Chiba Shinji, Nakamura Yutaka, Mizuno Tomoki, Abe Kazuyuki, Horii Yosuke, Nagashima Hiromi, Sasaki Nobuhito, Kanno Hiroyuki, Tanita Tatsuo, Yamauchi Kohei
Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka 0208505, Japan.
Department of Pathology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 3908621, Japan.
Clin Respir J. 2018 Mar;12(3):1166-1173. doi: 10.1111/crj.12647. Epub 2017 May 24.
Several gene variants are associated with a response to an inhaled corticosteroids (ICSs) treatment in patients with bronchial asthma. A variant of the glucocorticoid-induced transcript 1 (GLCCI1) genes has previously been associated with decreased lung function improvement upon treatment with ICSs in patients with bronchial asthma. Another report has also demonstrated that this genetic biomarker did not influence the change in flow volume in 1 second. However, no studies have considered the treatment content and the GLCCI1 variants. We were able to determine the relationship between the pulmonary function and clinical features and the variant of the GLCCI1 in Japanese asthmatic patients receiving long-term ICS treatment.
In this study, 405 patients with bronchial asthma, who were receiving ICS and living in Japan, were recruited, genotyped and underwent pulmonary function tests. To identify the GLCCI1 protein expression cells, endobronchial biopsy specimens were examined.
We found that the pulmonary function was not significantly different in the homozygotes compared to the wild types. Also, the homozygotes increased the risk of a sustained step-up of the asthma treatment when compared to the wild type and heterozygotes. GLCCI1-positive cells were localized to the bronchial epithelial cells. The amount of GLCCI1 protein that cultured epithelial cells harboring GLCCI1 variants produced was less than the GLCCI1 wild type in the presence of a corticosteroid.
A worsening of pulmonary function caused by GLCCI1 variants could be prevented due to recently used medications based on new action mechanisms.
几种基因变异与支气管哮喘患者吸入糖皮质激素(ICSs)治疗的反应相关。糖皮质激素诱导转录物1(GLCCI1)基因的一种变异先前已被证明与支气管哮喘患者接受ICSs治疗后肺功能改善降低有关。另一项报告也表明,这种基因生物标志物不影响一秒用力呼气容积的变化。然而,尚无研究考虑治疗内容和GLCCI1变异。我们能够确定接受长期ICS治疗的日本哮喘患者的肺功能、临床特征与GLCCI1变异之间的关系。
在本研究中,招募了405名接受ICS治疗且居住在日本的支气管哮喘患者,对其进行基因分型并进行肺功能测试。为了鉴定GLCCI1蛋白表达细胞,对支气管活检标本进行了检查。
我们发现,与野生型相比,纯合子的肺功能无显著差异。此外,与野生型和杂合子相比,纯合子增加了哮喘治疗持续升级的风险。GLCCI1阳性细胞定位于支气管上皮细胞。在存在糖皮质激素的情况下,携带GLCCI1变异的培养上皮细胞产生的GLCCI1蛋白量少于GLCCI1野生型。
基于新作用机制的近期使用药物可预防GLCCI1变异导致的肺功能恶化。