1628 1. ABSTRACT Telomere length has been subject of studies for many decades, aiming to elucidate its role in physiological processes, in process of aging and in diverse pathologies. Yet today, there is still no “big title” discovery that would lead to a practical use of telomeres as a reliable biomarker or target for a new drug. However, therapies for chronic disease patients are being tested and companies are already offering commercial tests for telomere length measurement. The strong genetic heritability of telomeres is opening the place for pharmacogenomics researches that could promote the personalized treatment of diverse diseases. In this article, we present the recent knowledge of telomeres genetic determination obtained by genome-wide association studies (GWAS), important biomarkers related to telomere length and review the possibilities of telomere’s practical implementation in the medical treatment of diverse The future of telomere length in personalized medicine Vesna Gorenjak 1 , Samina Akbar 1 , Maria G. Stathopoulou 1 , Sophie Visvikis-Siest 1, 2 1 INSERM UMR U1122, IGE-PCV, Gene-Environment Interactions in Cardio-Vascular Physiopathology, Faculty of Pharmacy – University of Lorraine, Nancy, 54000, France, 2 Department of Internal Medicine and Geriatrics, CHU Technopole Nancy-Brabois, Rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France TABLE OF CONTENTS 1. Abstract 2. Introduction 2.1. Telomere structure 2.2. Telomere function 2.3. Telomere-binding proteins 2.4. Telomere lengthening 3. The telomere syndromes and treatment 4. Leukocyte tl and methods of mesurements 5. Determinants of TL 5.1. Biomarkers related to TL 6. Heritability and genetic variants associated with relative TL 7. TELOMEREs as a biomarker 7.1. Telomeres as aging biomarker 7.2. Telomeres as a biomarker in age-related diseases 7.3. Telomeres as a biomarker in cancer prognostic 7.4. Telomeres as a biomarker in cardiovascular diseases (CVD) 7.5. Telomeres as a biomarker in psychiatric disorders 7.6. Telomeres as a biomarker in Alzheimer’s disease 8. Telomeres in anti-cancer treatment 8.1. Telomerase inhibitors 8.1.1. Telomerase inhibitor Imelstat (GRN163L) 8.1.2. G-quadruplex stabilisers 8.1.3. Natural products 8.2. Future perspectives and other therapies 9. Telomeres in treatment of other diseases 10. Commercial offer of telomere testing 11. Conclusions and new perspectives 12. References [Frontiers In Bioscience, Landmark, 23, 1628-1654, March 1, 2018]