UAF Researchers Tailor Medication to Alaska Natives
By Kelsey Gobroski
Sun Star Contributor
With the encouragement of a portion of a $10 million National Institute of Health Pharmacogenomics Research Network grant, the UAF Center for Alaska Native Health Research (CANHR) is pursuing how to pinpoint prescriptions for Alaska Native populations on the Yukon-Kuskokwim delta.
CANHR received about 10 percent of the grant’s funds to study the effects genetics and diets have on the anti-clotting medicine warfarin in the Yukon-Kuskokwim Yup’ik population. Their collaborators, including the University of Washington, will also be studying the effects of genetic background on other medicines in Native American populations. CANHR will be a liaison between the project’s headquarters in Washington and Alaska Natives, said Diane O’Brien, a nutritional physiologist.
The fact that they are working with UW is “a testimony to the success that CANHR is having,” O’Brien said. CANHR is relatively young, having been formed in 2001, and it has taken a while to “establish research partnerships with native communities,” she said.
The study is based out of pharmacogenetics, a growing medical field that seeks to tailor prescriptions to a person’s genetic susceptibility to medication. Enzymes that break down warfarin may be more or less effective depending on a person’s genetic background, project investigator Bert Boyer said. Too little warfarin, and patients continue to be susceptible to clotting-caused conditions such as strokes. Too much warfarin, and there isn’t enough clotting, leading to hemorrhage, according to Boyer.
Because of this flexibility, new patients taking the medicine need to be monitored – a resource-intensive process that might benefit from screening tests, said Scarlett Hopkins, a study coordinator. Warfarin’s effects are relatively well-known in Caucasian populations, but minority groups such as Alaska Natives aren’t well represented in this research, Boyer said. Pharmacogenetic studies are new to Alaska.
“I think this might be the first one,” Boyer said.
UAF’s portion of the study aims to form a community-planning group for outreach in the Yukon-Kuskokwim delta, to determine diet’s role in warfarin’s effectiveness, and to seek a genetic basis for bleeding time before clotting.
Blood sampling will begin at the end of the month. O’Brien will analyze the samples for vitamin K and a form of nitrogen that is present in fish. The nitrogen guides researchers to the amount of fish, which contains certain fatty acids, in a person’s diet. The study seeks to find whether those fatty acids that thin blood work against vitamin K, and if so to what extent. Vitamin K clots blood and so could modify warfarin’s effect. The study, a combination of these blood tests, questionnaires, and physical activity monitors, will take four years to sample 1,000 people.
Along with releasing the results of the study to the community, CANHR plans to give back to the individual participants by providing results of their screenings for cholesterol, blood pressure, and diabetes, Boyer said.
Scarlet Hopkins said that with the study’s results, it eventually may be easier for the medical community in rural areas to fine-tune dosages and know who is most susceptible to clotting or bleeding. At the moment, the main goal is to paint a broad overview of the population. “Individual prescription-fiddling comes with time,” Hopkins said. “If we can increase the quality of care for them, that’s our mission.”