Pharmacogenomics of asthma / 国际儿科学杂志

ABSTRACT

The major medications in asthma management includes bronchodilating B2-agonists,anti-inflammatory inhaled corticosteroids,leukotriene modifiers and theophyllines.However,there is a high degree of heterogeneity in each patient response to asthma drugs.Studies show that much as 70％ of the range of individual variability might be due to genetic characteristics of each patient.Pharmacogenomics offers the possibility to optimize medications for individual asthmatics to promote efficacy and avoid side effect by means of genetic information.Bronchodilator reversibility and asthma exacerbations in patients taking β-agonists contiously have relationship with the Gly16Arg genotype for the ADRβ2.Moreover,genetic variation in β2-adrenergic receptor (Arg16Gly) may predict response to anticholinergics for the treatment of asthma.In case of inhaled corticosteroids,using a traditional SNP-based approach identified a gene for corticotropin releasing hormone receptor 1 as a potential marker of response.Variants in CRHR1,TBX21,and FCER2 are related with the variability in response for lung function,airways responsiveness,and exacerbations in patients taking inhaled corticosteroids.Another major pathway is the one underlying response to cysteinyl leukotriene receptor antagonist.Variants in ALOX5,LTA4H,LTC4S,ABCC1,CYSLTR2 and SLCO2B1 are associated with the variable responses to LTs.Pharmacogenomic method based on the individual genetic information will be introduced into an asthma treatment guideline and provide patients best individual treatments.