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An Icelandic company says it has detected a version of a gene
that raises the risk of heart attack in African-Americans by more than
250 percent.
The company, DeCode Genetics, first found the variant gene among Icelanders
and then looked for it in the American population, in Philadelphia, Cleveland
and Atlanta.
Among Americans of European ancestry, the variant
is quite common, but it causes only a small increase in risk, about 16
percent.
The opposite is true among African-Americans. Only
6 percent of African-Americans have inherited the variant gene, but they
are 3.5 times as likely to suffer a heart attack as those who carry the
normal version of the gene, a team of DeCode scientists led by Dr. Anna
Helgadottir reported in an article released online yesterday by Nature
Genetics.
Last year a drug called BiDil evoked mixed reactions after it was shown
to sharply reduce heart attacks among African-Americans, first in a general
study and then in a targeted study, after it failed to show efficacy in
the general population. The drug, invented by Dr. Jay N. Cohn, a cardiologist
at the University of Minnesota, prompted objections that race-based medicine
was the wrong approach.
Dr Troy Duster professor of sociology at New York University believes
you shouldn't create ethnically based medicines, without also doing some
sociology. 'I'm certainly for saving lives,' says Dr Duster in an article
for Detroit News, 'but I wonder if this one-sided type of research will
actually do that. When you're talking about genetic diseases, there's
usually something in the environment that triggers their onset. Shouldn't
we be talking about the trigger?'
'Take the case of black men and prostate cancer. African-American
males have twice the prostate cancer rate that whites do. Right now, the
National Cancer Institute is searching for cancer genes among black men.
They're not asking, How come black men in the Caribbean and in sub-Saharan
Africa have much lower prostate cancer rates than all American men?'
'A balanced approach might involve asking, 'Is there
something in the American environment triggering these high rates? Is
it diet, stress or what?"
A drug named DG031 drug being tested by DeCode Genetics
may help African-Americans who have the variant gene. 'It would make scientific,
economic and particularly political sense to have a significant part of
the clinical trials done in an African-American population,' said Dr.
Kari Stefansson, the company's chief executive.
Dr. Duster, who is also an adviser to the federal Human
Genome Project and a past president of the American Sociological Association,
said he saw no objection to a trial, provided it focused on African-Americans
with the risk-associated variant of the gene and took into account that
people with ancestry from different regions of Africa might show variations
in risk.