August 13, 2015

Million Veteran Program data spurs research in pharmacogenomics of kidney disease

A team of Vanderbilt and Nashville VA researchers, led by Adriana Hung, M.D., MPH, has been awarded a grant from the U.S. Department of Veterans Affairs to use the Million Veteran Program (MVP) data to conduct diabetes research.

A team of Vanderbilt and Nashville VA researchers, led by Adriana Hung, M.D., MPH, has been awarded a grant from the U.S. Department of Veterans Affairs to use the Million Veteran Program (MVP) data to conduct diabetes research.

Adriana Hung, M.D., MPH

MVP is a national, voluntary research program funded entirely by the Department of Veterans Affairs Office of Research & Development and is part of the federal Precision Medicine Initiative announced earlier this year by President Obama.

The goal of MVP is to partner with veterans receiving their care in the VA Healthcare System to study how genes impact health, said Hung, a dual-appointed Vanderbilt/Nashville VA investigator.

To do this, MVP will build one of the world’s largest medical databases by collecting blood samples and health information from 1 million veteran volunteers.

Data collected from MVP will be stored anonymously for research on diseases like diabetes and cancer, and military-related illnesses such as post-traumatic stress disorder, according to the U.S. Department of Veterans Affairs.

The VA has already enrolled 390,000 veterans toward this goal, said Hung, assistant professor of Medicine in the Division of Nephrology and Hypertension, and principal investigator for the Nashville VA, which has been a top recruiter for the study.

Hung and her team will study the genetic determinants of the response to metformin for diabetes, tacrolimus-based immunotherapy for kidney transplant and the genetic determinants of hypertension.

“This will help to personalize treatment choices in the care provided to people with, or at risk for, kidney disease, and in the discovery of new targets for treatment and improved outcomes in the veteran population afflicted with these conditions,” Hung said.

More than 20 million Americans have moderate to severe chronic kidney disease (CKD). People with CKD will die prematurely from cardiovascular disease or progress to end stage renal disease and require dialysis. The two main causes of CKD are diabetes and hypertension.

Metformin is the first therapy for patients with diabetes, and reduces cardiovascular disease and progression of CKD. The response to metformin is highly variable and heritable. Additionally there are racial disparities in hypertension and in the way it affects the kidney.

“Vanderbilt is already known for being a top institution on pharmacogenomics,” Hung said. “This work will help in advancing the knowledge in pharmacogenomics as it relates to kidney disease risk and progression.”

Collaborators on the study include Csaba Kovesdy, M.D., from the Memphis VA; Todd Edwards, Ph.D., from Vanderbilt, along with Christianne Roumie, M.D., and Kelly Birdwell, M.D., MSCI, from the Nashville VA and Vanderbilt.

The team has experience working with national VA data, pharmaco-epidemiology, bioinformatics and biostatistics, Hung said, adding that all veterans are welcome to participate in the study.