%0 Journal Article
%T Ancestry in translational genomic medicine: handle with care
%A David Gurwitz
%A Jeantine E Lunshof
%J Genome Medicine
%D 2009
%I BioMed Central
%R 10.1186/gm24
%X The study of ancestry or ethnicity in biological and clinical sciences continues to raise controversy. In May 2001 the New England Journal of Medicine (NEJM) published a landmark study reporting that African-American heart failure patients with left ventricular dysfunction did not benefit from the popular angiotensin-converting enzyme inhibitor drug enalapril, while the same drug reduced the heart failure hospitalization risk of Caucasian patients by 44% [1]. The NEJM report, which eventually paved the road for the US Food and Drug Administration (FDA) approval of BiDil as the first 'ethnic medicine' four years later, was accompanied by two editorials - a rare practice for the NEJM - one heralding it as 'great help to physicians in their attempt to choose the best therapy for heart failure in patients of different races' [2], and the other condemning it and demanding that 'tax-supported trolling of data bases to find racial distinctions in human biology must end' [3]. Large disparities in health outcomes among socioeconomic and ethnic groups remain well documented, even in developed countries, and include drug-response variations due to genetic polymorphisms with different frequencies in different population subgroups [4]. Besides, it is unsurprising that many drugs work better for Caucasian patients, given the fact that a clear majority of clinical trial participants are of European ancestry [5]. Using ancestry or race/ethnicity as a surrogate biomarker for drug choice at the level of the individual is acceptable when this is the only approximation available until better biomarkers for clinical response are discovered and validated [6]. Using ancestry for establishing shortcuts in healthcare policy, however, is not an acceptable practice.In biomedical research, using race and ethnicity for stratification and in the reporting of results is often misleading and may skew scientific outcomes, as outlined by Timothy Caulfield and colleagues' well-thought out manuscript
%U http://genomemedicine.com/content/1/2/24