Researchers study gene interactions for personalized drug prescriptions

The University of Alaska Fairbanks will study how the genetics and diet of Yup'ik Eskimos affect the blood-thinning properties of a common drug used by heart and stroke patients.

The research could lead to personalized drug prescriptions. The UAF Center for Alaska Native Health Research will conduct the research as part of a $1.02 million National Institutes of Health sub-award through the University of Washington.

"We'll be looking at the genetic code that contributes to the rate the body breaks down the blood thinner warfarin," said Bert Boyer, acting CANHR director. "Knowing this information may eventually help physicians find a safe and effective dose."

CANHR researchers will team with UW professors Wylie Burke and Ken Thummel and others to create a Northwest-Alaska center to study pharmacogenomics-how genetics affects a person's ability to process drugs-in rural and underserved populations. UW received a five-year, $10 million grant from the NIH Pharmacogenomics Research Network and is one of 14 awardees nationally.

Pharmacogenomics researchers are looking to identify how genes could be used to tailor drug prescriptions to make them more effective and safer for patients.

Warfarin is a successful, but hard-to-manage, blood thinner, especially for people with limited access to health care like Alaska's Yup'ik Eskimos in the Yukon-Kuskokwim delta, where the CANHR study will take place. Too much of it could cause hemorrhaging and too little leads to blood clotting and blockage, Boyer said. A patient has to be monitored closely.

Genes have a substantial effect on the way the body processes drugs, he said. "If we know how genetic changes contribute to warfarin breakdown, perhaps physicians could prescribe a safe and effective dose more quickly."

Previous research in the United States has documented warfarin's interaction with genes in the Caucasian population, but Alaska Natives and Native Americans have not been studied.

CANHR researchers will also look at how polyunsaturated fatty acids and vitamin K interact with warfarin among the Yup'ik people. Their marine-based diet is rich in the fatty acids, but not foods with a lot of vitamin K, which is commonly found in green, leafy vegetables. The fatty acids are believed to act as a blood-thinning agent while vitamin K encourages blood clotting, Boyer explained.

The project will also offer a chance to use an isotopic measurement tool developed by CANHR, said Diane O'Brien, a scientist at the center. Typically, researchers studying diet ask participants questions about what and how much they eat and analyze the answers. However, O'Brien found that the stable isotope nitrogen 15 can be found in hair and blood samples and is an accurate measurement of how much polyunsaturated fatty acids a person has eaten.

"It's a quick, inexpensive and easy way to measure fish intake," O'Brien said. "It was CANHR-developed and now being applied. It's exciting."

CANHR, part of the UAF Institute of Arctic Biology, was established in 2001 by a NIH National Center for Research Resources grant. CANHR's mission is to build and increase research capacity to improve Alaska Native health.