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Starting with the launch of the Human Genome Project three decades ago, genomics has become progressively entrenched within the bedrock of the biomedical research enterprise. Capitalizing on the momentum of the project’s successful completion in 2003, genomics now regularly plays a central and catalytic role in basic and translational research, and studies increasingly demonstrate the vital role that genomic information can play in clinical care. Looking ahead, the anticipated advances in technology development, biological insights, and clinical applications (among others) will lead to more widespread integration of genomics into virtually all areas of biomedical research, the adoption of genomics into mainstream medical and public-health practices, and an increasing relevance of genomics in everyday life. On behalf of the research community, the National Human Genome Research Institute recently completed a multi-year process of strategic engagement to capture input about the future research priorities and opportunities in human genomics, with an emphasis on health applications. Here we articulate the highest-priority elements envisioned for the cutting-edge of human genomics going forward – that is, at “The Forefront of Genomics.”

International audience; Dysfunction of the epidermal permeability barrier can result in dehydration, electrolyte imbalance and poor thermoregulation. Immature skin is a portal of entry for infectious agents and potential toxins in topically applied substances. As the skin is one of the last organs to mature in utero, premature infants born before 34 weeks gestation are at great risk for complications. The transcription factor kruppel-like factor 4 (Klf4), has been shown by a targeted ablation, to have an essential function in barrier acquisition. We investigated whether Klf4 expression in utero is sufficient to establish the epidermal barrier. Specifically, we generated lines of mice that express Klf4 from a tetracycline inducible promoter when crossed with transgenic mice expressing the tetracycline transactivator tTA from the epidermal keratin 5 promoter. These mice exhibit acceleration in barrier acquisition as manifest by the exclusion of a dye solution one day earlier in development than controls. Underlying this dye impermeability are morphological changes, including an increased number of stratified layers, expression of terminal differentiation markers and assembly of cornified envelopes. By all criteria, Klf4 ectopic expression accelerates the normal process of terminal differentiation. Premature barrier acquisition in these mice follows the normal pattern rather than the pattern of the transgene promoter, indicating that there are fields of competence in which KLF4 acts. Although other transgenic mice have perturbed barrier acquisition, these mice are the first to accelerate the process of barrier establishment. These studies show that KLF4 regulates barrier acquisition and provides an animal model for studying how to accelerate the process of barrier acquisition for the premature infant.