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β2肾上腺素能受体基因Arg16Gly多态性与吸入性糖皮质激素加长效β受体激动剂治疗哮喘的肺功能反应:一项系统评价和荟萃分析

ADRB2 Arg16Gly Polymorphism and Pulmonary Function Response of Inhaled Corticosteroids plus Long-Acting Beta Agonists for Asthma Treatment: A Systematic Review and Meta-Analysis.

作者信息

Wang Xi, Li Qian, Liu Ruming, He Jin, Wu Di, Wang Yun, Zhang Jun

机构信息

The Department of Clinical Pharmacy, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

出版信息

Can Respir J. 2018 Jan 21;2018:5712805. doi: 10.1155/2018/5712805. eCollection 2018.

Abstract

BACKGROUND

The beta-2 adrenergic receptor (ADRB2) Arg16Gly polymorphism may alter the bronchodilation response to long-acting beta2-agonists, thereby influencing the clinical effectiveness of LABAs plus corticosteroids (ICS) treatment. But the results of individual studies are inconclusive.

METHODS

A systematic search was conducted in PubMed, Embase, the Cochrane Database, WHO International Clinical Trials Registry Platform, Chinese National Knowledge Infrastructure, Wanfang, Chinese BioMedical Literature Database, and VIP databases. The meta-analysis was performed with RevMan statistical software (version 5.2), and potential publication bias was estimated by Egger's test using STATA (version 12.0), with < 0.05 indicating significant publication bias.

RESULTS

We found 5 cohort studies with a total of 632 patients and included them in the meta-analysis. There are no significant differences in pulmonary function response between patients with the Arg/Arg and Arg/Gly phenotype (SMD -0.04, 95% CI -0.45 to 0.37; =0.84). There were also no significant differences in the pulmonary function response between patients with the Arg/Arg and Gly/Gly phenotype (MD -0.03, 95% CI -0.07 to 0.02; =0.28).

CONCLUSIONS

Our systematic review and meta-analysis suggest that ADRB2 Arg16Gly polymorphism is not associated with pulmonary response to asthma treatment with ICS plus LABAs.

摘要

背景

β2肾上腺素能受体(ADRB2)基因Arg16Gly多态性可能会改变长效β2激动剂的支气管扩张反应,从而影响长效β2激动剂联合糖皮质激素(ICS)治疗的临床效果。但个别研究结果尚无定论。

方法

在PubMed、Embase、Cochrane数据库、世界卫生组织国际临床试验注册平台、中国知网、万方、中国生物医学文献数据库和维普数据库中进行系统检索。使用RevMan统计软件(5.2版)进行荟萃分析,并使用STATA(12.0版)通过Egger检验估计潜在的发表偏倚,P<0.05表示存在显著发表偏倚。

结果

我们找到了5项队列研究,共632例患者,并将其纳入荟萃分析。携带Arg/Arg和Arg/Gly基因型的患者在肺功能反应上无显著差异(标准化均数差为-0.04,95%可信区间为-0.45至0.37;P=0.84)。携带Arg/Arg和Gly/Gly基因型的患者在肺功能反应上也无显著差异(均数差为-0.03,95%可信区间为-0.07至0.02;P=0.28)。

结论

我们的系统评价和荟萃分析表明,ADRB2基因Arg16Gly多态性与ICS联合LABA治疗哮喘的肺部反应无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e767/5833872/0f7d614e0f49/CRJ2018-5712805.001.jpg

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