β2 肾上腺素能受体变异与儿童和青少年急性哮喘临床结局的相关性。
Association between beta-2 adrenergic receptor variants and clinical outcomes in children and adolescents with acute asthma.
机构信息
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
出版信息
Einstein (Sao Paulo). 2022 Mar 25;20:eAO6412. doi: 10.31744/einstein_journal/2022AO6412. eCollection 2022.
OBJECTIVE
To investigate whether different genotypes of p.Arg16Gly, p.Gln27Glu, p.Arg19Cys and p.Thr164Ile variants interfere in response to treatment in children and adolescents with moderate to severe acute asthma.
METHODS
This sample comprised patients aged 2 to 17 years with a history of at least two wheezing episodes and current moderate to severe asthma exacerbation. All patients received multiple doses of albuterol and ipratropium bromide delivered via pressurized metered-dose inhaler with holding chamber and systemic corticosteroids. Hospital admission was defined as the primary outcome. Secondary outcomes were changes in forced expiratory volume in the first second after 1 hour of treatment, and for outpatients, length of stay in the emergency room. Variants were genotyped by sequencing.
RESULTS
A total of 60 patients were evaluated. Hospital admission rates were significantly higher in carriers of the genotype AA relative to those with genotype AG or GG, within the p.Arg16Gly variant (p=0.03, test χ2, alpha=0.05). Secondary outcomes did not differ between genotypes.
CONCLUSION
Hospital admission rates were significantly higher among carriers of the genotype AA within the p.Arg16Gly variant. Trial registration: ClinicalTrials.gov: NCT01323010.
目的
研究 p.Arg16Gly、p.Gln27Glu、p.Arg19Cys 和 p.Thr164Ile 变体的不同基因型是否会干扰中重度急性哮喘儿童和青少年的治疗反应。
方法
本样本包括 2 至 17 岁、有至少两次喘息发作史和当前中重度哮喘加重史的患者。所有患者均接受沙丁胺醇和异丙托溴铵经压力定量气雾剂吸入器和储雾罐给药，并接受全身皮质类固醇治疗。住院治疗是主要结局。次要结局是治疗后 1 小时用力呼气第一秒的变化，以及对门诊患者，急诊室的住院时间。通过测序对变体进行基因分型。
结果
共评估了 60 例患者。在 p.Arg16Gly 变体中，与携带基因型 AG 或 GG 的患者相比，携带基因型 AA 的患者的住院率显著更高（p=0.03，检验 χ2，alpha=0.05）。基因型之间的次要结局没有差异。
结论
在 p.Arg16Gly 变体中，携带基因型 AA 的患者的住院率显著更高。试验注册：ClinicalTrials.gov：NCT01323010。
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