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중증난치천식과 유전학

Severe Refractory Asthma and Genetics

  • 고영일 (전남대학교 의과대학 알레르기내과)
  • Koh, Young-Il (Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnnam National University Medical School)
  • 발행 : 2012.10.01

초록

Asthma is multifactorial complex disorder originated from genetic and environmental factors. Some genetic variants or alleles have been known to be associated with the presence or development of asthma. Gene polymorphisms may be associated with declined lung function and severe exacerbations in asthma, indicating the contribution of genetic variants to the development of severe refractory asthma. Severe refractory asthma is heterogeneous disease and may be classified into various phenotypes and endotypes. Each endotype might be characterized by the presence of gene polymorphisms, which might be useful to determine an endotype. In addition, patients with severe refractory asthma have been known to respond differently to asthma medications, which may be explained by pharmacogenetics. Polymorphisms in the genes related to the pathway or receptors for drugs may determine the good or poor responses to the medication. The pharmacogenetic studies may allow patients with severe asthma to take the most effective personalized medicine, which may control severe refractory asthma well. Collectively, genetic testing for the presence of severe asthma and pharmacogenetics for asthma medications may be useful for the diagnosis and management of severe refractory asthma.

키워드

참고문헌

  1. Duffy DL, Martin NG, Battistutta D, Hopper JL, Mathews JD. Genetics of asthma and hay fever in Australian twins. Am Rev Respir Dis 1990;142:1351-1358. https://doi.org/10.1164/ajrccm/142.6_Pt_1.1351
  2. Nieminen MM, Kaprio J, Koskenvuo M. A populationbased study of bronchial asthma in adult twin pairs. Chest 1991;100:70-75. https://doi.org/10.1378/chest.100.1.70
  3. Hopp RJ, Bewtra AK, Watt GD, Nair NM, Townley RG. Genetic analysis of allergic disease in twins. J Allergy Clin Immunol 1984;73:265-270. https://doi.org/10.1016/S0091-6749(84)80018-4
  4. Edfors-Lubs ML. Allergy in 7000 twin pairs. Acta Allergol 1971;26:249-285. https://doi.org/10.1111/j.1398-9995.1971.tb01300.x
  5. Antonicelli L, Bucca C, Neri M, et al. Asthma severity and medical resource utilisation. Eur Respir J 2004;23:723-729. https://doi.org/10.1183/09031936.04.00004904
  6. Busse WW, Banks-Schlegel S, Wenzel SE. Pathophysiology of severe asthma. J Allergy Clin Immunol 2000;106: 1033-1042. https://doi.org/10.1067/mai.2000.111307
  7. Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions: American Thoracic Society. Am J Respir Crit Care Med 2000;162:2341-2351. https://doi.org/10.1164/ajrccm.162.6.ats9-00
  8. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma: European Network for Understanding Mechanisms of Severe Asthma. Eur Respir J 2003;22:470-477. https://doi.org/10.1183/09031936.03.00261903
  9. Jarjour NN, Erzurum SC, Bleecker ER, et al. Severe asthma: lessons learned from the National Heart, Lung, and Blood Institute Severe Asthma Research Program. Am J Respir Crit Care Med 2012;185:356-362. https://doi.org/10.1164/rccm.201107-1317PP
  10. Moore WC, Meyers DA, Wenzel SE, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med 2010;181:315-323. https://doi.org/10.1164/rccm.200906-0896OC
  11. Wenzel S. Severe asthma: from characteristics to phenotypes to endotypes. Clin Exp Allergy 2012;42:650-658. https://doi.org/10.1111/j.1365-2222.2011.03929.x
  12. Chanez P, Wenzel SE, Anderson GP, et al. Severe asthma in adults: what are the important questions? J Allergy Clin Immunol 2007;119:1337-1348. https://doi.org/10.1016/j.jaci.2006.11.702
  13. Van Eerdewegh P, Little RD, Dupuis J, et al. Association of the ADAM33 gene with asthma and bronchial hyperresponsiveness. Nature 2002;418:426-430. https://doi.org/10.1038/nature00878
  14. Allen M, Heinzmann A, Noguchi E, et al. Positional cloning of a novel gene influencing asthma from chromosome 2q14. Nat Genet 2003;35:258-263. https://doi.org/10.1038/ng1256
