What is your current area of rare disease research?
Cell and Molecular Basis of Neurodegeneration in Multiple System Atrophy.
Why are you studying rare diseases? What got you interested in this field?
I want my lab to include projects that will ultimately help people who have limited medical alternatives.
I was recruited into studying MSA after an article about my lab’s genomics methods-based research appeared in the Wall Street Journal. A man, whose wife was an MSA patient, and her neurologist convinced me to apply those methods to samples from MSA patients.
What do you wish people knew or understood about rare disease research?
Rare diseases like MSA have both genetic and environmental underpinnings. A person may carry a genetic variant that causes a rare disease, but might not come down with the illness if environmental triggers are avoided. For example, many genetic variants for neurodegenerative diseases, but might not come down with the problem if exposure to pesticides and/or industrial chemicals can be avoided.
What have you learned from the rare disease community?
Over the years, I have met many incredible MSA patients and their caregivers who are absolutely dedicated to helping other patients understand how to deal with the heartbreaking problems associated with MSA. These selfless individuals have also spent much time raising MSA awareness across the country to help influence government agencies and foundations to support research aimed at helping find a cure for MSA.
What is your area of research?
We study challenging variants known as Variants of Uncertain Significance or VUS. Rare disease genetics discover rare variants, most times variants no one has ever studied or seen. Our goal is to bring insights to each one of these variants over the broad spectrum of rare diseases. This requires the development of tools to understand both how a gene alters human biology and how the variant alters the gene. To do this we utilize computational tools to generate hypotheses, followed by testing these hypotheses with additional tools ranging from biochemistry to the use of induced pluripotent stem cells and human organoids. More recently we have been trying to understand how to use RNA to gain insights into how DNA changes give rise to rare diseases within cells, including the recent discovery of Viral Induced Genetics. The ultimate goal of our work is to bring research opportunities to every variant where there is a need for better understanding.
Why are you studying rare diseases? What got you interested in this field?
The team of Nic Volker, Howard Jacob, and Elizabeth Worthey. I finish my PhD right after the first successful case of whole-exome sequencing within Nic Volker by the Jacob and Worthey labs at the Medical College of Wisconsin (MCW). I knew this was what I wanted to do, help kids by exploring the details of the genome. So I joined the Jacob lab, working with many of the world leaders in rare disease genomics. Over six years of training with the Jacob lab, which spanned time at MCW and HudsonAlpha, my passion for bringing research to the most challenging genomic variants continued to grow, especially seeing how devastating VUS could be for families and clinicians. In 2018, I was given the opportunity to come to Grand Rapids with Michigan State University and partner our tools with Spectrum Health and Helen DeVos Children's Hospital.
What do you wish people knew or understood about rare disease research?
Sequencing a genome is easy. Understanding what the genome says is now the hardest part. We need continued support, community engagement, and research leaders to invest into understanding more of what the genome encodes. Having a broader knowledge of the proteins coded by the genome makes rapid analysis of variants possible. This is advanced when families, patients, and clinicians unite to bring our genomics understanding into a world initiative, linking others with similar variants.
What have you learned from the rare disease community?
Our research matters, but we need to constantly keep our eyes on the clinical aspects of what we do and morph our research as needed. My eyes were opened on one of the first VUS I was asked to help on back in 2014 at MCW. Three days into helping on a variant, I was informed that the patient passed away. I knew how I viewed genetic variant research needed to change, we needed to do work in a timeframe that helps families instead of helping only basic knowledge that goes through an iterative slow research methodology. For most researchers, our timelines are those of research, meaning that taking on a project means months of work. But clinical requires answers quicker. This became a huge part of morphing our groups computer and data strategies, to get answers as quick as possible.
To learn more about Dr. Prokop’s work visit his website or read about his research.