Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma

哮喘 医学 支气管扩张剂 非洲裔美国人 基因分型 皮质类固醇 吸入性皮质类固醇 慢性阻塞性肺病 内科学 儿科 基因型 民族学 生物化学 历史 基因 化学
作者
Wendy Gould,Edward L. Peterson,Gloria Karungi,Amanda Zoratti,John Gaggin,Ghazwan Toma,Shiqing Yan,Albert M. Levin,James J. Yang,Karen Wells,Mingqun Wang,Robert R. Burke,Kenneth B. Beckman,Danijela Popadic,Susan Land,Rajesh Kumar,Max A. Seibold,David E. Lanfear,Esteban G. Burchard,L. Keoki Williams
出处
期刊:The Journal of Allergy and Clinical Immunology [Elsevier BV]
卷期号:126 (6): 1131-1138 被引量:39
标识
DOI:10.1016/j.jaci.2010.08.002
摘要

African American patients disproportionately experience uncontrolled asthma. Treatment with an inhaled corticosteroid (ICS) is considered first-line therapy for persistent asthma.We sought to determine the degree to which African American patients respond to ICS medication and whether the level of response is influenced by other factors, including genetic ancestry.Patients aged 12 to 56 years who received care from a large health system in southeast Michigan and who resided in Detroit were recruited to participate if they had a diagnosis of asthma. Patients were treated with 6 weeks of inhaled beclomethasone dipropionate, and pulmonary function was remeasured after treatment. Ancestry was determined by genotyping ancestry-informative markers. The main outcome measure was ICS responsiveness defined as the change in prebronchodilator FEV(1) over the 6-week course of treatment.Among 147 participating African American patients with asthma, average improvement in FEV(1) after 6 weeks of ICS treatment was 11.6%. The mean proportion of African ancestry in this group was 78.4%. The degree of baseline bronchodilator reversibility was the only factor consistently associated with ICS responsiveness, as measured by both an improvement in FEV(1) and patient-reported asthma control (P = .001 and P = .021, respectively). The proportion of African ancestry was not significantly associated with ICS responsiveness.Although baseline pulmonary function parameters appear to be associated with the likelihood to respond to ICS treatment, the proportion of genetic African ancestry does not. This study suggests that genetic ancestry might not contribute to differences in ICS controller response among African American patients with asthma.
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