Adrenergic β2-receptor genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol

Basu, Kaninika, Palmer, Colin N.A., Tavendale, Roger, Lipworth, Brian and Mukhopadhyay, Somnath (2009) Adrenergic β2-receptor genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol. Journal of Allergy and Clinical Immunology, 124 (6). pp. 1188-1194. ISSN 0091-6749

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Abstract

Background
On-demand inhaled albuterol is commonly prescribed worldwide. We have shown that the Arg16 allele of the adrenergic β2-receptor agonist gene (ADRB2) predisposes to exacerbations in young asthmatic patients taking regular salmeterol.

Objective
We have now extended our previous population by 636 patients and explored the role of the Arg16 allele on asthma exacerbations in the context of the use of on-demand albuterol and regular salmeterol.

Methods
Arg/Gly status at position 16 of ADRB2 was assessed in 1182 young asthmatic patients (age, 3-22 years) from Scotland. Asthma exacerbations, use of β-agonists and other medications over the previous 6 months, and lung function were also studied.

Results
An increased risk of exacerbations per copy of he Arg16 allele was observed in asthmatic patients, regardless of treatment regimen (odds ratio [OR], 1.30; 95% CI, 1.09-1.55; P = .003). This appears to be largely due to exposure to β2-agonists because the risk of exacerbations observed in patients with the Arg16 allele was only observed in those receiving daily inhaled long- or short-acting β2-agonist treatment (OR, 1.64; 95% CI, 1.22-2.20; P = .001). In contrast, there was no genotypic risk for exacerbations in patients using inhaled β2-agonists less than once a day (OR, 1.08; 95% CI, 0.85-1.36; P = .525). The Arg16 genotype–associated risk for exacerbations was significantly different in those exposed to β2-agonists daily versus those that were not (test for interaction, P = .022).

Conclusion
The Arg16 genotype of ADRB2 is associated with exacerbations in asthmatic children and young adults exposed daily to β2-agonists, regardless of whether the exposure is to albuterol or long-acting agonists, such as salmeterol.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical Medicine
Subjects: Q Science > QR Microbiology > QR0180 Immunology
Depositing User: Grecia GarciaGarcia
Date Deposited: 23 Aug 2011 12:03
Last Modified: 03 Dec 2012 13:09
URI: http://sro.sussex.ac.uk/id/eprint/7311
Google Scholar:24 Citations
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