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Effect of beta2-adrenergic receptor polymorphism in asthma control of patients receiving combination treatment.

Authors
Kim, SH; Ye, YM; Hur, GY; Lee, HY; Jee, YK; Lee, SH; Holloway, JW; Park, HS
Citation
Yonsei medical journal, 50(2):182-188, 2009
Journal Title
Yonsei medical journal
ISSN
0513-57961976-2437
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 microg/day) plus terbutaline (5 microg prn). as needed. During the 24-week active treatment period, they received budesonide 160 microg and formoterol 4.5 microg 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 (FEV(1)) 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.
MeSH terms
Administration, InhalationAdrenal Cortex Hormones/administration & dosage*Adrenergic beta-Agonists/administration & dosage*AdultAsthma/drug therapy*Asthma/genetics*FemaleGenotypeHumansMaleMiddle AgedReceptors, Adrenergic, beta-2/genetics*Young Adult
DOI
10.3349/ymj.2009.50.2.182
PMID
19430548
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
Journal Papers > Research Organization > Regional Clinical Trial Center
AJOU Authors
김승현예영민박해심
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