PostDoctoral Research Fellowship

这一博士后研究和培训补助金质疑“定制药物”的出现，因为医学科学专业人员、生物技术研究人员、制药规划战略家和普通公众不同程度地采用了特定人群生物差异的理论。本书将探讨“种族”在科学中的地位及其社会、生物、遗传和流行病学的有效性或无效性的持续混乱。以非洲裔美国人高血压和心力衰竭为例，该博士后资助的研究部分将包括对第一种名为BiDil的具有种族标志的药物的外观和合理性进行人种学、多地点研究。这种“非裔美国人药物”目前正在美国100多个临床地点进行为期两年的医学试验的第一年，由马萨诸塞州贝德福德的NitroMed公司生产。依靠多点实地调查的方法（Heath et al. 1999; Rapp 1999），我将在纽约地区的一个或多个试验点进行参与性观察，以了解医生和患者如何将“非洲裔美国人高血压”理解为与“高加索人”高血压不同的疾病。这方面的实地考察将补充参与观察和采访遗传学家研究SNP（单核苷酸多态性）作为生物学差异的标志物，对药物基因组学至关重要。关于表型特征是否可以在科学上掩盖一个人关于药物代谢酶的遗传构成的争论，最近在《新英格兰医学杂志》上把种族在科学中的使用提到了前面（Exner等人，2001年; Yancy等人，2001年），其中许多研究BiDilhave的人发表了关键论文，证明他们的全黑人研究是正确的，非裔美国人心力衰竭试验（Dries等人，1999; Exner等人，2001）。遗传学家在《自然遗传学》上发表文章，由于NEJM的争论，他们对种族作为遗传差异的替代标记提出了批评（2001年社论）。通过采访生物技术公司的发言人，这些公司致力于为药物基因组学目的绘制SNP图谱。在BiDil试验中，心脏病专家、高血压专家、黑人心脏病专家协会（ABC）成员、患者和患者倡导团体成员，我将记录种族和其他标记（如SNP）的部署，因为每一个标记都可能影响后基因组时代对差异、身份和健康的新的社会理解。这项博士后研究和培训奖学金将在纽约大学进行，由人类学高级教授Rayna Rapp赞助18个月，并在伦敦大学金匠学院与社会学教授Nikolas Rose合作6个月，既及时又中肯。药物基因组学领域刚刚兴起，而关于负责任地使用种族概念的问题-在生命科学和社会科学中都有选择地抵制-需要更详细的跨学科奖学金。该项目将建立在医学人类学和社会学研究人员的工作基础上，这些研究人员对各种社会和生物差异标记（如种族和疾病基因）的交叉感兴趣。它还将有助于研究有关疾病，身份，技术和市场的共同生产的科学的社会研究。

This post-doctoral research and training grant queries the emergence of "tailored medicine" as rationales of population-specific biological differences are varyingly taken up by professionals in the medical sciences, researchers in biotechnology, strategists in pharmaceutical planning and lay publics. The persistent confusion over the place of "race" in the sciences as well as its social, biological, genetic, and epidemiologicalvalidity, or invalidity, will be explored. Taking the example of African-American hypertension and heart failure, the research component of this postdoctoral grant will consist of an ethnographic, multi-sited study on the appearance of, and justification for, the first ethnically marked pharmaceutical drug called BiDil. This "African-American drug" is currently in its first year of a two-year medical trial at over 100 clinical sites in the U.S. and is produced by Bedford, MA based NitroMed, Inc. Relying on methods of multi-sited fieldwork (Heath et al. 1999; Rapp 1999), I will conduct participant observation at one or more trial sites in the New York area to learn how both doctors and patients understand "African-American hypertension" as a different disease than that of its "Caucasian" counterpart. This aspect of the fieldwork will be complemented by participant observation and interviews with geneticists researching SNPs (single nucleotide polymorphisms) as markers of biological difference crucial to pharmacogenomics. The controversy over whether or not phenotypic traits can scientifically belie one' genetic constitution regarding drug metabolizing enzymes has recently brought the usage of race in science to the fore in The New England Journal of Medicine (Exner et al. 2001; Yancy et al. 2001) where many of those working on BiDilhave published key papers justifying their all Black study, The African-American Heart Failure Trial (Dries et al. 1999; Exner et al. 2001). Geneticists publishing in Nature Genetics have upped their criticism of race as a surrogate marker for genetic difference due to the NEJM debates (Editorial 2001). By interviewing spokespeople for biotechnology companies working on SNP mapping for pharmacogenomics purposes,scientific advisors on NitroMed, Inc.'s BiDil trial, cardiologists, hypertension specialists, members of the Association of Black Cardiologists (ABC), patients, and patient advocate group members, I will chronicle the deployment of race and other markers (such as SNPs) as each potentially inflect new social understandings of difference, identity, and health in the post-genomic age. This Postdoctoral Research and Training Fellowship, to be carried out at New York University under the sponsorship of senior Professor of Anthropology Rayna Rapp for 18 months, and at the University of London, Goldsmith College with Professor of Sociology Nikolas Rose for 6 months, is both timely and pertinent. The field of pharmacogenomics is just emerging, while questions on the responsible use of the concept of race --selectively resisted in both the life and socialsciences--demand more detailed interdisciplinary scholarship. This project will build upon the work of researchers in medical anthropology and sociology interested in the intersection of various social and biological markers of difference, such as ethnicity and disease genes. It will furthermore contribute to research in the social studies of science concerned with the co-production of disease, identity, technology, and market.