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To: Ilaine who wrote (96611)	1/24/2005 5:54:39 PM
From: Ish	Read Replies (1) \| Respond to of 793691

<<How exactly would "medicine for blacks" work?>> DNA. Some day we'll all have DNA tests that show which medicines work the best.

To: Ilaine who wrote (96611)	1/24/2005 6:25:44 PM
From: neolib	Read Replies (1) \| Respond to of 793691

Your comment is correct wrt to skin color. However, medicine is clearly on a path of becoming genetically specific. And yes, it may well require careful genetic identification of who you are, a procedure which will only get cheaper in the future. There will clearly be arguments about research funding wrt to genetic groups, but this is nothing new AFAIK.

To: Ilaine who wrote (96611)	1/24/2005 7:03:29 PM
From: Lane3	Read Replies (2) \| Respond to of 793691

How exactly would "medicine for blacks" work? I wondered the same thing when they announced the news about this drug. Race, the genome By David B. Goldstein & Huntington F. Willard \| January 17, 2005 THE REV. Martin Luther King Jr. dreamed "that my four children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character." So what might he have said today if his children had a deadly illness and their physician wanted to base the treatment on the color of their skin? ADVERTISEMENT That's becoming a real question not only for African-Americans but for everyone as the genomic revolution yields both fabulous discoveries and ethical challenges that King could hardly have imagined when he spoke so eloquently on the steps of the Lincoln Memorial. The human genome, whose genetic code of 3 billion bits of DNA we now know, delivers the seemingly contradictory message that our species is all the same, yet different. Although we share 99.9 percent of our code with each other, that remaining one bit of DNA code in every 1,000 contributes to many of the distinctions we see in being white, black, healthy, or sick. Today, as we recall how King compelled us to reconsider how race affects education, employment, and social justice, we also should sharpen our focus on new racial challenges posed by emerging medical advances. A new drug illustrates the issue. BiDil is a medication for patients with heart failure that appears to be much more effective in treating black patients than whites. It may soon become the first drug marketed specifically to members of a particular racial group. That may sound like good news for black patients with heart failure, and indeed BiDil could have value. As geneticists and genome scientists, however, we are wary of the long-term implications for health and social policy. For centuries, most reputable scientists viewed the races as distinct genetic entities. If you were sick, deviant, or even poor, you might be regarded as a threat to the human gene pool. Fortunately, such ignorance did not persist, and the subsequent sequencing of the human genome and study of genome variation within populations showed that only about 10 to 15 percent of our genetic variation is due to average differences between members of different groups. Most scientists now consider these average genetic differences between, say, blacks and whites to be fairly small, if not negligible. Many social scientists in particular view race as biologically meaningless. The application for BiDil now before the Food and Drug Administration challenges that view. BiDil is a combination of two older medicines that together reduce blood pressure and possibly protect the heart and blood vessels from damage associated with certain heart diseases. When researchers tested the drug with an ethnically mixed population of patients with heart failure, it did not work well enough to win approval. However, subsequent analyses suggested the drug worked better among African-Americans, leading to a clinical study in 2001 that was endorsed by the Association of Black Cardiologists. Recently, the company running the trial announced the results were so good it would seek regulatory approval specifically for African-Americans to use the drug. However, such approval would pose many dilemmas in practical terms. For example, how does a physician decide who is African-American? Also, it can be similarly difficult to pin down why a medicine affects groups differently. Is it because African-Americans are exposed to more lead, pollutants and pesticides than Americans of European origin? Or does the answer lie more with the 10 to 15 percent of our genetic variation that is associated with geographic or racial groupings -- the hundreds of thousands of bits of genetic code that are characteristically different between, say, Africans, Europeans, and Asians. When it comes to BiDil, we just don't know the answers, and our ignorance leads to the social dilemma. If we understood scientifically why the medicine worked and for whom, we wouldn't have to rely on imperfect indicators like skin color. In the end, FDA may well be justified in approving BiDil for use in African-Americans, but it has a responsibility also to promote research to clarify quickly the factors that underlie the drug's selective effectiveness. FDA also should state clearly that any use of race in clinical medicine is an interim, and frankly unfortunate, measure that society should replace. King spoke a deep truth when he urged us to judge one another by the content of our characters instead of the color of our skins. As the genomic revolution unfolds, we should heed his words and resist new temptations to view the races as sharply distinct categories. David B. Goldstein is with the Galton Labs, University College of London, and the Institute of Genome Sciences & Policy at Duke University. Huntington F. Willard is director of the Institute of Genome Sciences & Policy. © Copyright 2005 Globe Newspaper Company.

To: Ilaine who wrote (96611)	1/24/2005 7:39:58 PM
From: aladin	Read Replies (2) \| Respond to of 793691

CB, You should really read more outside of the realm of politics. Its genetics, not eugenics. If we study a drug and discover it works better in women, men or some racial subgroup, we use that knowledge. By your reckoning if we find a conflict or adverse reaction in some demographic - should we hold back to preserve your '60's view of equality - or should we do the ethical thing and say its contra-indicated for that population? This came up recently with a heart medication - the 1st time the mainstream press has noticed, but plenty of gender and race specific maladies abound. With racial and ethnic groups this usually involves inherited diseases such as sickle cell anemia. Maybe you think we should stop all research on these? Did you know Lupus research suggests different treatments depending on your ethnic background? There are whole books on the epidemiology of ethnic diseases. John