- Bronchial asthma emergency treatment in children including clinical aspects and gene polymorphism β2-adrenergic receptors
Bronchial asthma emergency treatment in children including clinical aspects and gene polymorphism β2-adrenergic receptors
SOVREMENNAYA PEDIATRIYA.2016.8(80):65-69; doi 10.15574/SP.2016.80.65
Bronchial asthma emergency treatment in children including clinical aspects and gene polymorphism β2-adrenergic receptors
Banadyha N. V., Voloshyn S. B.
SHEI «Ternopil State Medical University by I.Ya. Horbachevsky Ministry of Health of Ukraine»
The purpose of the study: to explore the features of genes polymorphism Arg16Gly and β2-adrenoceptor in children with different clinical variants of bronchial asthma.
Patients and methods. It was performed a detailed clinical and instrumental examination and molecular genetic examination of 101 children with bronchial asthma (BA) who were admitted to hospitals. Genotyping Arg16Gly of β2-adrenoceptor gene was performed by isolating genomic DNA by PCR method.
Results. According to patient's examination results, 29 of them (28.71%) had an intermittent course of bronchial asthma, 72 patients (71.29%) — had a persistent course. In-depth study of the disease anamnesis defined that the bronchial obstruction syndrome was first debuted almost in half of the patients (45.54%) already in their early childhood. In 30 patients (29.70%) the first symptoms were diagnosed at preschool age and only in 25 patients (24.76%) broncho-obstructive syndrome manifested in primary school age. The further conducted analysis showed that 71 patients (70.30%) had a burdened genetic anamnesis. Exploring the differences between genotype polymorphism of the gene Arg16Gly ADR β2-receptors and their impact on the severity of bronchial asthma it was found the prevalence of Gly16Gly homozygous variant (55.17%) at the intermittent flow, while at the persistent flow prevailed Arg16Gly gene genotype of ADRβ2-receptor. The comparison of efficacy of drugs emergency treatment during bronchial asthma attack determined that the patients with genotype Arg16Gly gene of ADRβ2-receptors had better reaction for salbutamol, as emergency treatment drug, whereas for children with genotype Gly16Gly more effective was combined bronchodilator medication.
Conclusions. Using molecular genetics analysis was found that the genotype ADRβ22-receptor has an influence on the occurrence, severity of asthma in children, and identifies a group of patients (genotype Gly16Gly), in which the sensitivity of β2-receptors to drugs of fast action, such as β2-agonists short acting is rapidly depleted.
Key words: bronchial asthma, gene polymorphism, β2-adrenergic receptors, children.
References
1. Leshchenko IV, Lezhnina MB. 2009. Vozmozhnosti kontrolya BA na sovremennom urovne. Aktual'nye problemy. I. V. Leshchenko, Consilium medicum. Ekstravypusk: 2–5.
2. Petrovskiy VF, Ogorodova LM. 2008. Vybor farmakoterapii tyazheloy BA. Pul'monologiya. 3: 84–89.
3. Naka I, Hikami K, Nakayama K et al. 2013. A functional SNP upstream of the beta-2 adrenergic receptor gene (ADRB2) is associated with obesity in Oceanic populations. International Journal of Obesity. 37(9): 1204-1210. https://doi.org/10.1038/ijo.2012.206; PMid:23229733 PMCid:PMC3768098
4. Yelensky R, Li Y, Lewitzky S et al. 2012. A pharmacogenetic study of ADRB2 polymorphisms and indacaterol response in COPD patients. Pharmacogenomics Journal. 12: 484-488. https://doi.org/10.1038/tpj.2011.54; PMid:22158330
5. Bleecker ER, Meyers DA, Bailey WC et al. 2012. ADRB2 Polymorphisms and Budesonide/Formoterol Responses in COPD. Chest. 142(2): 320–328. https://doi.org/10.1378/chest.11-1655; PMid:22383665 PMCid:PMC3425335
6. De Paiva ACZ, De Lima Marson FA, Ribeiro JD, Bertuzzo CS 2014. Asthma: Gln27Glu and Arg16Gly polymorphisms of the beta2factors. 10(1): 8.
7. Bleecker ER, Postma DS, Lawrance RM et al. 2007. Effect of ADRB2 polymorphisms on response to longacting β2-agonist therapy: a pharmacogenetic analysis of two randomised studies. Lancet. 370(9605): 2118–2125. https://doi.org/10.1016/s0140-6736(07)61906-0
8. Rabe KF, Fabbri LM, Israel E et al. 2014. Effect of ADRB2 polymorphisms on the efficacy of salmeterol and tiotropium in preventing COPD exacerbations: a prespecified substudy of the POET-COPD trial. Lancet Respiratory Medicine. 2(1): 44-53. https://doi.org/10.1016/S2213-2600(13)70248-0
9. Thomsen M, Nordestgaard BG, Sethi AA et al. 2012. β2-adrenergic receptor polymorphisms, asthma and COPD: two large population based studies. European Respiratory Journal. 39(3): 558–566. https://doi.org/10.1183/09031936.00023511; PMid:22075484