Adrenergic beta(2)-receptor genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol

K. Basu, Colin N. A. Palmer, Roger Tavendale, Brian J. Lipworth, Somnath Mukhopadhyay

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    77 Citations (Scopus)

    Abstract

    Background: On-demand inhaled albuterol is commonly prescribed worldwide. We have shown that the Arg16 allele of the adrenergic beta(2)-receptor agonist gene (ADRB2) predisposes to exacerbations in young asthmatic patients taking regular salmeterol.

    Objective: We have now extended our previous population by 636 patients and explored the role of the Arg16 allele on asthma exacerbations in the context of the use of on-demand albuterol and regular salmeterol.

    Methods: Arg/Gly status at position 16 of ADRB2 was assessed in 1182 young asthmatic patients (age, 3-22 years) from Scotland. Asthma exacerbations, use of beta-agonists and other medications over the previous 6 months, and lung function were also studied.

    Results: An increased risk of exacerbations per copy of he Arg16 allele was observed in asthmatic patients, regardless of treatment regimen (odds ratio [OR], 1.30; 95% CI, 1.09-1.55; P = .003). This appears to be largely due to exposure to beta(2)-agonists because the risk of exacerbations observed in patients with the Arg16 allele was only observed in those receiving daily inhaled long- or short-acting beta(2)-agonist treatment (OR, 1.64; 95% CI, 1.22-2.20; P =.001). In contrast, there was no genotypic risk for exacerbations in patients using inhaled beta(2)-agonists less than once a day (OR, 1.08; 95% CI, 0.85-1.36; P =.525). The Arg16 genotype-associated risk for exacerbations was significantly different in those exposed to beta(2)-agonists daily versus those that were not (test for interaction, P =.022).

    Conclusion: The Arg16 genotype of ADRB2 is associated with exacerbations in asthmatic children and young adults exposed daily to beta(2)-agonists, regardless of whether the exposure is to albuterol or long-acting agonists, such as salmeterol. (J Allergy Clin Immunol 2009;124:1188-94.)

    Original languageEnglish
    Pages (from-to)1188-1194.e3
    Number of pages7
    JournalJournal of Allergy and Clinical Immunology
    Volume124
    Issue number6
    DOIs
    Publication statusPublished - Dec 2009

    Keywords

    • Asthma
    • child
    • polymorphism
    • asthma exacerbations
    • albuterol
    • salmeterol
    • beta(2)-adrenoceptor
    • adrenergic beta(2)-receptor agonist gene
    • FILAGGRIN NULL MUTATIONS
    • EARLY-CHILDHOOD
    • LUNG-FUNCTION
    • FOLLOW-UP
    • BETA(2)-ADRENERGIC RECEPTOR
    • BETA(2)-AGONIST THERAPY
    • YOUNG-ADULTS
    • CHILDREN
    • POLYMORPHISMS
    • BRONCHIOLITIS

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