In an effort to create "personalized drugs" that work for specific, targeted groups of people, many medical researchers have suggested the adoption of "race-based" medicine. Race-based meds like BiDil, aimed at African Americans with heart disease, are already on the market. But in a fascinating commentary in today's issue of Clinical Pharmacology & Therapeutics, infamous genomics maverick Craig Venter contributes to an article which proves that race-based medicine is doomed to fail. Why? Because "race" as most people understand it has almost nothing to do with genetics — and therefore makes a bad target for tailored medicines. Venter and the other authors of the study say that sometimes people of the same race share genetic similarities, but not often enough to base drug targeting on racial groups. The researchers prove their point by examining the two most-studied human genomes in the world: Those of white guys Craig Venter and James Watson. Turns out that the men's genomes are dissimilar enough that they would likely respond quite differently to common antidepressants — despite the fact that both identify as white. (This is particularly amusing for those who have followed Watson's career, since he was recently suspended from his job for racist comments about the genetic inferiority of blacks.) Write the authors:
[Venter and Watson's] genetic differences underscore the importance of personalized genomics over a race-based approach to medicine. To attain truly personalized medicine, the scientific community must aim to elucidate the genetic and environmental factors that contribute to drug reactions and not be satisfied with a simple race-based approach . . . One's ethnicity/race is, at best, a probabilistic guess at one's true genetic makeup.
This study, while mostly focused on personalized pharmaceuticals, has far-reaching implications. Essentially the authors are arguing that race has little to do with people's genomes, which flies in the face of at least a century of received wisdom that race is "genetic" as well as cultural. Write the scientists, "This [study] speaks to the value of knowing genomic sequence instead of relying on a patient's appearance or self-identified ethnicity." The authors also go on to say that sometimes even when a racial group appears to present similar biological problems, this may have less to do with genetics than environment:
For example, the higher incidence of hypertension in African Americans has been linked to darker skin color, but this may be due instead to socioeconomic status and higher levels of stress rather than to genetics.5 Knowing that socioeconomic status is related to hypertension allows us to identify individuals at risk regardless of race. Given the complex nature of drug responses, it would ultimately better serve all to dissect the relevant factors of a drug response instead of categorically stereotyping a culture with a presumed genetic background.
I am impressed. This quiet little study, published in an academic journal, has implications go far beyond the world of medicine and into the realms of politics and even (dare I say it) social justice. Individual Genomes Instead of Race for Personalized Medicine [Clinical Pharmacology & Therapeutics]