Moving beyond race and ethnicity to understand the effect of inhaled nitric oxide on bronchopulmonary dysplasia prevention

We read with interest the report by Askie et al.1 If a patient's genetic profile could be used to predict favorable responses to specific interventions, potential resulting benefits would include improved outcomes, lower costs, and decreased risk of unwanted side effects of unnecessary interventions. The authors conclude that "[inhaled nitric oxide] iNO therapy should be considered for preterm African American infants at high risk for [bronchopulmonary dysplasia] BPD. iNO to prevent BPD in African Americans may represent an example of a racially customized therapy for infants."1 We respectfully disagree; we do not believe this recommendation advances the goals of personalized medicine and targeted interventions, and feel it may lead to unintended consequences.

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