慢性阻塞性肺疾病（COPD）患者中，促肾上腺皮质激素释放激素受体1（CRHR1）基因多态性与吸入糖皮质激素治疗后肺功能改善之间的关联。
Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPD.
作者信息
Kim Woo J, Sheen Seung S, Kim Tae-Hyung, Huh Jin W, Lee Ji-Hyun, Kim Eun-Kyung, Lee Jin H, Lee Sang-Min, Lee Sangyeub, Lim Seong Y, Shin Tae R, Yoon Ho I, Oh Yeon-Mok, Lee Sang D
机构信息
Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea.
出版信息
Respirology. 2009 Mar;14(2):260-3. doi: 10.1111/j.1440-1843.2008.01425.x. Epub 2008 Dec 11.
BACKGROUND AND OBJECTIVE
Inhaled corticosteroids are used to treat COPD and asthma. An association between sequence variants in the corticotrophin-releasing hormone receptor 1 (CRHR1) gene and improved lung function in asthmatics treated with inhaled corticosteroids was reported recently. This study investigated the association between the change in lung function in response to inhaled corticosteroids and single-nucleotide CRHR1 polymorphisms in patients with COPD.
METHODS
COPD patients (n = 87) with a positive smoking history were recruited from the pulmonary clinics of 11 hospitals in Korea. Patients were treated with fluticasone propionate and salmeterol for 12 weeks and lung function was measured at baseline and after the 12-week treatment. Eighty-four of the 87 subjects were successfully genotyped.
RESULTS
Seventy-one patients with the wild-type GG genotype and 13 patients with the heterozygous GT genotype in rs242 941 were evaluated. After 12-week treatment, the change in FEV(1) was significantly higher in patients with wild-type GG genotype (6.0 +/- 0.8% of predicted FEV(1)) than in GT heterozygotes (-0.8 +/- 1.8, P = 0.003).
CONCLUSIONS
Improved FEV(1) following inhaled corticosteroid and a long-acting beta2-agonist was associated with CRHR1 genetic polymorphism in patients with COPD.
背景与目的
吸入性糖皮质激素用于治疗慢性阻塞性肺疾病（COPD）和哮喘。最近有报道称，促肾上腺皮质激素释放激素受体1（CRHR1）基因的序列变异与吸入性糖皮质激素治疗的哮喘患者肺功能改善之间存在关联。本研究调查了COPD患者吸入糖皮质激素后肺功能变化与CRHR1单核苷酸多态性之间的关联。
方法
从韩国11家医院的肺病诊所招募了87例有吸烟史的COPD患者。患者接受丙酸氟替卡松和沙美特罗治疗12周，并在基线和12周治疗后测量肺功能。87名受试者中的84名成功进行了基因分型。
结果
对rs242941中71例野生型GG基因型患者和13例杂合子GT基因型患者进行了评估。治疗12周后，野生型GG基因型患者的第一秒用力呼气容积（FEV₁）变化（占预测FEV₁的6.0±0.8%）显著高于GT杂合子患者（-0.8±1.8，P = 0.003）。
结论
吸入糖皮质激素和长效β₂受体激动剂后FEV₁的改善与COPD患者的CRHR1基因多态性有关。
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