  15. Zhang Y, Leaves NI, Anderson GG, et al. Positional cloning of a quantitative trait locus on chromosome 13q14 that influences immunoglobulin E levels and asthma. Nat Genet 2003;34:181-186. https://doi.org/10.1038/ng1166
  16. Laitinen T, Polvi A, Rydman P, et al. Characterization of a common susceptibility locus for asthma-related traits. Science 2004;304:300-304. https://doi.org/10.1126/science.1090010
  17. Oguma T, Palmer LJ, Birben E, Sonna LA, Asano K, Lilly CM. Role of prostanoid DP receptor variants in susceptibility to asthma. N Engl J Med 2004;351:1752-1763. https://doi.org/10.1056/NEJMoa031785
  18. Lee SH, Park JS, Park CS. The search for genetic variants and epigenetics related to asthma. Allergy Asthma Immunol Res 2011;3:236-244. https://doi.org/10.4168/aair.2011.3.4.236
  19. Li X, Howard TD, Zheng SL, et al. Genome-wide association study of asthma identifies RAD50-IL13 and HLA-DR/DQ regions. J Allergy Clin Immunol 2010;125: 328-335. https://doi.org/10.1016/j.jaci.2009.11.018
  20. Jongepier H, Boezen HM, Dijkstra A, et al. Polymorphisms of the ADAM33 gene are associated with accelerated lung function decline in asthma. Clin Exp Allergy 2004;34: 757-760. https://doi.org/10.1111/j.1365-2222.2004.1938.x
  21. Van Diemen CC, Postma DS, Vonk JM, Bruinenberg M, Schouten JP, Boezen HM. A disintegrin and metalloprotease 33 polymorphisms and lung function decline in the general population. Am J Respir Crit Care Med 2005;172:329-333. https://doi.org/10.1164/rccm.200411-1486OC
  22. Sadeghnejad A, Ohar JA, Zheng SL, et al. Adam33 polymorphisms are associated with COPD and lung function in long-term tobacco smokers. Respir Res 2009;10:21. https://doi.org/10.1186/1465-9921-10-21
  23. Wilk JB, Chen TH, Gottlieb DJ, et al. A genome-wide association study of pulmonary function measures in the Framingham Heart Study. PLoS Genet 2009;5:e1000429. https://doi.org/10.1371/journal.pgen.1000429
  24. Hancock DB, Eijgelsheim M, Wilk JB, et al. Meta-analyses of genome-wide association studies identify multiple loci associated with pulmonary function. Nat Genet 2010;42: 45-52. https://doi.org/10.1038/ng.500
  25. Repapi E, Sayers I, Wain LV, et al. Genome-wide association study identifies five loci associated with lung function. Nat Genet 2010;42:36-44. https://doi.org/10.1038/ng.501
  26. Li X, Howard TD, Moore WC, et al. Importance of hedgehog interacting protein and other lung function genes in asthma. J Allergy Clin Immunol 2011;127:1457-1465. https://doi.org/10.1016/j.jaci.2011.01.056
  27. Gudbjartsson DF, Bjornsdottir US, Halapi E, et al. Sequence variants affecting eosinophil numbers associate with asthma and myocardial infarction. Nat Genet 2009;41:342-347. https://doi.org/10.1038/ng.323
  28. Rosa-Rosa L, Zimmermann N, Bernstein JA, Rothenberg ME, Khurana Hershey GK. The R576 IL-4 receptor alpha allele correlates with asthma severity. J Allergy Clin Immunol 1999;104:1008-1014. https://doi.org/10.1016/S0091-6749(99)70082-5
  29. Wenzel SE, Balzar S, Ampleford E, et al. IL4R alpha mutations are associated with asthma exacerbations and mast cell/IgE expression. Am J Respir Crit Care Med 2007;175: 570-576. https://doi.org/10.1164/rccm.200607-909OC
  30. Burchard EG, Silverman EK, Rosenwasser LJ, et al. Association between a sequence variant in the IL-4 gene promoter and FEV(1) in asthma. Am J Respir Crit Care Med 1999;160:919-922. https://doi.org/10.1164/ajrccm.160.3.9812024
  31. Sandford AJ, Chagani T, Zhu S, et al. Polymorphisms in the IL4, IL4RA, and FCERIB genes and asthma severity. J Allergy Clin Immunol 2000;106(1 Pt 1):135-140. https://doi.org/10.1067/mai.2000.107926
  32. Martinez FD, Graves PE, Baldini M, Solomon S, Erickson R. Association between genetic polymorphisms of the beta2-adrenoceptor and response to albuterol in children with and without a history of wheezing. J Clin Invest 1997; 100:3184-3188. https://doi.org/10.1172/JCI119874
  33. Taylor DR, Drazen JM, Herbison GP, Yandava CN, Hancox RJ, Town GI. Asthma exacerbations during long term beta agonist use: influence of beta(2) adrenoceptor polymorphism. Thorax 2000;55:762-767. https://doi.org/10.1136/thorax.55.9.762
