• Approximately 50% of the North American population are slow acetylators, lacking a functional acetyltransferase in plasma and so are at an increased risk of potentially serious side effects from medications including general anesthesia, anti-tuberculosis treatment, local anesthetics and other medications. Only 5 -10% of those of Asian descent share this genotype. Fast acetylators, the dominant trait, predominate among the Inuit and Japanese, while the slow phenotype is more common among Scandinavians, Jews and North African caucasians. It has been suggested that slow acetylators are also at increased risk of bladder cancer, and fast acetylators are at higher risk of colo-rectal cancer.
  
• The alcohol degradative pathway has human polymorphisms in both alcohol dehydrogenase and acetaldehyde dehydrogenase. About 50% of Asians have an inactive ALDH, and experience toxic reactions to the ingestion of alcohol, including headache, nausea, vomiting, and hypotension.
  
• A common genetic polymorphism of drug metabolism shows as a mutation in the cytochrome P450 2D6 gene, and people with this gene lack the ability to adequately metabolize substrates of this enzyme. This genetic mutation has an incidence of about 5-10% in the North American white population, and 1% in the Asian population. Substrates of this enzyme include some of the more commonly used opiates and blood pressure medications. And cytochrorne 2C19 activity is absent in 20% of Asians and 3-5% of whites, affecting the ability of patients to metabolize the frequently prescribed omeprazole.
  
• Functional immune diversity is receiving increasing attention, and specific genetic markers correlated with decreased immune surveillance are being characterized. This includes about 25% of the population lacking a mannose-binding lectin, which may increase their risk of contracting some viral upper respiratory infections (Koch, et al. (2001) JAMA 285: 1316-1321).

All of these genetic polymorphisms can be easily detected using current techniques, and could significantly alter a patient's course of treatment. However, these analyses are rarely used, due in part to the currently prohibitive cost of such tests, and in part to the lack of familiarity on the part of the public and the medical community with their meaning and value.

The genetic heterogeneity of tumors is commonly assessed in order to predict prognosis for the patient. It may soon be possible to design specific therapies for each individual tumor based upon specific genetic markers. It is likely that the use of other genetic markers will become more common in the future, as individualized patient therapy becomes an accepted practice.

The intermeshing of genomics, pharmocogenetics, and microbiology with naturopathic principals of diet and lifestyle modification, therapeutic nutrition, botanical medicine and homeopathy will maximally benefit patient health. Utilizing the College's resources - a talented, committed and flexible faculty, dedicated, experienced clinicians, a growing and diverse patient population, laboratory and medical facilities and an emerging research program, the Institute will explore and promote the role of genetic polymorphisms in human health. We will further expand our pool of expertise in diverse populations and create a dynamic collaboration of science and medicine by working with other institutions. These will include: the Veterans Administration Medical Center, Arizona State University, the county health centers - Maricopa Integrative Health Systems and Springdale Village (one of the Valley's largest and most progressive nursing homes and intermediate care facilities.