# Precision medicine for Asian Americans requiring anesthesia

> **NIH NIH R35** · STANFORD UNIVERSITY · 2020 · $367,069

## Abstract

PROJECT SUMMARY
Greater than 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 descendants from East Asia, a genetic variant (present in 8% of the
world population) severely limits reactive aldehyde metabolism. The goal for my program is to develop specific
treatment strategies (precision anesthesia) for Asian Americans that cannot efficiently metabolize reactive
aldehydes in order to reduce reactive aldehyde toxicity during surgery.
For this MIRA proposal, I will initially focus on determining in the basic science laboratory methods to reduce
injury from reactive aldehydes, particularly for this genetic variant, by using models of cardiac ischemia-
reperfusion injury. This is my area of expertise, as I am an anesthesiologist with over a decade of basic
science training studying mechanisms of anesthetic-, analgesic- and remote conditioning-induced protection
from cardiac ischemia-reperfusion injury. To carry out these studies, we generated tools to study reactive
aldehydes including a knock-in mouse model to reflect the human genetic variant and sensitive assays to
detect reactive aldehydes. From my preliminary data, we have 3 possible strategies to test in order to reduce
reactive aldehyde-induced organ damage for this genetic variant. We will also determine how reactive
aldehyde generation and metabolism contribute to anesthetic mechanisms of cardiac protection and the cross-
talk that may occur between anesthetics and remote conditioning. Broadly, my program will provide targets,
treatments, and models to study reactive aldehydes; discovering strategies to reduce aldehydes and cellular
injury during surgery.
Asian Americans will require specific anesthetic plans for surgeries particularly due to this genetic variant
decreasing their ability to metabolize reactive aldehydes. Besides reactive aldehyde metabolism, this variant
also has an important role in drug metabolism (in particular for nitroglycerin) and pain control. 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 this large subset of Asian Americans.

## Key facts

- **NIH application ID:** 9929010
- **Project number:** 5R35GM119522-05
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Eric Richard Gross
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $367,069
- **Award type:** 5
- **Project period:** 2016-08-01 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9929010

## Citation

> US National Institutes of Health, RePORTER application 9929010, Precision medicine for Asian Americans requiring anesthesia (5R35GM119522-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9929010. Licensed CC0.

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