Cardiovascular health and telomere length: what does this mean and how does this affect the health of people who are lesbian, gay, and bisexual*?
People who are lesbian, gay, and bisexual (LGB) experience discrimination. This unjust treatment can be harmful to an individual’s health by being part of the reason they smoke, have stress from stigma, or experience barriers to getting health care. These factors can create health disparities between LGB and straight individuals. They can even lead to faster biological aging in LGB people. Faster biological aging can lead to poor health and a higher risk of heart disease.
In this study, scientists will be able to study these differences by looking at individuals’ telomeres. Telomeres are at the end of each of our individual chromosomes. As we get older, all our telomeres become “frayed” and shorter. Over the past 40 years, scientists have come to understand how telomere length can help us better understand the development of various diseases and aging.
Studying and measuring these kinds of disparities between LGB and straight people is important, as it informs policies and programs designed to improve the health of LGB individuals, especially in Kaiser Permanente. This work also contributes to improving our knowledge about LGB health overall.
*Based on self-identification in the KP Research Bank survey
Improving medication treatment for major depressive disorder
Major depressive disorder (MDD), meaning persistent sadness and loss of interest in regular activities, affects about 10 percent of people in the U.S. at some point in their lives. MDD is among the top five causes of disability worldwide. Currently, the choice of an antidepressant medication for a specific person is based on trial and error. There is no way for physicians to know ahead of time how someone will respond to an antidepressant medication. Clinical trials show that only about one-third of people with MDD get better with a first medication. Physicians’ inability to choose the best treatment for each person is a problem that adds to how bad MDD can be for people who have the condition. Knowing ahead of time how each person will respond to a particular medication could greatly improve treatment and reduce suffering.
This study will use proteomics to help solve this problem. Proteomics, a relatively new area of science, studies the proteins inside our bodies, including the way they work and interact with each other inside cells. Proteomics is very complex and is considered one of the biggest frontiers in biology and personalized medicine after genomics. This new project on MDD will use proteomics to study the proteins that could affect how antidepressant medications interact with individuals’ proteomic make-up. New knowledge from this study could eventually help physicians prescribe the best antidepressant for each person who has MDD by way of identifying specific proteomic biomarkers in their blood.
Genetic susceptibility to lung disease: idiopathic bronchiectasis
Bronchiectasis causes ongoing inflammation and damage to the lungs but is not life threatening. Most people who get bronchiectasis develop it sometime after age 50. Main symptoms include over-production of mucus and chronic coughing. Some people are more likely to develop this condition than others, but we don’t understand why; for 4 out of 10 people who develop bronchiectasis, there doesn’t seem to be a clear cause. In this project, scientists will study if differences in certain genes make some people more likely to develop bronchiectasis than others. These findings could be used to identify people who are more likely to get bronchiectasis, so that earlier treatment could decrease the problems related to having the condition.
Neutropenia, genetic variants, acute infection, and chemotherapy
Neutropenia means that a person has a low count of a type of white blood cell called a neutrophil. White blood cells help our bodies fight infections and heal injuries. Neutrophils are the most common type of white blood cells. Neutropenia can be caused by various diseases and medications, including chemotherapy. There is a type of genetic variant that causes people to have lower levels of neutrophils, even when they’re healthy. Inheriting two copies of this genetic variant (called “Duffy null genotype”) is particularly common in people with ancestry from West Africa and some places in East Africa and the Middle East.
The lower level of neutrophils from having Duffy null genotype isn’t typically a problem. However, lower levels of neutrophils can affect how physicians treat patients when they’re receiving chemotherapy for cancer treatment. Since the white blood cell count and neutrophil count is used to check for side effects from chemotherapy, understanding how people with this genetic variant respond to infection and chemotherapy is very important. In addition, since the white blood cell count and neutrophil count is used to help diagnose infections, it is important to understand how these counts change in people with this genetic variant.
In this study, scientists will study people who have the Duffy null genotype to find out how their white blood cell and neutrophil counts change during acute infections. They also will study how people with the genetic variant respond to medications — such as chemotherapy — that decrease their white blood cell counts. They will work to find out if these people are more likely to have more severe decreased white blood cell counts in response to chemotherapy, and whether they are more likely to get infections during chemotherapy.
