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Director of NIH’s New Genomic Health Disparities Center Discusses Research Plans

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Charles Rotimi
Director
NIH Intramural Center for Genomics and Health Disparities
The National Institutes of Health this week announced the establishment of its NIH Intramural Center for Genomics and Health Disparities that will use genomics approaches to study diseases that impact minority populations.
 
The trans-NIH research center will collect and analyze genetic, lifestyle, and socio-economic data to research how populations are affected by diseases, such as obesity, diabetes, and hypertension.
 
NICGHD will be established within NIH’s Office of Intramural Research and administered by the National Human Genome Research Institute. Research activities at the NICGHD will take place on NIH’s Bethesda campus. The center will receive support from NIH’s Office of the Director, the National Institute of Diabetes and Digestive and Kidney Diseases, as well as the Center for Information Technology.
 
The center will be headed by Charles Rotimi, a genetic epidemiologist and the former director of the National Human Genome Center at Howard University. Rotimi has also been appointed senior investigator in the Inherited Disease Research Branch in NHGRI’s Division of Intramural Research. At NICGHD, Rotimi will continue his previous research exploring the cultural, lifestyle, and genetic underpinnings for complex and common diseases that affect the African diaspora.
 
Rotimi spoke to Pharmacogenomics Reporter this week about NICGHD’s research goals and current gaps in knowledge with regard to the utility of genomics in understanding health disparities.
 

 
Why did NIH decide to develop the center at this time?
 
Right now we’re at a point where genomics is really informing the way we do biomedical research. The genomic tools are ripe, in the sense of providing us with the necessary cost-effective way to be able to scan the whole genome, to understand the disease susceptibility and resistance, and also to understand how human migrations and local evolutionary processes have conditioned what we see at the genome level.
 
In that regard, it’s critically important to make sure that these genomic tools that are being developed are indeed going to be applicable to all human populations, and all human populations are positioned such that they will derive the benefits that comes with it.
 
Which other divisions at the NIH will the NICGHD be working with?
 
The center is a trans-NIH center. The primary home is NHGRI, but it’s actually supported by NIDDK, and it’s also supported by the CIT. Also, we do intend to form collaborations with the Center for Minority Health. One of my major areas of research is hypertension. So, we do intend to work with the National Heart, Lung, and Blood Institute.
 
What is the state of the science currently with regard to the genomic understanding of health disparities?
 
We’re really at the infancy stages. We’re just at the point where we’re beginning to understand how some of the differential distributions we see in these genetic variances, which may be important for complex diseases, are distributed across different populations. Most of the things we’re finding, if not all of them, do not give us the uniqueness, but they do give us differential distributions. So, those differential distributions may be such that might help us explain why some groups may have a higher frequency of a particular condition compared to others. That is what we’re going to try to document in a systematic manner, when we look at diseases that disproportionately affect minority groups.
 
In the market, how is genomics being applied to alleviate health disparities?
 
Currently, [genomics] really is not being applied in any direct sense. The future is promising, though. For example, what we’re finding in terms of prostate cancer, the variance that has been identified in [chromosome 8q] turns out to be important and is actually the function of variance in terms of susceptibility to prostate cancer that may have implications for understanding the higher rate of the disease that we see in African Americans.
 
The important thing here is that by making sure African American, and other African populations, are appropriately represented in the genomic revolution, we will ensure that whatever is there — the differences in distribution — will be studied and systematically documented. [NICGHD’s work will help determine] whether or not [these genomic differences] are important in the end in terms of reducing disparities. This is something that needs to be made obvious in the very near future.
 
What projects do you have lined up for NICGHD in the near future?
 
I am going to continue my work I’ve been doing. Over the years I’ve looked at what I call the triangular relationship between obesity, hypertension, and diabetes. I do that work, and I’ll continue to do that, in populations of the African diaspora. We have study sites in Nigeria, Ghana, Kenya. We do intend to expand to other African countries.
 
We have a major effort going on here in the Washington, DC, metropolitan area. We are planning to do a genome-wide association scan on more than 2,000 African Americans, who we enrolled for the past four to five years from the Washington, DC, area.
 
We also have ongoing projects in China to enroll about 2,000 type 2 diabetics and controls, so we can also do a genome-wide scans on those patients. I believe that by looking at the Chinese, the African, and the African American populations, along with the data in existing European populations, we will be able to understand some of these differences in variance better.
 
Are there any pharmacogenomics studies that you will be conducting with regard to health disparities?
 
Right now we’re not engaged in any pharmacogenomics studies. But that’s an area that we do intend to expand into. We are probably going to start that by forming collaborations, with probably [our colleagues] at Duke. So, we do intend to bring pharmacogenomics under the umbrella of the center, also.
 
Do you think that eventually the center’s findings might aid drug or diagnostic development?
 
We are hoping that the findings from the center will definitely contribute to our understanding of how genetic variation impacts disease distributions, and impacts [people’s] susceptibility to various environmental factors. In the future, we do hope that the findings from the center, and also the way we incorporate findings from other studies into our own work, would inform things like drug development and understanding why some people respond to drugs differently than others.
 
Where is the funding for the center coming from?
 
The process for establishing the center came with a budget that pays for the staff, and a proportion of that will be devoted to the research itself. We do have an annual budget that could be improved upon with time, depending on how we expand our work. … Right now, the annual budget for the center is $1.7 million.
 
How many staff members do you have, and do you plan to hire more?
 
I came with some of my staff from Howard University. Currently, we have five people on staff here, and we do intend to expand to about 10 or 12 people.
 
Is there something you wanted to highlight about the center that I haven’t asked about?
 
Sometimes when people hear ‘genomics’ and ‘disparity’ they get nervous. Again, just to emphasize that what we’re interested in [at NICGHD] is, we see genomics as a piece of the puzzle, not the whole puzzle. By understanding genomics, we may be able to understand how cultural and lifestyle characteristics impact differential distribution of diseases, which we call health disparities.
 
That’s interesting that you said that when people hear ‘genomics’ and ‘disparity’ they get nervous. Certainly, there has been concern that insurers might deny minority populations coverage if they are genetically predisposed to certain diseases. Is this fear something that has held back genomic research on health disparities?
 
I think there is some nervousness in that direction, and I think rightfully so, given the history of biomedical research in the United States. For me, it’s critically important that we include all world populations in this genomic era, so the differences that we see at the genomic level are adequately represented across all human populations. I think that is very important, but we need to do that with the full realization that the major part of health disparities are indeed driven by poor social structures that drive people toward poor health.

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