Ortega Victor E, Hawkins Gregory A, Peters Stephen P, Bleecker Eugene R
Center for Human Genomics, Section of Pulmonary, Critical Care, Allergy, and Immunologic Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Immunol Allergy Clin North Am. 2007 Nov;27(4):665-84; vii. doi: 10.1016/j.iac.2007.09.007.
Asthma is a complex genetic disease with multiple genetic and environmental determinants contributing to the observed variability in response to common antiasthma therapies. One focus of asthma pharmacogenetic research has been the beta2-adrenergic receptor gene (ADR beta 2) and its effect on individual responses to beta agonist therapy. Knowledge about the effects of ADR beta 2 variation on therapeutic responses is evolving and should not alter current Asthma Guideline approaches, which consist of the use of short-acting beta agonists (SABAs) for as-needed symptom-based therapy and the use of a regular long-acting beta agonist (LABA) in combination with inhaled corticosteroid therapy for those asthmatics whose symptoms are not controlled by inhaled corticosteroid alone. These approaches are based upon studies showing a consistent pharmacogenetic response to regular use of SABAs and less consistent findings in studies evaluating LABAs. The emerging pharmacogenetic studies are provocative and should lead to functional studies. Meanwhile, the conflicting data concerning LABAs may be caused by such factors as small sample sizes of study populations and differences in experimental design.
哮喘是一种复杂的遗传性疾病，多种遗传和环境因素决定了对常见抗哮喘疗法反应的可变性。哮喘药物遗传学研究的一个重点是β2肾上腺素能受体基因（ADRβ2）及其对个体对β激动剂治疗反应的影响。关于ADRβ2变异对治疗反应影响的知识正在不断发展，不应改变当前的哮喘指南方法，该方法包括使用短效β激动剂（SABA）进行按需症状治疗，以及对于症状不能仅通过吸入皮质类固醇控制的哮喘患者，使用长效β激动剂（LABA）与吸入皮质类固醇联合治疗。这些方法基于研究表明对常规使用SABA有一致的药物遗传学反应，而在评估LABA的研究中结果不太一致。新出现的药物遗传学研究具有启发性，应该会引发功能研究。同时，关于LABA的相互矛盾的数据可能是由研究人群样本量小和实验设计差异等因素导致的。
