关键词: 吸入性糖皮质激素布地奈德, 药物基因多态性, 支气管哮喘, 疗效

Abstract: AIM: To investigate the relationship among the rs37973 polymorphism of glucocorticoid induced transcription factor 1 (GLCCI1) gene, the rs1876828 polymorphism of corticotropin-hormone receptor 1 (CRHR1) gene, the rs28364072 polymorphism of Fc fragment of IgE receptor II (FCER2) gene and the response to inhaled corticosteroids (ICS) budesonide in patients with asthma.  METHODS: 152 blood samples of patients with asthma were collected. The DNA were studied by blood samples. Fluorescence in situ hybridization method was used to detect the polymorphism of GLCCI1,  CRHR1, FCER2. Lung function index of the ICS before and after treatment, such as forced vital capacity (FVC), first second forced breath volume (FEV1) and first second forced breath volume of forced lung (FEV1/FVC%), and Eosinophil count (EOS) et al. were collected. The change value of FVC, FEV1, FEV1/FVC and their improvement rate were calculated. The relationship between GLCCI1, CRHR1 and FCER2 gene polymorphism and altered lung function before and after treatment in asthma patients was analyzed. RESULTS: There was significant difference between Han and Uyghur asthmatic patients in the distribution frequency of GLCCI1 and FCER2 genotypes. No CRHR1 AA genotype was found in the study population, but there was significant difference between Han and Uyghur patients in the distribution frequency of CRHR1 GG and GA genotype. The difference of FVC and the improvement rate of FVC in GLCCI1 AA type and GG type patients was similar before and after treatment (P>0.05), but the difference of FVC and the improvement rate of FVC in AG type patients were significantly increased compared with GG type patients' (P<0.05). The difference of FEV1/FVC before and after drug treatment in FCER2 AA and AG genotype was similar (P>0.05), but the difference of FEV1/FVC before and after ICS treatment in FCER2 AA and AG genotype was significantly higher than that in GG (P<0.05). The difference of FEV1/FVC before and after treatment in patients with CRHR1 GA genotype was more significant than that with GG genotype (P<0.05). Han and Uygur patients with FCER2 AA and GG genotype had similar changes in pulmonary function indexes after treatment (P>0.05), while Uygur patients with AG genotype had significantly increased in FEV1 improvement rate, FEV1/FVC difference and FEV1/FVC improvement rate after ICS treatment compared with Han patients (P<0.05).CONCLUSION: There was relevance among GLCCI1 rs37973, CRHR1 rs1876828, FCER2 rs28364072 gene polymorphism and lung function in inhaled corticoids budesonide treatment, which may be a genetic indicator to predict the efficacy of inhaled glucocorticoids in asthma patients.

Key words: inhaled glucocorticoids budesonide, gene polymorphism, bronchial asthma, efficacy