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Mallick I, Panchal P, Kadam S, Mohite P, Scheele J, Seiz W, Agarwal A, Sharma OP. In-silico identification and prioritization of therapeutic targets of asthma. Sci Rep 2023; 13:15706. [PMID: 37735578 PMCID: PMC10514284 DOI: 10.1038/s41598-023-42803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
Asthma is a "common chronic disorder that affects the lungs causing variable and recurring symptoms like repeated episodes of wheezing, breathlessness, chest tightness and underlying inflammation. The interaction of these features of asthma determines the clinical manifestations and severity of asthma and the response to treatment" [cited from: National Heart, Lung, and Blood Institute. Expert Panel 3 Report. Guidelines for the Diagnosis and Management of Asthma 2007 (EPR-3). Available at: https://www.ncbi.nlm.nih.gov/books/NBK7232/ (accessed on January 3, 2023)]. As per the WHO, 262 million people were affected by asthma in 2019 that leads to 455,000 deaths ( https://www.who.int/news-room/fact-sheets/detail/asthma ). In this current study, our aim was to evaluate thousands of scientific documents and asthma associated omics datasets to identify the most crucial therapeutic target for experimental validation. We leveraged the proprietary tool Ontosight® Discover to annotate asthma associated genes and proteins. Additionally, we also collected and evaluated asthma related patient datasets through bioinformatics and machine learning based approaches to identify most suitable targets. Identified targets were further evaluated based on the various biological parameters to scrutinize their candidature for the ideal therapeutic target. We identified 7237 molecular targets from published scientific documents, 2932 targets from genomic structured databases and 7690 dysregulated genes from the transcriptomics and 560 targets from genomics mutational analysis. In total, 18,419 targets from all the desperate sources were analyzed and evaluated though our approach to identify most promising targets in asthma. Our study revealed IL-13 as one of the most important targets for asthma with approved drugs on the market currently. TNF, VEGFA and IL-18 were the other top targets identified to be explored for therapeutic benefit in asthma but need further clinical testing. HMOX1, ITGAM, DDX58, SFTPD and ADAM17 were the top novel targets identified for asthma which needs to be validated experimentally.
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Affiliation(s)
- Ishita Mallick
- Innoplexus Consulting Pvt. Ltd, 7th Floor, Midas Tower, Next to STPI Building, Phase 1, Hinjewadi Rajiv Gandhi Infotech Park, Hinjawadi, Pune, Maharashtra, 411057, India
| | - Pradnya Panchal
- Innoplexus Consulting Pvt. Ltd, 7th Floor, Midas Tower, Next to STPI Building, Phase 1, Hinjewadi Rajiv Gandhi Infotech Park, Hinjawadi, Pune, Maharashtra, 411057, India
| | - Smita Kadam
- Innoplexus Consulting Pvt. Ltd, 7th Floor, Midas Tower, Next to STPI Building, Phase 1, Hinjewadi Rajiv Gandhi Infotech Park, Hinjawadi, Pune, Maharashtra, 411057, India
| | - Priyanka Mohite
- Innoplexus Consulting Pvt. Ltd, 7th Floor, Midas Tower, Next to STPI Building, Phase 1, Hinjewadi Rajiv Gandhi Infotech Park, Hinjawadi, Pune, Maharashtra, 411057, India
| | - Jürgen Scheele
- Innoplexus AG, Frankfurter Str. 27, 65760, Eschborn, Germany
| | - Werner Seiz
- Innoplexus AG, Frankfurter Str. 27, 65760, Eschborn, Germany
| | - Amit Agarwal
- Innoplexus Consulting Pvt. Ltd, 7th Floor, Midas Tower, Next to STPI Building, Phase 1, Hinjewadi Rajiv Gandhi Infotech Park, Hinjawadi, Pune, Maharashtra, 411057, India
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García-Martín E, García-Menaya JM, Esguevillas G, Cornejo-García JA, Doña I, Jurado-Escobar R, Torres MJ, Blanca-López N, Canto G, Blanca M, Laguna JJ, Bartra J, Rosado A, Fernández J, Cordobés C, Agúndez JAG. Deep sequencing of prostaglandin-endoperoxide synthase (PTGE) genes reveals genetic susceptibility for cross-reactive hypersensitivity to NSAID. Br J Pharmacol 2021; 178:1218-1233. [PMID: 33450044 DOI: 10.1111/bph.15366] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Cross-reactive hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) is a relatively common adverse drug event caused by two or more chemically unrelated drugs and that is attributed to inhibition of the COX activity, particularly COX-1. Several studies investigated variations in the genes coding for COX enzymes as potential risk factors. However, these studies only interrogated a few single nucleotide variations (SNVs), leaving untested most of the gene sequence. EXPERIMENTAL APPROACH In this study, we analysed the whole sequence of the prostaglandin-endoperoxide synthase genes, PTGS1 and PTGS2, including all exons, exon-intron boundaries and both the 5' and 3' flanking regions in patients with cross-reactive hypersensitivity to NSAIDs and healthy controls. After sequencing analysis in 100 case-control pairs, we replicated the findings in 540 case-control pairs. Also, we analysed copy number variations for both PTGS genes. KEY RESULTS The most salient finding was the presence of two PTGS1 single nucleotide variations, which are significantly more frequent in patients than in control subjects. Patients carrying these single nucleotide variations displayed a significantly and markedly lower COX-1 activity as compared to non-carriers for both heterozygous and homozygous patients. CONCLUSION AND IMPLICATIONS Although the risk single nucleotide variations are present in a small proportion of patients, the strong association observed and the functional effect of these single nucleotide variations raise the hypothesis of genetic susceptibility to develop cross-reactive NSAID hypersensitivity in individuals with an impairment in COX-1 enzyme activity.
