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- Open Access
The clinical and genetic factors for predicting the response to inhaled corticosteroids
© Nagase et al; licensee BioMed Central Ltd. 2013
- Published: 3 May 2013
- Single Nucleotide Polymorphism
- Bronchial Hyperresponsiveness
- Reversibility Test
- Peripheral Blood Eosinophil
- Logistic Multivariate Analysis
It has been reported that a part of asthma patients does not respond well to inhaled corticosteroids (ICS) and the benefit by long term treatment by high-dose ICS is limited in such patients. But the clinical or genetic factors for predicting ICS response have not been fully established especially in adults. The aim of this study is to establish the factor for predicting the response to ICS treatment.
Patients treated only by ICS for more than 6 months were enrolled and classified into responder group (R group, n=30) if FEV1 improvement ≥ 5% and non-responder group (NR group, n =40, FEV1 improvement<5%). The relationship between ICS response and pre-treatment clinical indices and 21 single nucleotide polymorphism (SNP) were retrospectively analyzed.
In R group, peripheral blood eosinophil % (R: NR = 7.5: 4.3%) and serum total IgE level (550.4: 497.1 U/ml) was significantly higher as compared to NR group. R group also showed significantly lower %VC (97.5: 114.8%), %FEV1.0 (77.9: 101.3%), FEV1.0% (67.5: 76.4%) and higher bronchial hyperresponsiveness. Bronchial reversibility test was available in 30 patients (R: n=11, NR: n=19) and reversibility was significantly higher in R group (15.9: 5.4%). By logistic multivariate analysis for those 30 patients, bronchial reversibility was significantly related to ICS response. SNP in IFN-γ R1 L467P was also related to ICS response. Post /Pre FEV1 ratio was significantly higher in homo/hetero group as compared to wild group (140.2 v.s 108.8%).
Pre-treatment bronchial reversibility was identified as a prediction factor for ICS response. It has been reported that SNP in IFN-γR is associated with allergic diseases and serum IgE level and the SNP might be potentially related to ICS response.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.