Pharmacogenomic variabilities in geo-ancestral subpopulations and their clinical implications: Results of collaborations with Hmong in the United States

Boguang Sun, Ya Feng Wen, Kathleen A. Culhane-Pera, Muaj Lo, Robert J. Straka

Research output: Contribution to journalShort surveypeer-review

3 Scopus citations


Underrepresentation of subpopulations within geo-ancestral groups engaged in research can exacerbate health disparities and impair progress toward personalized medicine. This is particularly important when implementing pharmacogenomics which uses genomic-based sources of variability to guide medication selection and dosing. This mini-review focuses on pharmacogenomic findings with Hmong in the United States and their potential clinical implications. By actively engaging Hmong community in pharmacogenomic-based research, several clinically relevant differences in allele frequencies were observed within key pharmacogenes such as CYP2C9 and CYP2C19 in Hmong compared to those in either East Asians or Europeans. Additionally, using state-of-the-art genome sequencing approaches, Hmong appear to possess novel genetic variants within CYP2D6, a critical pharmacogene affecting pharmacokinetics of a broad range of medications. The allele frequency differences and novel alleles in Hmong have translational impact and real-world clinical consequences. For example, Hmong patients exhibited a lower warfarin stable dose requirement compared to East Asian patients. This was predicted based on Hmong’s unique genetic and non-genetic factors and confirmed using real-world data from clinical practice settings. By presenting evidence of the genetic uniqueness and its translational impact within subpopulations, such as the Hmong, we hope to inspire greater inclusion of other geo-ancestrally underrepresented subpopulations in pharmacogenomic-based research.

Original languageEnglish (US)
Article number1070236
JournalFrontiers in Genetics
StatePublished - Jan 4 2023

Bibliographical note

Funding Information:
We gratefully acknowledge Hmong community members and organizations for their participation in pharmacogenomics research over the years.

Publisher Copyright:
Copyright © 2023 Sun, Wen, Culhane-Pera, Lo and Straka.


  • Asian American
  • Hmong
  • community-based participatory research
  • health disparities
  • minority health
  • personalized medicine
  • pharmacogenomics

PubMed: MeSH publication types

  • Journal Article
  • Review


Dive into the research topics of 'Pharmacogenomic variabilities in geo-ancestral subpopulations and their clinical implications: Results of collaborations with Hmong in the United States'. Together they form a unique fingerprint.

Cite this