Sun Boguang, Thao Tou, Culhane-Pera Kathleen, Yang Eric, Thor Mai Yang, Yang Pao, Xiong Metta, Vang Zoua, Straka Robert J
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States.
SoLaHmo Partnership for Health and Wellness, Community-University Healthcare Center, Minneapolis, MN, United States.
Front Pharmacol. 2024 Sep 24;15:1432906. doi: 10.3389/fphar.2024.1432906. eCollection 2024.
In collaboration with the Minnesota Hmong community, we have previously discovered significant differences in allele frequencies for key Single Nucleotide Variations (SNVs) within Very Important Pharmacogenes (VIPs) between Hmong and East Asians. Recognizing the potential clinical implications of these observed differences, we sought to validate these observations in a Hmong cohort residing in California, the state with the largest Hmong population in the US. Robust validation of these differences would affect motivation for clinicians treating individuals who identify as Hmong to consider pharmacogenomic (PGx) testing as a means to improve clinical decision making when using therapeutic agents in this unique population.
Guided by California Hmong community leaders and utilizing the basic approach of community-based participatory research, demographic, clinical information and a buccal swab was obtained from Hmong adults residing in California. A commercial PGx testing panel was performed on these samples and specific allele frequencies of interest were compared between California and Minnesota Hmong. Allele frequency differences between California Hmong, East Asians and Europeans, were also compared. Return-of-PGx-results and presentations of group data were made to members of the Hmong along with PGx educational sessions to help interpret the observations.
In 118 California Hmong who completed the study, the allele frequencies for SNV's were similar to previous Minnesota Hmong results. Furthermore, out of the 18 SNVs that were not previously reported in Hmong, allele frequencies were statistically different in 38% (7/18) of SNVs comparing California Hmong to East Asians, and in 77.8% (14/18) SNVs comparing California Hmong to Europeans.
These results validate the original study's findings that Hmong people living in different US locations have similar allele frequencies for key PGx genes. Further, for many of these PGx genes, their allele frequencies are significantly different compared to either East Asians or Europeans. Clinicians should consider these important differences when prescribing medications for people who identify as Hmong.
我们之前与明尼苏达苗族社区合作，发现苗族与东亚人在非常重要的药物代谢基因（VIPs）中的关键单核苷酸变异（SNVs）的等位基因频率存在显著差异。认识到这些观察到的差异可能具有的临床意义，我们试图在美国苗族人口最多的加利福尼亚州的一个苗族队列中验证这些观察结果。对这些差异进行有力验证将影响临床医生对苗族患者进行治疗时的积极性，促使他们考虑进行药物基因组学（PGx）检测，以此作为在这个独特人群中使用治疗药物时改善临床决策的一种手段。
在加利福尼亚苗族社区领袖的指导下，采用基于社区的参与性研究的基本方法，从居住在加利福尼亚的苗族成年人那里获取人口统计学、临床信息和口腔拭子样本。对这些样本进行商业PGx检测，并比较加利福尼亚和明尼苏达苗族中感兴趣的特定等位基因频率。还比较了加利福尼亚苗族、东亚人和欧洲人之间的等位基因频率差异。向苗族成员反馈PGx检测结果并展示群体数据，同时开展PGx教育课程以帮助解读这些观察结果。
在完成研究的118名加利福尼亚苗族中，SNV的等位基因频率与之前明尼苏达苗族的结果相似。此外，在之前未在苗族中报道的18个SNV中，将加利福尼亚苗族与东亚人相比，38%（7/18）的SNV的等位基因频率存在统计学差异；将加利福尼亚苗族与欧洲人相比，77.8%（14/18）的SNV的等位基因频率存在统计学差异。
这些结果验证了原研究的发现，即生活在美国不同地区的苗族在关键PGx基因上具有相似的等位基因频率。此外，对于许多这些PGx基因，其等位基因频率与东亚人或欧洲人相比存在显著差异。临床医生在为苗族患者开处方时应考虑这些重要差异。
