Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Pharmacogenomics J. 2011 Dec;11(6):383-92. doi: 10.1038/tpj.2011.46. Epub 2011 Oct 11.
Despite the availability of several classes of asthma medications and their overall effectiveness, a significant portion of patients fail to respond to these therapeutic agents. Evidence suggests that genetic factors may partly mediate the heterogeneity in asthma treatment response. This review discusses important findings in asthma pharmacogenetic and pharmacogenomic studies conducted to date, examines limitations of these studies and, finally, proposes future research directions in this field. The focus will be on the three major classes of asthma medications: β-adrenergic receptor agonists, inhaled corticosteroids and leukotriene modifiers. Although many studies are limited by small sample sizes and replication of the findings is needed, several candidate genes have been identified. High-throughput technologies are also allowing for large-scale genetic investigations. Thus, the future is promising for a personalized treatment of asthma, which will improve therapeutic outcomes, minimize side effects and lead to a more cost-effective care.
尽管有几类哮喘药物可供使用，且这些药物总体上有效，但仍有相当一部分患者对这些治疗药物没有反应。有证据表明，遗传因素可能在一定程度上介导了哮喘治疗反应的异质性。本文综述了迄今为止进行的哮喘药物遗传学和药物基因组学研究的重要发现，探讨了这些研究的局限性，并最终提出了该领域未来的研究方向。重点将放在哮喘的三大类药物上：β-肾上腺素能受体激动剂、吸入性皮质类固醇和白三烯调节剂。虽然许多研究受到样本量小的限制，需要对研究结果进行重复验证，但已经确定了几个候选基因。高通量技术也允许进行大规模的遗传研究。因此，哮喘的个体化治疗前景广阔，这将改善治疗效果，最小化副作用，并提供更具成本效益的治疗。
