ADRB2多态对长效β2激剂治疗反应的影响:对两项随机化研究的药物遗传学分析
Eugene R Bleecker1, Dirkje S Postma, Rachael M Lawrance
1Center for Human Genomics, Wake Forest University School of Medicine, Winston-Salem, NC, USA. ebleeck@wfubmc.edu
Lancet (London, England)
|December 25, 2007
概括
具有特定β2-上腺素受体 (ADRB2) 基因变异的喘患者仍然可以从吸入性皮质类固醇和长效β2-激动剂中受益. 这项研究没有发现ADRB2多形态对喘患者治疗反应的药物遗传效应.
科学领域:
- 药物遗传学 药物遗传学
- 呼吸系统医学 呼吸系统医学
- 遗传学 是一个遗传学.
背景情况:
- 新出现的证据表明,喘患者对beta2-adrenergic受体 (ADRB2) 的氨基酸16的氨酸具有同位性,可能不会对长期作用的β2-agonist疗法做出有效反应.
- 这项研究旨在调查ADRB2基因多态化对长效β2-激动剂的治疗反应的影响,当与吸入性皮质类固醇一起使用时.
研究的目的:
- 确定ADRB2多态是否影响吸入性皮质类固醇和长效β2agonists治疗的患者的喘恶化和控制.
- 在两个不同的喘研究中,评估特定ADRB2基因型对治疗结果的影响.
主要方法:
- 两项研究 (一项双盲,一项开放标签) 涉及总共2655名喘患者,按ADRB2基因型分层.
- 参与者在各种治疗方案中接受了吸入性皮质类固醇与长效β2-激动剂 (布松胺/形式醇或流动/沙米特醇) 结合.
- 分析的重点是ADRB2多态性和严重喘恶化和喘控制的主要终点之间的关系.
主要成果:
- 两项研究都没有发现ADRB2 Gly16Arg基因型或亚型型对严重喘恶化的发生率有显著影响.
- 二级终点,包括肺功能 (FEV1),峰值呼气流,药物使用和夜间唤醒,在基因型组之间没有显著差异.
- 在这两项研究中,喘恶化频率和其他临床结果在所有ADRB2基因型中都是相似的.
结论:
- 该研究表明,ADRB2变异对吸入性皮质类固醇以及长效β2agonists在喘中的治疗反应没有药物遗传学影响.
- 这些发现表明,喘患者可以继续当前的治疗方案,无论他们的ADRB2基因型.
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