Xu Yuzhu, Wu Hongxu, Wu Xiaojie, Xu Yongjian, Zhao Jianping, Xie Jungang, Yu Jun
Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Medicine (Baltimore). 2017 Dec;96(52):e9442. doi: 10.1097/MD.0000000000009442.
Glucocorticoids are the primary anti-inflammatory therapy for asthma, but their effects are characterized by some interindividual variability that might have a genetic basis.We aimed to determine the relationship between pulmonary function change and the variant of the glucocorticoid-induced transcript 1 (GLCCI1) gene in patients with asthma receiving long-term ICS treatment, the association of GLCCI1 genotypes and the level of GLCCI1 expression and cytokines production.A total of 418 patients with asthma, including 25 individuals from 11 families with a history of asthma, were enrolled. The effects of single-nucleotide polymorphisms (SNPs) in GLCCI1 on changes in lung function in response to inhaled glucocorticoids were assessed. The expression levels of GLCCI1 mRNA and cytokines were also measured.The SNP rs37973 in GLCCI1 was independently associated with changes in forced expiratory volume at one second (FEV1) and FEV1%pred. Individuals homozygous for the wild-type allele who had a percent FEV1 change greater than 5% were more common than individuals homozygous for the rare allele. When patients were stratified according to genotype, GLCCI1 expression was enhanced upon administration of low-dose dexamethasone among patients with the rs37973 A allele; however, GG homozygotes required high-dose dexamethasone to achieve enhanced GLCCI1 expression. Furthermore, the levels of some cytokines were significantly reduced after glucocorticoid treatment in individuals with the AA and AG genotypes.The genetic variant rs37973 in GLCCI1 is associated with poorer clinical therapeutic response to inhaled glucocorticoids in a Chinese asthma population.
糖皮质激素是哮喘的主要抗炎治疗药物,但其效果存在个体间差异,这种差异可能具有遗传基础。我们旨在确定接受长期吸入性糖皮质激素(ICS)治疗的哮喘患者肺功能变化与糖皮质激素诱导转录物1(GLCCI1)基因变异之间的关系、GLCCI1基因分型与GLCCI1表达水平及细胞因子产生的关联。共纳入418例哮喘患者,其中包括来自11个有哮喘病史家庭的25名个体。评估了GLCCI1中单核苷酸多态性(SNP)对吸入糖皮质激素后肺功能变化的影响,还测量了GLCCI1 mRNA和细胞因子的表达水平。GLCCI1中的SNP rs37973与一秒用力呼气容积(FEV1)及FEV1%预计值的变化独立相关。FEV1变化百分比大于5%的野生型等位基因纯合个体比罕见等位基因纯合个体更常见。根据基因型对患者进行分层时,在携带rs37973 A等位基因的患者中,给予低剂量地塞米松后GLCCI1表达增强;然而,GG纯合子需要高剂量地塞米松才能实现GLCCI1表达增强。此外,AA和AG基因型个体在糖皮质激素治疗后某些细胞因子水平显著降低。GLCCI1中的基因变异rs37973与中国哮喘人群吸入糖皮质激素的临床治疗反应较差有关。