Project location: Rural communities in southwest Alaska
Category: Pharmacogenomics of blood clotting and warfarin metabolism
Project Description: The Northwest-Alaska Pharmacogenomic Research Network (NWA-PGRN) is led by scientists at the University of Washington and involves collaborations between investigators in CANHR, the University of Washington, the University of Montana and American Indian and Alaska Native (AI/AN) community members in Alaska and Montana. The goals of the studies involving CANHR are to understand the contribution of genetic variation and how consumption of a subsistence diet from the ocean influences how well blood clots in Yup'ik people. We also want to understand how the foods people eat and their genetic variation interacts to influence how well "Warfarin" or "Coumadin", a medication used to prevent blood clots, works in Yup'ik people. Our ultimate goal is to share the information we learn with Yup'ik people and their health-care providers, so that a safe and effective dose of warfarin can be prescribed to patients to improve their health outcomes and to avoid any risk for excessive bleeding.
Why study Warfarin? Warfarin is the most widely used medicines for the treatment and prevention of stroke and deep vein thrombosis. Scientists know a lot about the influence of genetic variation and diet in determining a safe and effective warfarin dose in people of European descent, but we know nothing about how genetics and diet may influence blood clotting or warfarin dosing in AI/AN people. In particular, we want to know whether polyunsaturated fats from marine mammals and fish and vitamin K consumption from leafy green vegetables can modify the genetic associations related to warfarin pharmacotherapy. In addition, it is sometimes hard to determine just the right amount of warfarin to give people – especially people that live in rural areas that are not near a hospital where blood clotting time can be frequently monitored. Patient characteristics such as age, gender, weight, diet, the use of other medications, and genetic variation can all affect warfarin dosing. All of these factors contribute to differences in warfarin dose requirements for a particular individual. We are trying to understand how all of these factors influence a safe and effective dose of warfarin in Yup'ik people.
Our NWA-PGRN partnership also works closely with a small group of Yup'ik community members from the Yukon-Kuskowkim Delta of Alaska, to ensure that we develop a shared understanding of our research progress and findings, as well as to assure that important pharmacogenetic findings are available to YKHC health-care providers so that our study outcomes can be used to enhance patient care. In addition, our work with community members has helped us to understand how people feel about pharmacogenetic testing and research and what they want to know in regard to our progress. We have learned that community members support this research, and that they would like us to share our important findings with YKHC providers.
CANHR Project Staff: Bert Boyer, Scarlett Hopkins, Jynene Black and Eliza Orr
UW Project Staff: Ken Thummel and Wylie Burke (PIs)
Funded by: The NIH NIGMS U01GM092676