OBJECTIVE: To determine the relationship between allelic variations in genes involved in fluticasone propionate (FP) metabolism and asthma control among children with asthma managed with inhaled FP. STUDY DESIGN: The relationship between variability in asthma control scores and genetic variation in drug metabolism was assessed by genotyping 9 single nucleotide polymorphisms in the CYP3A4, CYP3A5, and CYP3A7 genes. Genotype information was compared with asthma control scores (0=well controlled to 15=poorly controlled), determined using a questionnaire modified from the National Heart Lung and Blood Institute's Expert Panel 3 guidelines. RESULTS: Our study cohort comprised 734 children with asthma (mean age, 8.8±4.3 years) and was predominantly male (61%) and non-Hispanic white (53%). More than one-half of the children (56%; n=413) were receiving an inhaled glucocorticoid daily, with FP the most frequently prescribed agent (65%). Among the children receiving daily FP, single nucleotide polymorphisms in CYP3A5 and CYP3A7 were not associated with asthma control scores. In contrast, asthma control scores were significantly improved in the 20 children (7%) with the CYP3A4*22 allele (median, 3; range, 0-6) compared with the 201 children without the CYP3A4*22 allele (median, 4; range, 0-15; P=.02). The presence of CYP3A4*22 was associated with improved asthma control scores by 2.1 points (95% CI, 0.5-3.8). CONCLUSION: The presence of CYP3A4*22, which is associated with decreased hepatic CYP3A4 expression and activity, was accompanied by improved asthma control in the FP-treated children. Decreased CYP3A4 activity may improve asthma control with inhaled FP.
OBJECTIVE: To determine the relationship between allelic variations in genes involved in fluticasone propionate (FP) metabolism and asthma control among children with asthma managed with inhaled FP. STUDY DESIGN: The relationship between variability in asthma control scores and genetic variation in drug metabolism was assessed by genotyping 9 single nucleotide polymorphisms in the CYP3A4, CYP3A5, and CYP3A7 genes. Genotype information was compared with asthma control scores (0=well controlled to 15=poorly controlled), determined using a questionnaire modified from the National Heart Lung and Blood Institute's Expert Panel 3 guidelines. RESULTS: Our study cohort comprised 734 children with asthma (mean age, 8.8±4.3 years) and was predominantly male (61%) and non-Hispanic white (53%). More than one-half of the children (56%; n=413) were receiving an inhaled glucocorticoid daily, with FP the most frequently prescribed agent (65%). Among the children receiving daily FP, single nucleotide polymorphisms in CYP3A5 and CYP3A7 were not associated with asthma control scores. In contrast, asthma control scores were significantly improved in the 20 children (7%) with the CYP3A4*22 allele (median, 3; range, 0-6) compared with the 201 children without the CYP3A4*22 allele (median, 4; range, 0-15; P=.02). The presence of CYP3A4*22 was associated with improved asthma control scores by 2.1 points (95% CI, 0.5-3.8). CONCLUSION: The presence of CYP3A4*22, which is associated with decreased hepatic CYP3A4 expression and activity, was accompanied by improved asthma control in the FP-treated children. Decreased CYP3A4 activity may improve asthma control with inhaled FP.
Authors: P Kuehl; J Zhang; Y Lin; J Lamba; M Assem; J Schuetz; P B Watkins; A Daly; S A Wrighton; S D Hall; P Maurel; M Relling; C Brimer; K Yasuda; R Venkataramanan; S Strom; K Thummel; M S Boguski; E Schuetz Journal: Nat Genet Date: 2001-04 Impact factor: 38.330
Authors: Laure Elens; Rachida Bouamar; Dennis A Hesselink; Vincent Haufroid; Teun van Gelder; Ron H N van Schaik Journal: Pharmacogenet Genomics Date: 2012-05 Impact factor: 2.089
Authors: J Steven Leeder; Roger Gaedigk; Kenda A Marcucci; Andrea Gaedigk; Carrie A Vyhlidal; Bradley P Schindel; Robin E Pearce Journal: J Pharmacol Exp Ther Date: 2005-04-21 Impact factor: 4.030
Authors: John B J Kwok; Marianne Hallupp; Clement T Loy; Daniel K Y Chan; Jean Woo; George D Mellick; Daniel D Buchanan; Peter A Silburn; Glenda M Halliday; Peter R Schofield Journal: Ann Neurol Date: 2005-12 Impact factor: 10.422
Authors: S Anttila; J Hukkanen; J Hakkola; T Stjernvall; P Beaune; R J Edwards; A R Boobis; O Pelkonen; H Raunio Journal: Am J Respir Cell Mol Biol Date: 1997-03 Impact factor: 6.914
Authors: Cassandra E Deering-Rice; Darien Shapiro; Erin G Romero; Chris Stockmann; Tatjana S Bevans; Quang M Phan; Bryan L Stone; Bernhard Fassl; Flory Nkoy; Derek A Uchida; Robert M Ward; John M Veranth; Christopher A Reilly Journal: Am J Respir Cell Mol Biol Date: 2015-12 Impact factor: 6.914
Authors: Chris Stockmann; Christopher A Reilly; Bernhard Fassl; Roger Gaedigk; Flory Nkoy; Bryan Stone; Jessica K Roberts; Derek A Uchida; J Steven Leeder; Catherine M T Sherwin; Michael G Spigarelli; Garold S Yost; Robert M Ward Journal: J Allergy Clin Immunol Date: 2015-03-29 Impact factor: 10.793
Authors: Robert M Ward; Daniel K Benjamin; Jonathan M Davis; Richard L Gorman; Ralph Kauffman; Gregory L Kearns; Mary Dianne Murphy; Catherine M T Sherwin Journal: J Pediatr Date: 2017-09-21 Impact factor: 4.406
Authors: Cassandra E Deering-Rice; Chris Stockmann; Erin G Romero; Zhenyu Lu; Darien Shapiro; Bryan L Stone; Bernhard Fassl; Flory Nkoy; Derek A Uchida; Robert M Ward; John M Veranth; Christopher A Reilly Journal: J Biol Chem Date: 2016-10-07 Impact factor: 5.157
Authors: Jessica K Roberts; Chad D Moore; Robert M Ward; Garold S Yost; Christopher A Reilly Journal: J Pharmacol Exp Ther Date: 2013-03-19 Impact factor: 4.030