A tailor-made cloth matches each person as its size is measured in details. Dr. Masayuki Yamamoto, Executive Director of Tohoku University Tohoku Medical Megabank Organization (ToMMo), is eager to provide Tohoku residents after Great East Japan Earthquake, 3.11, 2011 with personalized medicine like a tailor-made cloth: a suitable medical treatment selected for individual constitution respectively by a detailed survey looking at residents' genome sequences and life styles. On the 20^th of April in 2013, ToMMo hosted a symposium to kick off the Tohoku Medical Megabank Cohort Study this spring, with the hall filled to capacity of up to 300 enthusiastic participants and journalists.

Held at TKP Garden City Sendai Hall, the symposium was entitled, "Miyagi to become healthy residents' prefecture: next generation healthcare created by every citizen's participation." The number of participants in the ToMMo recruitment seminar before the symposium was also about one hundred, which was more than ToMMo's staffs had expected.

Better healthcare for Tohoku residents

At the symposium, Dr. Ichiro Tsuji, Department Chair at the Department of Preventive Medicine and Epidemiology at ToMMo, firstly presented the plan of a prospective cohort study called "Tohoku Medical Megabank Cohort Study." "We will not do just for a research. Rather, we would like to support the residents' health in Tohoku," said Dr. Tsuji. The missions of ToMMo are realizing ICT in local medical networks, personalized and preventive medicine for the residents in Tohoku by bio-bank and training programs for medical practitioners; ToMMo hopes that it would eventually lead Tohoku to be a hub of drug discovery and medical information technology.

Tohoku Whole Genome Reference Panel as the first goal

Dr. Nobuo Fuse, Deputy Department Chair at the Department of Integrative Genomics at ToMMo, announced ToMMo's first goal of this year: Creating "Tohoku Whole Genome Reference Panel by reading genome sequences of 1,000 residents." The panel will be used as a helpful tool to analyze specific genome mutations related to certain diseases, and it is going to be the first reference panel from Japan.

Other bio-bank activities in Japan

Other speakers were also invited to explain the overview of bio-bank projects in Japan. Dr. Hitoshi Nakagama of National Cancer Center introduced National Center Biobank Network (NCBN) researching the relationship between lifestyle-related illnesses and cancer. The combination of the results from patient cohort study in NCBN and those from prospective cohort study in ToMMo would be a worthwhile achievement to realize personalized medicine in Japan.

Interpretation of risk from genomic information is a key

Dr. Michiaki Kubo of Riken Center for Genomic Medicine also presented where Japan is on the development of biobank, introducing the management system of 10 years project at Riken for personalized medicine. According to Dr. Kubo, a key to the true realization of personalized medicine using genomic information from individuals is how to interpret the risks of becoming diseases we see from the cohort studies and how we apply the interpretation of the risks to medical treatments. That is a critical point of transition from standard medicine to personalized medicine and preventive medicine.

Law, ethics and new era of Medicine

Another guest speaker Dr. Satoko Tatsui of Rikkyo University encouraged the professors of ToMMo to develop the cohort project with careful ethical practices. She explained the basics of "What does law mean for a new public health project?" and presented the ethical and legal discussions of applying embryonic stem cells studies for medicine. She emphasized the importance of ToMMo's discussion process involved with the public. Introducing a quote "Law is a project to pursue justice," she explained that rationality has been highly valued in the cases of modern society. Dr. Kubo also added, "The progress of genome medicine is so rapid, but we have to develop the field balancing the risks and benefits for the social welfare. What Dr. Tatsui said is very important, and we have to keep that in mind."

ToMMo's motivation

Dr. Yamamoto expressed his idea: the reason why ToMMo starts Tohoku Medical Megabank Cohort Project is to give personalized medicine to the residents in Iwate and Miyagi prefectures suffered seriously by the Great East Japan Earthquake. That is why the project was proposed to the government. ToMMo would like to have a great success with people in the area that experienced 3.11.

Q & A time

At the last part of the symposium, the speakers answered the questions for 40 minutes as follows:

Q1. What will be the significance of collaboration with the other organizations?

A. (Dr. Kubo): There are two major elements of becoming ill; one is by heredity and the other is by environment. Now it is believed in medicine that the influences of the elements are half and half although we are not certain of that. Every disease might have a different tendency, and ToMMo is going to investigate these, spending upcoming five to 10 years.

Q2. What are merits for the residents in Tohoku to participate in this project?

A. (Dr. Tsuji): Residents participated in the project would be able to receive the results of more detailed health check. For example, you could receive the data of pepsinogen and kidney. You will also fill in the form of daily diet. Based on the all results, our goal is that you will be able to have a consultation for preventing diseases.

A. (Dr. Fuse): Every week within ToMMo, we are elaborating a form of questionnaire for the benefits of participants' health.

Q3. How do you collaborate with other bio-banks in Japan?

A. (Dr. Tsuji): There are already some bio-banks in Japan such as Biobank Japan, 10,000 cohort project by J-MICC (Japan Multi-Institutional Collaborative Cohort Study) and Biobank at National Cancer Institute. We are willing to make a consortium so that Japan makes a large, comprehensive bio-bank.

A. (Dr. Yamamoto): It's important to build trust among the other organizations and make a progress together for the society of healthy and long-lived people.

Q4. What is your plan to gather the samples of 1,000 people for making Tohoku Whole Genome Reference Panel? Why did you decide the number?

A. (Dr. Fuse): We are planning to work with the Community Support Centers for this program. We decided the number "1,000" for making the panel after balancing our capacity of data analysis and the accuracy of calculating the disease rates which are even less than 1 %.

A. (Dr. Yamamoto): We consulted numerous literatures all over the world and decided the number. For the accuracy, we are going to read genome sequence 30 times per sample. Tohoku Whole Genome Reference Panel will be the first reference panel of Japanese people in the world, which would be so precious in our history.

Dr. Nobuo Yaegashi, Deputy Executive Director of ToMMo, gave a closing address saying, "I am so delighted that our cohort study finally gets started after a long time of preparation."