  34. Israel E, Chinchilli VM, Ford JG, et al. Use of regularly scheduled albuterol treatment in asthma: genotype-stratified, randomised, placebo-controlled cross-over trial. Lancet 2004; 364:1505-1512. https://doi.org/10.1016/S0140-6736(04)17273-5
  35. Wechsler ME, Lehman E, Lazarus SC, et al. Beta-Adrenergic receptor polymorphisms and response to salmeterol. Am J Respir Crit Care Med 2006;173:519-526. https://doi.org/10.1164/rccm.200509-1519OC
  36. Wechsler ME, Kunselman SJ, Chinchilli VM, et al. Effect of beta2-adrenergic receptor polymorphism on response to longacting beta2 agonist in asthma (LARGE trial): a genotypestratified, randomised, placebo-controlled, crossover trial. Lancet 2009;374:1754-1764. https://doi.org/10.1016/S0140-6736(09)61492-6
  37. Bleecker ER, Nelson HS, Kraft M, et al. Beta2-receptor polymorphisms in patients receiving salmeterol with or without fluticasone propionate. Am J Respir Crit Care Med 2010;181:676-687. https://doi.org/10.1164/200809-1511OC
  38. Kim SH, Ye YM, Hur GY, et al. Effect of beta2-adrenergic receptor polymorphism in asthma control of patients receiving combination treatment. Yonsei Med J 2009;50: 182-188. https://doi.org/10.3349/ymj.2009.50.2.182
  39. Irusen E, Matthews JG, Takahashi A, Barnes PJ, Chung KF, Adcock IM. P38 Mitogen-activated protein kinase-induced glucocorticoid receptor phosphorylation reduces its activity: role in steroid-insensitive asthma. J Allergy Clin Immunol 2002;109:649-657. https://doi.org/10.1067/mai.2002.122465
  40. Huizenga NA, Koper JW, De Lange P, et al. A polymorphism in the glucocorticoid receptor gene may be associated with and increased sensitivity to glucocorticoids in vivo. J Clin Endocrinol Metab 1998;83:144-151. https://doi.org/10.1210/jc.83.1.144
  41. Hawkins GA, Lazarus R, Smith RS, et al. The glucocorticoid receptor heterocomplex gene STIP1 is associated with improved lung function in asthmatic subjects treated with inhaled corticosteroids. J Allergy Clin Immunol 2009; 123:1376-1383. https://doi.org/10.1016/j.jaci.2009.01.049
  42. Tantisira KG, Lake S, Silverman ES, et al. Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids. Hum Mol Genet 2004;13:1353-1359. https://doi.org/10.1093/hmg/ddh149
  43. Tantisira KG, Hwang ES, Raby BA, et al. TBX21: a functional variant predicts improvement in asthma with the use of inhaled corticosteroids. Proc Natl Acad Sci U S A 2004;101:18099-18104. https://doi.org/10.1073/pnas.0408532102
  44. Tantisira KG, Lasky-Su J, Harada M, et al. Genomewide association between GLCCI1 and response to glucocorticoid therapy in asthma. N Engl J Med 2011;365:1173-1183. https://doi.org/10.1056/NEJMoa0911353
  45. Koster ES, Maitland-van der Zee AH, Tavendale R, et al. FCER2 T2206C variant associated with chronic symptoms and exacerbations in steroid-treated asthmatic children. Allergy 2011;66:1546-1552. https://doi.org/10.1111/j.1398-9995.2011.02701.x
  46. Telleria JJ, Blanco-Quiros A, Varillas D, et al. ALOX5 promoter genotype and response to montelukast in moderate persistent asthma. Respir Med 2008;102:857-861. https://doi.org/10.1016/j.rmed.2008.01.011
  47. Lima JJ, Zhang S, Grant A, et al. Influence of leukotriene pathway polymorphisms on response to montelukast in asthma. Am J Respir Crit Care Med 2006;173:379-385. https://doi.org/10.1164/rccm.200509-1412OC
  48. Asano K, Shiomi T, Hasegawa N, et al. Leukotriene C4 synthase gene A (-444)C polymorphism and clinical response to a CYS-LT(1) antagonist, pranlukast, in Japanese patients with moderate asthma. Pharmacogenetics 2002;12:565-570. https://doi.org/10.1097/00008571-200210000-00009
  49. Mougey EB, Feng H, Castro M, Irvin CG, Lima JJ. Absorption of montelukast is transporter mediated: a common variant of OATP2B1 is associated with reduced plasma concentrations and poor response. Pharmacogenet Genomics 2009;19:129-138. https://doi.org/10.1097/FPC.0b013e32831bd98c
  50. Hew M, Bhavsar P, Torrego A, et al. Relative corticosteroid insensitivity of peripheral blood mononuclear cells in severe asthma. Am J Respir Crit Care Med 2006;174:134-141. https://doi.org/10.1164/rccm.200512-1930OC
  51. Jiang X. The emerging role of microRNAs in asthma. Mol Cell Biochem 2011;353:35-40. https://doi.org/10.1007/s11010-011-0771-z