# Precision medicine for Asian Americans requiring anesthesia

> **NIH NIH R35** · STANFORD UNIVERSITY · 2023 · $435,563

## Abstract

PROJECT SUMMARY:
Nearly 40 million people in the United States annually are provided anesthesia for surgery. Reactive
aldehydes, produced during surgery, are toxic metabolites which drive cellular dysfunction and end organ
damage. For Asian Americans that are descents from East Asia a genetic variant (present in nearly 540
million people in the world) severely limits reactive aldehyde metabolism. Besides inefficient reactive aldehyde
metabolism, several other genetic differences occur for Asians within the lipid peroxidation pathway; a pathway
which regulates damage that occurs during organ injury. As mortality following surgery is the third leading
cause of death in the United States, with organ injury a major cause of this mortality, understanding how these
genetic differences in Asians may alter lipid peroxidation-induced organ damage could unlock novel treatment
strategies for all ethnicities to reduce organ injury occurring during surgery.
For this MIRA program, we will study the genetic differences existing within the lipid peroxidation pathway for
Asians, including the genetic variant which causes inefficient reactive aldehyde metabolism and the impact on
organ injury. To carry out these studies, we generated tools to study reactive aldehydes in the basic science
laboratory including a knock-in mouse model to reflect the human genetic variant that causes inefficient
reactive aldehyde metabolism and sensitive assays to detect reactive aldehydes. We will use these tools to
examine whether an analgesic given during surgery exacerbates cellular injury for rodents with inefficient
aldehyde metabolism. Further, we will also study how reactive aldehydes may impact a transient receptor
potential channel to trigger organ injury. We also expanded these aldehyde tools by developing non-invasive
methods to assess reactive aldehyde levels in humans and methods to identify phenotypes for inefficient
reactive aldehyde metabolism. We plan to use these tools in humans undergoing surgery to identify people
with inefficient reactive aldehyde metabolism and monitor their aldehyde levels during surgery in real-time.
Asian Americans are one of the fastest growing populations in the United States and are projected to reach
nearly 34 million by the year 2050. Asian Americans will require specific anesthetic plans for surgeries due to
genetic differences in the lipid peroxidation pathway, including genetics which cause inefficient reactive
aldehyde metabolism. Providing precision medical care for people who require surgery with this genetic
variant will ultimately reduce health care costs and improve quality of care for a large subset of Asian
Americans. As we describe here, studying genetic differences can also provide insight into biological
mechanisms and unlock novel strategies that can impact medical care for people of all ethnicities.

## Key facts

- **NIH application ID:** 10620647
- **Project number:** 5R35GM119522-08
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Eric Richard Gross
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $435,563
- **Award type:** 5
- **Project period:** 2016-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10620647

## Citation

> US National Institutes of Health, RePORTER application 10620647, Precision medicine for Asian Americans requiring anesthesia (5R35GM119522-08). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10620647. Licensed CC0.

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