Effect of beta2-Adrenergic Receptor Polymorphism in Asthma Control of Patients Receiving Combination Treatment.
10.3349/ymj.2009.50.2.182
- Author:
Seung Hyun KIM
1
;
Young Min YE
;
Gyu Young HUR
;
Hyun Young LEE
;
Young Koo JEE
;
Seung Ho LEE
;
John W HOLLOWAY
;
Hae Sim PARK
Author Information
1. Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, Korea. hspark@ajou.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
beta2-adrenergic receptor polymorphism;
long-acting beta2-agonist;
bronchodilating effect
- MeSH:
Administration, Inhalation;
Adrenal Cortex Hormones/*administration & dosage;
Adrenergic beta-Agonists/*administration & dosage;
Adult;
Asthma/*drug therapy/*genetics;
Female;
Genotype;
Humans;
Male;
Middle Aged;
Receptors, Adrenergic, beta-2/*genetics;
Young Adult
- From:Yonsei Medical Journal
2009;50(2):182-188
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Combination treatment of inhaled corticosteroid (ICS) plus long-acting beta2-agonist (LABA) is widely used as a maintenance regimen for the management of asthma. This study evaluated the effect of the beta2-adrenergic receptor (ADRB2) polymorphism on lung function and asthma control with regular use of combination treatment of an inhaled ICS plus LABA. MATERIALS AND METHODS: 43 Korean asthmatics who were symptomatic despite regular ICS use for at least 3 months were enrolled. For a 2-week run-in period, they received ICS (budesonide 800 microgram/day) plus terbutaline (5 microgram prn). as needed. During the 24-week active treatment period, they received budesonide 160 microgram and formoterol 4.5 microgram b.i.d. as maintenance and rescue medication. Pulmonary function and quality of life scores were monitored every 8 weeks; morning/evening peak expiratory flow meter (PEFR) was recorded daily. Patients were genotyped for ADRB2 Arg16Gly using single base extension methodology. RESULTS: During the run-in period, there were no significant between-group differences in lung function; after 8 weeks of active treatment, Arg/Arg patients had significantly higher forced expiratory volume in 1 secord (FEV1) and maximal mid-expiratory flow (MMEF) (p = 0.023 and p = 0.021, respectively), and better asthma control and quality of life after 24 weeks (p = 0.016 and p = 0.028, respectively). During treatment, there was a greater improvement in morning/evening PEFR in Arg/Arg patients. CONCLUSION: Asthmatic patients with the Arg/Arg genotype at codon 16 of ADRB2 achieve better asthma control with long-term regular use of combined budesonide and formoterol treatment, suggesting that the ADRB2 genotype may dictate choice of treatment strategy.
