An Army veteran from Montgomery, Ala., recently became the 500,000th person to voluntarily enroll in the Department of Veterans Affairs’ Million Veteran Program (MVP), which the VA claims makes MVP the largest genomic database in the world.
MVP is funded entirely by the VA’s Office of Research & Development. Its goal is to partner with veterans receiving their care in the VA Healthcare System to study how genes affect health.
Launched in 2011 and part of the White House Precision Medicine Initiative, MVP’s participants donate blood from which DNA is extracted. A baseline and periodic follow-up surveys track veterans’ military experiences, health and lifestyles. Researchers believe the information contained in the database could hold the key to preventing and treating diseases.
Speaking at the White House on Feb. 25, 2016, President Obama said, “Our Precision Medicine Initiative has been designed to get all these various building blocks brought together so that the whole is greater than the sum of its parts. So that, for example, the VA — which has been gathering genomic data on a large number of our men and women who have served this country in order to serve them better within the VA system — can make them connect with researchers at a particular university who are focused on a particular disease, and can we use big data to accelerate the research process much more rapidly.”
As part of the program, participating veterans grant researchers secure access to their electronic health records and agree to be contacted about participating in future research. Samples and data used are coded to protect participants’ identification and privacy, the VA said. Approximately 62 percent of MVP enrollees report a current or past diagnosis of high blood pressure and about a third report tinnitus. Also, nearly a third or 32 percent of Veterans present with a history or current diagnosis of cancer.
Last year the VA announced four studies that will use genetic and other data from MVP to answer key questions on heart disease, kidney disease, and substance use—high-priority conditions affecting veterans.
The studies, involving consortiums of VA researchers and university colleagues, are exploring specific questions related to chronic illnesses common among veterans. They are also helping establish new methods for securely linking MVP data with other sources of health information, including non-VA sources such as the Centers for Medicaid and Medicare Services.
The studies include the following:
Cardiovascular risk factors—Drs. Farooq Amin and Peter Wilson at the Atlanta VA Medical Center, and Dr. Kelly Cho at the Boston VA Health Care System are leading an effort probing the genes that influence how obesity and lipid levels affect heart risk. Using MVP data, their team is also looking at whether these genetic factors differ among African Americans and Hispanics.
Multi-substance use—Drs. Daniel Federman and Amy Justice at the VA Connecticut Healthcare System, and Dr. Henry Kranzler at the Philadelphia VA Medical Center are examining the genetic risk factors for chronic use of alcohol, tobacco, and opioids—and the dangerous use of all three together.
Pharmacogenomics of kidney disease—Dr. Adriana Hung at the VA Tennessee Valley Healthcare System is focusing on how genes affect the risk and progression of kidney disease. One goal is to examine how patients with diabetes—who often develop kidney problems—respond differently to the drug metformin, the standard first-line treatment for diabetes, based on their genetic profile. The project will also look at the genetics of hypertension, a major risk factor for kidney disease.
Metabolic conditions—Dr. Philip Tsao at the VA Palo Alto Health Care System and Dr. Kyong-Mi Chang at the Philadelphia VA Medical Center are leading a team of researchers from five VA regions and two universities exploring the role of genetics in obesity, diabetes, and abnormal lipid levels (namely, cholesterol and triglycerides), as drivers of heart disease.