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种族和民族如何影响哮喘的精准治疗?

How does race and ethnicity effect the precision treatment of asthma?

作者信息

Zhang Ellen, Levin Albert M, Williams L Keoki

机构信息

Center for Individualized and Genomic Medicine Research (CIGMA), Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.

Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.

出版信息

Expert Rev Precis Med Drug Dev. 2019;4(6):337-356. doi: 10.1080/23808993.2019.1690396. Epub 2019 Nov 14.

Abstract

INTRODUCTION

Asthma is a common condition that affects large numbers of children and adults, yet the burden of disease is not equally distributed amongst groups. In the United States, African Americans and Puerto Ricans have higher rates of asthma and its complications when compared with European Americans. However, clinical trials and genetic studies have largely focused on the latter group.

AREAS COVERED

Here we examine what is known regarding differences in asthma treatment response by race-ethnicity. We also review existing genetic studies related to the use of asthma medications, paying special attention to studies that included substantial numbers of non-white population groups. Publicly accessible search engines of the medical literature were queried using combinations of the terms asthma, race, ethnicity, pharmacogenomics, and pharmacogenetics, as well as the names of individual asthma medication classes. The list of articles reviewed was supplemented by bibliographies and expert knowledge.

EXPERT OPINION

A substantial and coordinated effort is still needed to both identify and validate genetic biomarkers of asthma medication response, as currently there are no clinically actionable genetic markers available for this purpose. The path to identifying such markers in non-white populations is even more formidable, since these groups are underrepresented in existing data.

摘要

引言

哮喘是一种常见疾病,影响着大量儿童和成人,但疾病负担在不同群体中分布不均。在美国,与欧裔美国人相比,非裔美国人和波多黎各人的哮喘及其并发症发生率更高。然而,临床试验和基因研究主要集中在后者群体。

涵盖领域

在此,我们研究了种族/族裔在哮喘治疗反应方面差异的已知情况。我们还回顾了与哮喘药物使用相关的现有基因研究,特别关注纳入大量非白人人群组的研究。使用哮喘、种族、族裔、药物基因组学、药物遗传学以及个别哮喘药物类别名称的组合,查询了可公开访问的医学文献搜索引擎。所审查文章的列表通过参考文献和专家知识进行了补充。

专家意见

仍然需要做出大量且协调一致的努力来识别和验证哮喘药物反应的基因生物标志物,因为目前尚无用于此目的的临床可行基因标记。在非白人人群中识别此类标记的道路更加艰巨,因为这些群体在现有数据中的代表性不足。

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