The promise of personalized medicine is not for everyone

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African Americans are underrepresented in large-scale genetic and neuroscience studies. Lisa Valley / Unsplash

Could your medical treatment someday match your DNA? This is the promise of “personalized medicine,” an individualized approach that has captured the imagination of clinicians and researchers over the past few years. The concept is based on the idea that small genetic differences from one person to another can be used to design customized treatments for conditions as diverse as cancer and schizophrenia.

In principle, “personality” is not intended to mean one person and not another, although this may not be the case. It is clear that current genetic and medical research data are underrepresented for certain population groups.

Case in point: In 2018, Researchers published A surprising study of youth suicide rates. Scientists have long believed that young white people have the highest suicide rates. But, check Data from the Centers for Disease Control and PreventionThey found that suicide rates for African-American children under the age of 13 were twice as high as for whites.

This finding upended long-held assumptions about racial imbalances in mental illness. This cannot be explained by economic conditions, which suggests that other factors play a role, perhaps even genetics. Suicide is a complicated personal business, but Science has shown that genes play an important role.

This unexpected finding may have implications for prevention and treatment based on genes – in other words, personalized medicine. But the state of current genetic research suggests that African Americans are likely to miss out on many of the potential future benefits of personalized medicine.

as lead author Jeffrey Bridge from Nationwide Children’s Hospital of Ohio note for Washington Post“Most of the previous research relates largely to white suicide. Therefore, we don’t even know whether the same risk and protective factors apply to black youth.”

Few experts have studied the possible genetic causes of African-American suicide, focusing instead on environmental and social causes.

While most mental illnesses such as depression are first diagnosed in adulthood, they actually have their origins early in development, when genes and the environment interact to form the developing fetal brain. For example, me and my colleagues A study was published in May Genes and pregnancy problems have been shown to combine to increase the risk of developing schizophrenia.

This should cause some concern, because African American women have much higher rates of pregnancy complications. Black children die in Twice the rate of white infants. Again, this is not explained by social and economic reasons.

In summary, the higher rate of pregnancy problems likely increases the risk of mental illness in African Americans, and this may explain the observed increased rate of suicides. Additional genetic data about this population could shed light on the problem.

To better understand the genes that increase the risk of mental illness, researchers study the brains of people who have died. They are examining how genetic differences can lead to changes in the brains of people who have developed these conditions. This is one of the best ways to understand any brain disorder on a biological level.

But African Americans are underrepresented in large-scale genetic and neuroscience studies. One analysis for 2009 It revealed that 96 percent of the participants in the large genetic studies were of European ancestry. When researchers looked at it two years ago, they found The proportion of people of African descent in these studies only increased by 2.5 percent. Likewise, studies of the brains of African Americans are almost non-existent.

Why the low participation rate? One reason is that researchers prefer populations that are more genetically homogeneous to ensure study accuracy. Individuals of European descent are More genetically similar of African Americans.

Suppose some experts African Americans are less likely to participate in genetic studies due to a mistrust of the medical community.

At the Lieber Institute for Brain Development, where I work, people can donate the brains of family members who wish to contribute to scientific research. we have the Largest group of African American minds donated to study mental illness, although relatively small compared to the availability of Caucasian brains. In our experience, the rate of donation for African American families is similar to that of white families, suggesting that distrust may not be as widespread as expected.

Without studies focusing on the African American brain, scientists will struggle to fully understand how any unique genetic risk in the African American population translates into prevention and treatment for all disorders involving the brain, including suicide.

Researchers must invest in correcting this shortcoming before the personalized medicine train is too far from the station for the African American community to ride.

This article has been republished from Conversationa non-profit news site dedicated to exchanging ideas from academic experts.

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Daniel R. receives. Weinberger was funded by the National Institutes of Health and the Lieber Institute. The work of the Lieber Institute is funded in part by NIH grants and gifts from the Lieber and Maltz family foundations.

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