Effect of β2-Adrenergic Receptor Polymorphism in Asthma Control of Patients Receiving Combination Treatment

• Published in: Yonsei medical journal 2009, 50(2), , pp.182-188
• Main Authors: Kim, Seung-Hyun, Ye, Young-Min, Hur, Gyu-Young, Lee, Hyun-Young, Jee, Young-Koo, Lee, Seung-Ho, Holloway, John W, Park, Hae-Sim
• Format: Article
• Language: English
• Subjects: Original; 의학일반
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2009.50.2.182

Purpose: Combination treatment of inhaled corticosteroid (ICS) plus long-acting β2-agonist (LABA) is widely used as a maintenance regimen for the management of asthma. This study evaluated the effect of the β2-adrenergic receptor (ADRB2) polymorphism on lung function and asthma control with regular use of combination treatment of an inhaled ICS plus LABA. Materials and Methods: 43 Korean asthmatics who were symptomatic despite regular ICS use for at least 3 months were enrolled. For a 2-week run-in period, they received ICS (budesonide 800 μg/day) plus terbutaline (5 μg prn). as needed. During the 24-week active treatment period, they received budesonide 160 μg and formoterol 4.5 μg b.i.d. as maintenance and rescue medication. Pulmonary function and quality of life scores were monitored every 8 weeks; morning/evening peak expiratory flow meter (PEFR) was recorded daily. Patients were genotyped for ADRB2 Arg16Gly using single base extension methodology. Results: During the run-in period, there were no significant between-group differences in lung function; after 8 weeks of active treatment, Arg/Arg patients had significantly higher forced expiratory volume in 1 secord (FEV1) and maximal mid-expiratory flow (MMEF) (p = 0.023 and p = 0.021, respectively), and better asthma control and quality of life after 24 weeks (p = 0.016 and p = 0.028, respectively). During treatment, there was a greater improvement in morning/evening PEFR in Arg/Arg patients. Conclusion: Asthmatic patients with the Arg/Arg genotype at codon 16 of ADRB2 achieve better asthma control with long-term regular use of combined budesonide and formoterol treatment, suggesting that the ADRB2 genotype may dictate choice of treatment strategy. KCI Citation Count: 11