetes in men alone.
3. Identification of individuals at high risk of type 2 diabetes and prevention of type 2 diabetes in these individuals
Thus, efforts are currently underway to identify individuals at high risk of type 2 diabetes and thereby provide

an impetus for the development of effective and efficient preventive measures for these individuals, based on theinformation available from the type 2 diabetes susceptibility gene loci thus far identified. Of these, a polygenic
risk score (PRS) is drawing the greatest attention as a viable approach based on calculation of a sum of genomewide genotypes weighted by corresponding genotype effect sizes for numerous SNPs derived from GWAS data
ranging from hundreds to millions. Of note, this approach is bringing within reach the promise of predicting therisks for multifactorial diseases, including type 2 diabetes, with similar precision to diseases determined by asingle gene. Indeed, using some 80,000 SNPs from GWAS data in Japanese, thus far the author and colleagues
have been able to construct an RPS that helps predict the risk for type 2 diabetes in the Japanese population, in
contrast to its Western counterpart, which is shown to have failed to predict the risk for type 2 diabetes in theJapanese population.
In the coming years, the focus will be placed on investigating the preventive effects of risk-stratified lifestyleintervention against type 2 diabetes. Following this will be efforts focused on further increasing the predictive
ability of the PRS, predicting the differing pathophysiology of type 2 diabetes, thereby helping establish efficient,effective preventive measures against onset of type 2 diabetes. In the event that a highly predictive PRS has
become established and available for clinical use, however, care needs to be given to ensuring ethical and legal
provisions against the unreasonable discrimination or detrimental treatment of individuals undergoing PRS
evaluations.
References
1. Suzuki K, et al. Identification of 28 new susceptibility loci for type 2 diabetes in the Japanese population. Nature

Genet. 2019;51:379-286.
2. Spracklen CN, et al. Identification of type 2 diabetes loci in 433,540 East Asian individuals. Nature. 2020;582:240245.

Closing Remarks
Kenichi Ishibashi, MD, PhD
Chairman, Board of Directors, IMS