Mabelane Tshegofatso, Masekela Refiloe, Dandara Collet, Hadebe Sabelo
Department of Medicine, Sefako Makgatho Health Science University, Ga-Rankuwa, South Africa.
Department of Paediatrics, Nelson Mandela School of Medicine, Inkosi Albert Luthuli Hospital, University of KwaZulu-Natal, Durban, South Africa.
Front Allergy. 2023 May 9;4:1165311. doi: 10.3389/falgy.2023.1165311. eCollection 2023.
Asthma is a common chronic condition in children and in an African setting is often highly prevalent in urban areas as compared to rural areas. Asthma is a heritable disease and the genetic risk is often exacerbated by unique localised environmental factors. The Global Initiative for Asthma (GINA) recommendation for the control of asthma includes inhaled corticosteroids (ICS) alone or together with short-acting β-agonists (SABA) or long-acting β-agonists (LABA). While these drugs can relieve asthma symptoms, there is evidence of reduced efficacy in people of African ancestry. Whether this is due to immunogenetics, genomic variability in drug metabolising genes (pharmacogenetics) or genetics of asthma-related traits is not well defined. Pharmacogenetic evidence of first-line asthma drugs in people of African ancestry is lacking and is further compounded by the lack of representative genetic association studies in the continent. In this review, we will discuss the paucity of data related to the pharmacogenetics of asthma drugs in people of African ancestry, mainly drawing from African American data. We will further discuss how this gap can be bridged to improve asthma health outcomes in Africa.
哮喘是儿童常见的慢性疾病，在非洲地区，与农村地区相比，城市地区哮喘的患病率通常更高。哮喘是一种遗传性疾病，独特的局部环境因素往往会加剧其遗传风险。全球哮喘防治创议（GINA）对哮喘控制的建议包括单独使用吸入性糖皮质激素（ICS），或与短效β受体激动剂（SABA）或长效β受体激动剂（LABA）联合使用。虽然这些药物可以缓解哮喘症状，但有证据表明，它们对非洲裔人群的疗效会降低。这是否是由于免疫遗传学、药物代谢基因的基因组变异性（药物遗传学）或哮喘相关性状的遗传学所致，目前尚不清楚。非洲裔人群缺乏一线哮喘药物的药物遗传学证据，而且该大陆缺乏代表性的基因关联研究，这进一步加剧了这一问题。在这篇综述中，我们将主要参考非裔美国人的数据，讨论非洲裔人群中与哮喘药物药物遗传学相关的数据匮乏问题。我们还将进一步讨论如何弥补这一差距，以改善非洲的哮喘健康状况。
