Treatment response heterogeneity in asthma: the role of genetic variation.

Abstract:

INTRODUCTION:Asthmatic patients show a large heterogeneity in response to asthma medication. Rapidly evolving genotyping technologies have led to the identification of various genetic variants associated with treatment outcomes. Areas covered: This review focuses on the current knowledge of genetic variants influencing treatment response to the most commonly used asthma medicines: short- and long-acting beta-2 agonists (SABA/LABA), inhaled corticosteroids (ICS) and leukotriene modifiers. This review shows that various genetic variants have been identified, but none are currently used to guide asthma treatment. One of the most promising genetic variants is the Arg16 variant in the ADRB2 gene to guide LABA treatment in asthmatic children. Expert commentary: Poor replication of initially promising results and the low fraction of variability accounted for by single genetic variants inhibit pharmacogenetic findings to reach the asthma clinic. Nevertheless, the identification of genetic variation influencing treatment response does provide more insights in the complex processes underlying response and might identify novel targets for treatment. There is a need to report measures of clinical validity, to perform precision-medicine guided trials, as well as to understand how genetic variation interacts with environmental factors. In addition, systems biology approaches might be able to show a more complete picture of these complex interactions.

journal_name

Expert Rev Respir Med

authors

Vijverberg SJH,Farzan N,Slob EMA,Neerincx AH,Maitland-van der Zee AH

doi

10.1080/17476348.2018.1403318

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

55-65

issue

1

eissn

1747-6348

issn

1747-6356

journal_volume

12

pub_type

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