A groundbreaking study led by researchers at Singapore’s A*Star Genome Institute has uncovered significant immune system variations among different Asian ethnicities, challenging the one-size-fits-all approach to medical diagnostics and treatments. The research, which analyzed over 1.2 million immune cells from 625 healthy donors across Singapore, Thailand, South Korea, Japan, and India, suggests that ethnicity plays as critical a role as gender in shaping biological responses. Published in the scientific journal Cell in March 2025, the findings could pave the way for more personalized healthcare strategies tailored to Asia’s diverse populations.
Unveiling the Asian Immune Diversity Atlas
The Asian Immune Diversity Atlas (Aida), as the project is named, represents a landmark effort to map out immune cell profiles across five Asian nations. Spearheaded by Dr. Shyam Prabhakar, associate director at A*Star GIS’ Single Cell & Spatial Technologies, the study highlights what he describes as “massive differences” in immune-related blood markers among ethnic groups. Collaborating with researchers from South Korea, Japan, Thailand, and India, the team meticulously examined blood samples to create a comprehensive dataset that reveals how immune responses vary not just between countries but also among ethnic subgroups within them. 
Dr. Prabhakar emphasized the historical bias in biomedical research, which has predominantly focused on European populations. “Diagnostic approaches developed based on such data often do not translate accurately for other ethnicities, like Asians” he said. The revelation that immune differences between Asian ethnicities can be as pronounced as those between men and women was, in his words, “really shocking.” He argues that just as gender diversity is considered essential in drug trials, ethnicity must now be factored into medical research and clinical applications.
Ethnic Variations and Medical Implications
One of the study’s key findings centers on specific immune cells, such as CD4+ T naive cells, which are indicators of inflammation linked to aging. The research revealed that age impacts these cells differently among Chinese, Malay, and Indian Singaporeans. This disparity suggests that as individuals from these groups age, their risks for inflammation-related diseases may diverge, necessitating distinct screening and prevention strategies. For instance, a standard inflammation test might yield different baseline results for a Malay individual compared to an Indian one, even if both are of the same age and overall health status.
Similarly, the study found significant variations in healthy immune reference ranges across countries and ethnicities when it comes to blood tests used to detect infectious diseases or serious conditions like leukemia. These tests typically measure the proportions of white blood cells, such as lymphocytes and monocytes, to diagnose patients. However, what is considered “normal” for one ethnic group may not apply to another, potentially leading to misdiagnoses if universal standards are applied without adjustment. Dr. Prabhakar noted that while the Aida study has established these biological differences, further research is needed to refine diagnostic criteria and adapt them to specific populations.
Addressing a Long-Standing Gap in Research
For decades, the global biomedical community has relied heavily on data derived from Western cohorts, often overlooking the genetic and environmental diversity of other regions. This Eurocentric focus has resulted in diagnostic tools and treatments that may be less effective or even misleading when applied to non-European populations. The Aida project seeks to address this gap by providing a detailed immunological blueprint for Asians, who represent a significant portion of the world’s population yet remain underrepresented in medical research.
The implications of this oversight are profound. Drug trials conducted on a single ethnic group, for example, may produce results that do not hold true for others. “You cannot do your drug trial on one ethnicity and say that the results apply to all” Dr. Prabhakar warned. His team’s findings underscore the need for inclusive research practices that account for Asia’s ethnic mosaic, from the Han Chinese to the Tamil communities of South India, each potentially exhibiting unique immune profiles shaped by genetics, diet, and environment.
Future Directions for Personalized Medicine
Looking ahead, the A*Star team plans to expand their research beyond immune cells to other organs, including the skin, colon, and gastric system, with a particular focus on Singapore’s multi-ethnic population. They also aim to investigate how ethnic differences might influence susceptibility to chronic conditions like diabetes, which disproportionately affects certain Asian groups. By mapping these variations, researchers hope to develop predictive models that identify at-risk individuals more accurately, enabling early interventions that could mitigate disease progression.
“Knowing disease risk is our best way of reducing healthcare costs” Dr. Prabhakar explained. “If you know accurately who’s at high risk, then you can prioritize the person and get them to come into the clinic more often. Early detection is the best way of curing and reducing healthcare costs.” This vision of personalized medicine, tailored not just to an individual’s genetic makeup but also to their ethnic background, could transform healthcare delivery in Asia, where diverse populations often face unique health challenges.
Challenges and Opportunities Ahead
While the Aida study marks a significant step forward, it also raises complex questions about implementation. Developing ethnicity-specific diagnostic tools and treatment protocols will require substantial investment, international collaboration, and regulatory frameworks that balance innovation with equity. There is also the challenge of ensuring that such advancements do not inadvertently deepen existing disparities, particularly in countries where access to healthcare varies widely between urban and rural areas or across socioeconomic lines.
Moreover, the study’s findings, set to be presented at the 2025 Human Cell Atlas General Meeting in Singapore from June 9 to 11, are likely to spark broader discussions within the global scientific community. How can researchers ensure that ethnicity-based medical approaches do not lead to stigmatization or discrimination? And how can data from projects like Aida be integrated into public health systems across Asia, many of which are already strained by resource constraints?
A New Era for Asian Healthcare?
The Asian Immune Diversity Atlas is more than a scientific achievement; it is a call to rethink how medicine is practiced in one of the world’s most diverse regions. As researchers continue to unravel the biological intricacies of Asian populations, the hope is that healthcare will become not only more precise but also more equitable. For now, the study serves as a reminder that diversity—whether in ethnicity, culture, or biology—must be at the heart of medical innovation.
As the A*Star team pushes forward with their ambitious research agenda, questions linger about how quickly these insights can be translated into tangible benefits for patients. Will Asia’s healthcare systems rise to the challenge of embracing personalized medicine, or will systemic barriers slow progress? Only time will tell, but the foundation laid by this landmark study offers a promising start.
