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Is Race-Based Medicine On The Horizon?

test tubesObjectors say it is the wrong approach.

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.

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