title: A personalized medicine approach for Asian Americans with the aldehyde dehydrogenase 2*2 variant.
abstract: Asian Americans are one of the fastest-growing populations in the United States. A relatively large subset of this population carries a unique loss-of-function point mutation in aldehyde dehydrogenase 2 (ALDH2), ALDH2*2. Found in approximately 560 million people of East Asian descent, ALDH2*2 reduces enzymatic activity by approximately 60% to 80% in heterozygotes. Furthermore, this variant is associated with a higher risk for several diseases affecting many organ systems, including a particularly high incidence relative to the general population of esophageal cancer, myocardial infarction, and osteoporosis. In this review, we discuss the pathophysiology associated with the ALDH2*2 variant, describe why this variant needs to be considered when selecting drug treatments, and suggest a personalized medicine approach for Asian American carriers of this variant. We also discuss future clinical and translational perspectives regarding ALDH2*2 research.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California 94305.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Gross
authors.forename: Vanessa O
authors.initials: VO
authors.lastname: Zambelli
authors.forename: Bryce A
authors.initials: BA
authors.lastname: Small
authors.forename: Julio C B
authors.initials: JC
authors.lastname: Ferreira
authors.forename: Che-Hong
authors.initials: CH
authors.lastname: Chen
authors.forename: Daria
authors.initials: D
authors.lastname: Mochly-Rosen
mesh_terms: D000444:Aldehyde Dehydrogenase / Q000235:genetics* / Q000378:metabolism; D000071396:Aldehyde Dehydrogenase, Mitochondrial; D000818:Animals; D001213:Asian / Q000235:genetics*; D004252:DNA Mutational Analysis; D003661:Decision Support Techniques; D064420:Drug-Related Side Effects and Adverse Reactions / Q000201:enzymology / Q000208:ethnology / Q000235:genetics / Q000517:prevention & control; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D061214:Patient Safety; D018579:Patient Selection; D010597:Pharmacogenetics / Q000379:methods*; D010599:Pharmacokinetics; D010641:Phenotype; D017354:Point Mutation; D057285:Precision Medicine; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: C096127:ALDH2 protein, human; D000444:Aldehyde Dehydrogenase; D000071396:Aldehyde Dehydrogenase, Mitochondrial
keywords: ALDH2; Asian; alcohol; cancer; ischemia; precision medicine; prediction in pharmacology