Genetic polymorphisms and preeclampsia
 American Indian and other minority groups are under-represented in medical careers and among biomedical researchers. There are many possible explanations; but lack of educational opportunities and learning projects that seem relevant to the health problems of AI communities may be one factor. The North Dakota INBRE project funded through the National Institute of Health (NIH) supports genetic research focused on a health care problem of special interest (preeclampsia) for the Turtle Mountain community. About six percent of pregnancies are complicated by high blood pressure, abnormal protein in the urine, and other signs, which together are called “pre-eclampsia” (PE). The complications of PE can be serious and can result in prematurity and death for the baby, as well as occasionally death of the mother. Although no cause has been found for PE, some risk factors have been identified, including certain genetic changes (mutations in the DNA). These genetic theories have been tested in Caucasian populations, but never in American Indian communities. It is not known whether these changes are common in American Indian populations or whether they might carry the same risk as they appear to in non-Indian people. All research is carried out according to strict ethical standards, and proper approval obtained from tribal government, federally mandated research protection boards (IRBs), the Indian Health Service, and (most importantly) from each individual person who is invited to participate. The TMCC preeclampsia research project strives to accomplish four primary goals:
- Student research assistants learn valuable skills to plan and conduct of medical research, important laboratory methods for genetic research, and publishing research results that will be of use to physicians providing care to American Indian people.
- The Turtle Mountain community has become more engaged in the planning of future biomedical research in this area.
- Skills needed to conduct biomedical research are enhanced among the TMCC faculty.
- The most important outcome is to generate student interest in further studies that could lead to a medical or biomedical research career.
Research Developments
- The laboratory protocol for analysis of FVL remains problematic. In mid-August I asked Dr. Sheri Dorsam at NDSU to essentially take primary responsibility for developing this protocol. She has also had some difficulty with the primer set that we were using and has determined that another primer set flanking the original ones would give a longer product that might be easier to analyze. She has started work on this new primer set.
- Jacob Davis has completed the CITI online research ethics training as required by the UND IRB. In addition to his other duties, he will be trained and certified to obtain informed consent from potential participants. We continue to hold twice weekly journal sessions with the student research assistants and have reviewed a number of papers again this month.
- We added another 4 participants to our sample repository. We now have a total of 171 participants. Melanie Nadeau has been oriented to the Excel spreadsheet data abstraction form that will be used to obtain necessary data from participants’ medical records. Dr. Best developed this spreadsheet and oriented Ms. Nadeau to the charts and this process.
- Dr. Best conducted another 10 PCR reactions and analyses, along with 1 restriction enzyme digest of products.
- Our main focus is still on developing a reliable and accurate lab protocol for genotyping our samples. Dr. Best conducted another 11 PCR reactions and 3 enzymatic digestion analyses. Sheri Dorsam has conducted another 5 or 6 reactions on our behalf at NDSU. It seems as though we are making some progress, and have seen the amplification process working fairly well now with the new primer set that Dorsam developed. We are focusing mainly on obtaining proper enzymatic digestion of the products now and that seems to be improving too. I remain hesitant to declare victory, since we have been down a number of blind alleys before too!
- Melanie Nadeau has done a draft abstraction of 10 charts now at IHS. We are in the process of getting additional clearance for her to use the electronic portion of the records. This will help a lot in the abstraction process. In addition, Ms. Nadeau has made initial contact and requested records from 3 referral facilities, to complement the records that we have from IHS.
- The UND IRB has granted an annual renewal of our project as well as approving a couple of minor protocol changes. The most important one was to allow us to advertise our project to the prenatal patients by having IHS send letters directly to prenatal patients with information about our project. This will hopefully generate additional contacts for our staff.
- We added another 5 participants to our sample repository. We now have a total of 176 participants.
Conferences and Meetings
- Melanie Nadeau developed and submitted an abstract to a national conference on prenatal complications. This is sponsored by the NIH and the HHS Bureau of Children’s’ Health; and was held in Atlanta, GA, Dec. 6-8, 2006. The abstract/poster reports on our efforts and special techniques to effectively recruit American Indian participants into a genetic research project.
- Dr. Best attended and presented at the Aberdeen Area Tribal Chairman’s Health Board sponsored meeting at UTEC, Bismarck, North Dakota on Sept. 19, 2006. The purpose of the meeting was to encourage tribal colleges to incorporate public health research and themes into their curriculum. Our project to do this using a genetic epidemiology project at Turtle Mountain Community College was explained.
- Final planning was completed for our faculty development workshop. We hosted Marcia O’Leary, CEO of Missouri Breaks Industries Research Inc. of Timber Lake, South Dakota. This is “Buy Indian” corporation that is the grantee for the Strong Heart Study of cardiovascular disease, as well as a number of other NIH supported grants. Her presentation highlighted some of the opportunities for economic development available to tribes and tribal members. This was held Nov. 17, 2006.
Other Events of Significance
- We hosted about 25 students from Mr. Tony Vandal’s 8th grade class and spent a couple hours explaining our project and allowing them the experience of loading simulated DNA samples onto gels.
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