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A VA biobank is the largest source of genetic data on black Americans


At the start of the pandemic in 2020, Adriana Hung, an associate professor of nephrology who treats patients at Vanderbilt University Medical Center, noticed that a disproportionate number of black patients hospitalized with the coronavirus were dying from acute renal failure.

To test his theory that the virus could activate two mutations in the APOL1 gene – a combination of gene variants find in about 1 in 8 people of African descent – Hung turned to the Million Veteran Program (MVP), a federally funded genetic biobank and the largest source of genetic data on black Americans. She quickly got confirmation.

“The whole world was trying to figure out what was going on, but they didn’t have that resource,” said Hung, whose results were published in the journal JAMA Internal Medicine in January.

The MVP, which is run by Veterans Affairs and holds data on more than 150,000 black Americans, was crucial to its discovery. Today, thanks to Hung’s intuition and the speed and reach of the database, a pharmaceutical company is about to seek Food and Drug Administration approval for a new drug targeting APOL1; and African Americans, long underrepresented in medical research, have received useful attention overdue.

Created in 2011, MVP has 903,000 backers and is on track to reach its goal of one million members next year.

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In the voluntary program, veterans provide a blood sample for DNA, allow confidential access to their medical records, and complete occasional surveys to gather information, including their family medical history, exposure to chemicals toxic during their military service, their sleep and exercise habits, and the atmosphere.

The overall goal is to accelerate the development of “personalized medicine,” or individualized, preventative health strategies, said Sumitra Muralidhar, director of MVP. “I get goosebumps when I think about it,” she added. “We are making a dent.”

“The MVP is probably the most useful biobank in the world,” said Joel Gelernter, professor of psychiatry at Yale School of Medicine. Gelernter has collaborated with other researchers on more than a dozen papers based on MVP, including a recent study of the biological underpinnings of post-traumatic stress disorder and depression. He said the biobank has been particularly helpful in investigating PTSD and substance abuse like opioids and alcohol, two conditions that afflict more veterans than civilians.

The explosion of genetic research following the completion in 2003 of the Human Genome Project inspired several similar projects.

The All of Us Program at the National Institutes of Health, launched in 2018, also invited 1 million Americans to help build a biobank. So far, he has collected blood, saliva or urine samples, access to medical records and data from portable devices of more than 374,000 attendees, nearly half of whom identify with a historically underrepresented racial or ethnic group. The UK Biobank, which began in 2006, collected data on half a million subjects. Other great programs include Vanderbilt University BioVU and FinnGen in Finland.

The MVP, however, is not only the largest biobank, but also the most diverse representation, Muralidhar said.

The program has grown so quickly in part because of VA’s integrated reach, with over 100 participating clinics. Another benefit is the altruism of its unpaid participants, Muralidhar said.

“We surveyed veterans before launching the program and 70% said they would participate if asked,” she said. “They don’t expect anything in return, and the key thing they’ve said over and over again is ‘Will this help another veteran? If so, I’m in. ”

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Sylvester Norman, 67, a Coast Guard veteran and retired daycare worker in Nashville, said he was thrilled to join when he first heard about the program there. about two years. Norman is the eldest of four brothers, all of whom have suffered from kidney disease. Two died and another received two kidney transplants.

“It’s not going to benefit me at this point, but my God, it will benefit the people who come behind me because I know what I’m going through,” he said.

Major journals have published an eclectic range of research based on MVP data, with several studies claiming to be the most important of their kind.

In a May 2021 study in Nature Neuroscience on the genetic nature of depression involving more than one million participants, including 300,000 MVP subjects, Gelernter and other researchers identified several new genetic variants that may increase disease risk.

A study published in August in the journal Nature Medicine on the genetic risk of coronary artery disease (CAD) drew on data from more than 400,000 MVP participants, finding that the risk of CAD appears to be the same among white, East Asian, African, and Native American populations.

Another study based on MVP, published in June, linked 127 medical conditions height-associated genes, with most results applicable to both blacks and whites. Being tall, he found, is associated with a lower risk of high blood pressure and heart disease, but also carries a higher risk of atrial fibrillation and certain circulatory disorders. A separate research project involving more than 190,000 veterans found that eating yogurt is good for the heart.

Muralidhar said she has no plans to quit after recording the millionth veteran, although she may need a new name for the program. Going forward, she said she hopes to focus on broadening the range of participants to include more women – currently less than 10% of those in the biobank, in part due to under-representation. women in the military – and also diseases that have received less attention from researchers.

“We understand some medical conditions better than ever and we want to continue,” Muralidhar said.