It's no secret that ethnicity and health disparities are strongly linked, and the Meharry Clinical and Translational Research Center (MeTRC) is working to connect the dots.
Established in 2008, the MeTRC grant has cultivated minority researchers by funding their projects and built an infrastructure of laboratories, training, and support staff. Funding for the center first came as a $4 million annual gift for five years from the National Institutes of Health in 2009. The grant was successfully renewed in 2014 with a total budget of $15 million for five years.
Bench to Bedside
Translational research is a newer branch of scientific research that turns lab discoveries into successful, real world treatments. MeTRC scientists seek to understand diseases and health disorders that disproportionately impact minorities so that strategies for cure can be implemented.
"There are significance differences in terms of incidence, prevalence and different levels of disease when you compare different ethnic groups," said Samuel E. Adunyah, PhD, chair and professor of Biochemistry and Cancer Biology at Meharry. "It could be linked to where we live, or it could be genetic factors or other factors including socioeconomics."
Diseases where racial disparities are most prevalent include HIV/AIDS, cancer, diabetes, cardiovascular disease and neurological disorders. MeTRC focuses on many minority populations with an emphasis on African Americans and Latinos.
Adunyah said the highest prevalence of HIV/AIDS in the U.S. is among African Americans in the Southeast, with both young African American men and women at higher risk of the disease than other races.
In addition, prostate cancer rates among African American men are almost 2.5 times higher than that of Caucasian men (see page xx). "What are the factors that cause that?" Adunyah asked. "That's the huge question, and the solutions are on different fronts."
Identifying genetic risk factors requires a team of scientists, including cancer biologists, molecular biologists, immunologists, and microbiologist partnering with providers, while social determinants require public health officials, communities and population-based scientists working together. Churches also play an important role in reaching minorities for their inclusion in such studies.
"Community-based participatory research is important because you can't just go to a community and tell them what's wrong," said Adunyah.
Investigators often work with churches and religious groups to reach a particular community. "If you ask someone to provide blood samples for you to take back to the clinic, they will only participate if they trust you," he said.
Locally MeTRC has partnered with the state health department, Tennessee Center for AIDS Research, diabetes groups and the Meharry-Vanderbilt Community Engaged Research Core, which builds relationships between scientists and community organizations. They've also partnered with Nashville schools to form the Meharry/Vanderbilt/Tennessee State University Cancer Partnership, funded through a National Cancer Institute grant.
"By bringing groups of different disciplines together, you're creating translational linguistics so the findings in one group can be used by the findings in another group," Adunyah said. "That translates into patient care. You can't tackle it from one front."
MeTRC has made great strides, particularly in the area of HIV/AIDS research. "We now understand more about how the virus spreads and genetic message coding," Adunyah said. "We understand more how the virus integrates into the DNA of a host cell ... and are able to look at those areas that can be targeted for drug development to inhibit those areas."
MeTRC researchers have also participated in findings that revealed a link between cocaine and amphetamines and their ability to interfere with the efficiency of HIV/AIDS drugs. Another discovery involves a condition related to end stage renal disease in HIV/AIDS patients, which is found in about 18 percent of African Americans. "We've been able to identify genes and proteins that predispose individuals to that disease," Adunyah said. "That's very important because we can begin to have ideas and strategies to block that from a person with renal disease." These findings have been supported by similar findings from other institutions.
Additional findings by MeTRC investigators could affect utilization of painkillers in a broader population. The discovery involves a difference in pain perception among Caucasians and African Americans.
In 2016, MeTRC received funding from the National Institute on Minority Health and Disparities, a branch of the National Institutes of Health. They're also part of a new initiative called eMERGE - a national network organized and funded by the National Human Genome Research Institute that combines DNA biorepositories with electronic medical record systems for large scale, high-throughput genetic research.
"We try to find out whether the genomic makeup of individuals is related to different types of cancer so you can recommend them for specific treatment through precision medicine," Adunyah said. The MeTRC investigators have committed to testing 500 African Americans with early cancer diagnosis or at risk for cancer to potentially identify specific genetic changes in those individuals related to their cancer. Meharry is the only historically black college among those participating in this groundbreaking initiative.
A Community Partner
Locally, MeTRC is looking to partner with area providers outside their usual network, including oncology groups that see minority populations. Adunyah said those relationships often bring about amended protocols from study review boards to allow for outside participants. "We're always looking for more collaborators," Adunyah said.