# Precision medicine for Asian Americans requiring anesthesia

> **NIH NIH R35** · STANFORD UNIVERSITY · 2024 · $74,319

## 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:** 11100361
- **Project number:** 3R35GM119522-09S3
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Eric Richard Gross
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $74,319
- **Award type:** 3
- **Project period:** 2016-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11100361

## Citation

> US National Institutes of Health, RePORTER application 11100361, Precision medicine for Asian Americans requiring anesthesia (3R35GM119522-09S3). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/11100361. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*