Genetic predictors of response to therapy in childhood asthma

Asthma is a common chronic condition in children, where the response to treatment can be heterogeneous within a population. Genetic variations may partly explain the inconsistent response to asthma treatment between individuals. There is a relatively small but consistent body of literature linking genetic variations to improved response to different classes of asthma treatment, including short- and long-acting beta-agonists, corticosteroids, and leukotriene modifiers. In most cases, the advantage conferred by a single genetic mutation for treatment response is relatively small; the Arg16Gly single nucleotide polymorphism of the beta2-adrenoceptor is the exception to this rule and is associated with a marked difference in response to short-acting beta-agonists. Pharmacogenetic studies have only recently been undertaken in asthmatic individuals, and much more work is required before clinical applications arise. Future genome-wide association (GWA) studies and randomized controlled trials in genetically susceptible populations will determine whether asthma treatment can be tailored to an individual based on their DNA. The aim of the present paper is to review pharmacogenetic studies concerning asthma medications, with a primary focus on studies involving children.