Milwaukee veterans participate in national groundbreaking genetic study
Meg Jones
Almost two decades ago Jonathan Brewer stuck out his hand and recited an oath to join America's military.
On Thursday, Brewer again extended his hand, this time to donate enough blood to fill a tiny vial, about two tablespoons. In a way, Brewer is continuing to protect and defend. This time, he's helping his fellow veterans.
Brewer was among a few dozen veterans who stopped at a display for the Million Veteran Program set up at the south entrance of the Zablocki Veterans Affairs Medical Center. The groundbreaking research project is collecting blood and biographical information, including family, health and employment histories.
Scientists are hoping to use the genetic information from Brewer and 1 million other American military veterans to study diabetes, cancer and other illnesses and understand how genes affect health.
Researchers know that health studies require a large number of volunteers, but it's often very difficult to find enough people to participate. And once the study is over, other researchers have to start the process over to find another sizable group of participants.
It turns out that veterans are the perfect study group because their decades-long health records, including lab tests, prescriptions and X-rays, are easily accessible throughout the VA medical system. They're folks who already volunteered to serve the nation and they tend to continue to volunteer after they leave the military.
"If you look at any other health care system, people hop from one (clinic) to another depending on their benefits," said Suma Muralidhar, a physician and director of the Million Veteran Program.
"With veterans, it's a stable population. Plus, they're altruistic. They look at this as another opportunity to serve the country. And because they're in the system so long we can follow them longitudinally."
Attempting to find links between diseases and genes is not new — scientists have researched that for decades. But often their studies were disappointing because they didn't have DNA from enough people.
The Million Veteran Program aims to remedy that problem. Started in 2011, the program has now signed up more than 630,000 veterans, including at least 14,000 at the Milwaukee VA hospital, one of 65 sites collecting blood and biographical information.
"Why this is groundbreaking is the scale — 1 million people," said Jeff Whittle, local site investigator at the Milwaukee VA for the program. "No other large group of people in a genetic cohort are primarily veterans who have been exposed to environmental stressors."
Noting the fact stress can cause changes in genes, Whittle said the stressors veterans have undergone are unique including combat and exposure to depleted uranium or Agent Orange.
The hope is to gather 1 million genetic samples by 2020 or 2021.
But researchers aren't waiting until then to start their studies. Muralidhar said 20 different research projects are in the pipeline, with eight that have already launched, and more waiting to start.
Among them are studies on mental health issues affecting veterans, including post-traumatic stress disorder, schizophrenia, bipolar depression and substance abuse. Also, studies on chronic kidney and heart disease, age-related macular degeneration and diabetes as well as breast cancer and tinnitus, the ringing in ears experienced by many veterans exposed to bomb blasts.
Whittle anticipates that in the next few years VA researchers affiliated with the Medical College of Wisconsin will use the veterans' sequenced DNA to study cancer, heart arrhythmia and bone metabolism.
Although the test subjects are veterans, the knowledge gained will help everyone, said Muralidhar.
"Research is such an important part of all health care. We want to bring the best and latest health care to the bedside," Muralidhar said.
Because the American veteran population of 8.7 million is mostly male, the biorepository of genetic profiles also skews male and that may affect studies, Muralidhar admitted, which is why organizers are trying to get more female veterans to participate. Roughly 8% of Million Veteran Program participants are female. Aside from gender, though, the program is one of the most diverse genetic collections in the world — 17% African-American, 7% Hispanic and 2% American Indian.
The program is open only to veterans already enrolled in the VA health care system. And that means few young veterans have participated. Muralidhar said a pilot program has started to begin enrolling current service members.
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Bill Olcott, 71, a volunteer who helps people sign up for the Million Veteran Program at VA clinics in Appleton and Green Bay, said participants are usually shown a short video first to explain how the program works.
"They have concerns about DNA analysis and do they have access to it. The answer is no. They ask if their employer will have access and we tell them there's no way to track it," said Olcott, an Army cartographer who spent a year in Vietnam and a program participant.
DNA profiles do not become part of the veterans' health records, and researchers who use the information don't have access to volunteers' identities.
After Brewer walked by the Million Veteran Program display Thursday and agreed to participate, LeAnne Pomeroy, an Air Force veteran who has donated her DNA, asked him a few questions and explained the procedure. She gave him a questionnaire and postage-paid envelope to fill out later and told Brewer he would be contacted for a follow-up survey.
Brewer, 40, a Navy veteran, clenched his fist as Pomeroy inserted the needle and said, "When I saw the program, I was interested in what it was. I was gung-ho."
Veterans already enrolled in the VA health care system can volunteer for the Million Veteran Program in Room 5425 at the Zablocki Veterans Affairs Medical Center, 5000 W. National Ave., from 8 a.m. to 3 p.m. Monday through Thursday and 8 a.m. to 2 p.m. Fridays. For more information go to research.va.gov/mvp/ or call (866) 441-6075.