Asthma steroid pharmacogenetics: a study strategy to identify replicated treatment responses

Proc Am Thorac Soc. 2004;1(4):364-7. doi: 10.1513/pats.200409-043MS.

Abstract

Asthma treatment with inhaled steroids demonstrates significant between-person variability. Genetic variation could contribute to this response to inhaled glucocorticosteroids. Difficulties in performing genetic association studies are well known. We designed a test and validation strategy to assess steroid pathway candidate genes. One hundred thirty-one single nucleotide polymorphisms in 14 candidate genes in the steroid pathway were genotyped in an 8-week clinical trial of 470 adults with moderate to severe asthma. We then validated our findings in a second population of individuals with childhood asthma in a 4-year clinical trial of inhaled corticosteroids and a third population of adults with asthma. One gene, corticotrophin-releasing hormone receptor 1 (CRHR1, NM_004382), demonstrated multiple single nucleotide polymorphism associations within each of the three populations. The approach of a test and multiple replication populations is a valuable strategy in asthma pharmacogenetics, which can insure valid association findings.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / genetics*
  • Adult
  • Aged
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / genetics*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Fluocinolone Acetonide / administration & dosage
  • Fluocinolone Acetonide / analogs & derivatives*
  • Genetic Variation
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Pharmacogenetics
  • Respiratory Function Tests
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Fluocinolone Acetonide
  • flunisolide