New Kaiser Permanente research aims to reveal genetic and environmental ca

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New Kaiser Permanente research aims to reveal genetic and

environmental causes behind deadly and disabling diseases

http://www.news-medical.net/?id=21924

The Kaiser Permanente Northern California Division of Research is

launching one of the largest research projects in the United States

to examine the genetic and environmental factors that influence

common diseases such as heart disease, cancer, diabetes, high blood

pressure, Alzheimer's disease, asthma and many others.

The goal of the Kaiser Permanente Research Program on Genes,

Environment and Health (RPGEH) is to discover which genes and

environmental factors -- the air we breathe, the water we drink, as

well as lifestyles and habits -- are linked to specific diseases.

Researchers hope to explain how genes and environmental factors work

together to influence the risk of getting a disease or affect its

severity or outcome, according to program co-investigators

Schaefer, PhD, director of the RPGEH and a research scientist at the

Kaiser Permanente Division of Research in Oakland, and Neil Risch,

PhD, director of the UCSF Institute for Human Genetics and an

adjunct investigator at Kaiser Permanente. The Research Program will

also include studies of genetic and non-genetic factors that affect

how people respond to specific medications, including the occurrence

of side effects.

Almost all common diseases and health conditions are linked both to

genetic and environmental factors, according to the

researchers. " Understanding the critical interaction between genes

and the environment on health will have an important impact on the

way all of us look at health and disease in the future, " said

Schaefer. " For instance, our research could help us identify not

only what diseases a person may be at risk for, but also identify

how to reduce that risk, or how best to treat the disease. This

research program provides an exciting opportunity to make

significant progress toward improvements in health and medical care. "

Member participation is critical to the success of the RPGEH. With

that in mind, Kaiser Permanente is inviting members to participate

in a survey that will be the first step in building the research

program. Approximately 2 million adult members in Northern

California will receive a survey by mail, asking questions about

their background, health history, lifestyle and habits, and their

family's medical history. Later, researchers will invite members to

give a biological sample in the form of blood or saliva that can be

used to obtain genetic information. Before any research involving

genetic information can occur, the RPGEH will obtain informed,

written consent from Kaiser Permanente members.

By combining the genetic, health, and survey information from

hundreds of thousands of members into databases, researchers hope to

gain a deeper understanding of what combinations of genes and

environmental factors influence the risk of complex diseases.

The success of RPGEH hinges on having a high number of Kaiser

Permanente participants, with good representation of all groups in

the population. Large groups provide the statistical power that is

necessary to detect the subtle and complex relationships between

genes, environmental factors and disease. " Because the population we

hope to include in this program is so large and diverse, the

research can be generalized, " explained Schaefer.

With RPGEH, Kaiser Permanente is contributing to public health by

taking the work of the human genome project -- describing the

sequence of genetic information in great detail -- to the next step

of translating that information into an understanding of how genes

influence our health. Kaiser Permanente has a diverse membership and

46 years of research experience, making it uniquely qualified to

lead this kind of large-scale, long-term research that could

personalize medicine for millions of individuals.

" In the world of medicine today, one way a physician determines a

patient's risk for a serious condition like heart disease is by

taking a family history, " said Joe Selby, MD, MPH, director of the

Division of Research. " However, the Research Program on Genes,

Environment and Health will hopefully give us information that is

far more useful and will enable the medical community to be much

more precise in pinpointing the causes of disease and tailoring

treatment for the individual. "

Cutting edge studies such as the RPGEH that include large numbers of

people are not unprecedented. The Framingham Heart Study, The

Women's Health Initiative (WHI) and the Nurses Health Study (NHS)

are just a few examples of large-scale research projects that have

helped us understand a great deal about prevalent health conditions.

Kaiser Permanente's Division of Research is a bellwether in high-

profile research that has led to significant health care findings

through use of its research database. For example, a Kaiser

Permanente/FDA study on the painkiller Vioxx revealed an increased

risk of cardiovascular events for those taking the drug.

To ensure that the RPGEH meets the highest scientific standards, as

well as addresses issues of potential concern to different

communities, the Division of Research has set up both a scientific

advisory panel -- consisting of non-Kaiser Permanente individuals

with relevant scientific and professional credentials -- and a

community advisory panel with leaders from diverse communities

throughout Northern California. These panels will advise and guide

all aspects of the Research Program. All data collection and

research by the RPGEH has been and will be reviewed and overseen by

the Kaiser Permanente Institutional Review Board (IRB) for the

Protection of Human Subjects. This federally mandated Board includes

physicians, lawyers, and community members who are not involved in

the Research Program.

Participation in the RPGEH is completely voluntary. An individual's

genetic information will not be used in genetic studies without

their written consent. Moreover, as with all studies carried out by

the Division of Research, protecting the confidentiality and

security of our members' information is our first priority. Kaiser

Permanente has a long track record of protecting the security and

confidentiality of information provided by research participants.

The KP Division of Research maintains separate information and

databases from the health plan and members' medical records. No

research data is stored with identifying information. In the

database, each participant will be given a unique code that will

replace their medical record number, name and other identifying

information. The code can only be linked back to identifying

information by a small number of Division of Research staff members

who must have a special password. The data is for research only.

Studies done by the Division of Research are funded almost entirely

with money from outside Kaiser Permanente in the form of federal

grants, such as those from the National Institutes of Health, or

from other organizations and foundations. Funding for the RPGEH

comes from the Wayne and Gladys Valley Foundation, the Ellison

Medical Foundation, and Kaiser Permanente's Community Benefit

Program. For more information on the Kaiser Permanente Research

Program on Genes, Environment and Health, go to www.dor.kaiser.org.

The Kaiser Permanente Division of Research conducts, publishes, and

disseminates epidemiologic and health services research to improve

the health and medical care of Kaiser Permanente members and the

society at large. It seeks to understand the determinants of illness

and well-being and to improve the quality and cost-effectiveness of

health care. Currently, DOR's 400-plus staff is working on more than

250 epidemiological and health services research projects.

http://www.kaiserpermanente.org/