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Affiliation(s)
- Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Jesús M García-Menaya
- Allergy Service, Badajoz University Hospital. ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - Gara Esguevillas
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A Cornejo-García
- Research Laboratory, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Inmaculada Doña
- Allergy Unit, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Raquel Jurado-Escobar
- Research Laboratory, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - María J Torres
- Allergy Unit, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Natalia Blanca-López
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - Gabriela Canto
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - Miguel Blanca
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - José J Laguna
- Allergy Unit and Allergy-Anaesthesia Unit, ARADyAL Instituto de Salud Carlos III, Hospital Central Cruz Roja, Madrid, Spain
| | - Joan Bartra
- Allergy Section, Pneumology Department, Hospital Clinic, ARADyAL Instituto de Salud Carlos III, Universitat de Barcelona, Barcelona, Spain
| | - Ana Rosado
- Allergy Service, Alcorcón Hospital, Madrid, Spain
| | - Javier Fernández
- Allergy Unit, ARADyAL Instituto de Salud Carlos III, Regional University Hospital, Alicante, Spain
| | - Concepción Cordobés
- Allergy Service, Badajoz University Hospital. ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Venter C, Meyer RW, Nwaru BI, Roduit C, Untersmayr E, Adel‐Patient K, Agache I, Agostoni C, Akdis CA, Bischoff S, du Toit G, Feeney M, Frei R, Garn H, Greenhawt M, Hoffmann‐Sommergruber K, Lunjani N, Maslin K, Mills C, Muraro A, Pali I, Poulson L, Reese I, Renz H, Roberts GC, Smith P, Smolinska S, Sokolowska M, Stanton C, Vlieg‐Boerstra B, O'Mahony L. EAACI position paper: Influence of dietary fatty acids on asthma, food allergy, and atopic dermatitis. Allergy 2019; 74:1429-1444. [PMID: 31032983 DOI: 10.1111/all.13764] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/12/2019] [Accepted: 02/21/2019] [Indexed: 12/11/2022]
Abstract
The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and management of these disorders. In addition to their nutritive value, fatty acids have important immunoregulatory effects. Fatty acid-associated biological mechanisms, human epidemiology, and intervention studies are summarized in this review. The influence of genetics and the microbiome on fatty acid metabolism is also discussed. Despite critical gaps in our current knowledge, it is increasingly apparent that dietary intake of fatty acids may influence the development of inflammatory and tolerogenic immune responses. However, the lack of standardized formats (ie, food versus supplement) and standardized doses, and frequently a lack of prestudy serum fatty acid level assessments in clinical studies significantly limit our ability to compare allergy outcomes across studies and to provide clear recommendations at this time. Future studies must address these limitations and individualized medical approaches should consider the inclusion of specific dietary factors for the prevention and management of asthma, food allergy, and atopic dermatitis.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology University of Colorado Denver School of Medicine, Children's Hospital Colorado Colorado
| | | | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine University of Gothenburg Gothenburg Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Karine Adel‐Patient
- Service de Pharmacologie et d'Immunoanalyse, Laboratoire d'Immuno‐Allergie Alimentaire (LIAA) INRA, CEA, Université Paris Saclay Gif sur Yvette Cedex France
| | | | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda ‐ Ospedale Maggiore Policlinico Milano Italy
- Dipartimento di Scienze Cliniche e di Comunita Universita' degli Studi Milano Italy
| | - Cezmi A. Akdis
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Stephan Bischoff
- Institut für Ernährungsmedizin Universität Hohenheim Stuttgart Germany
| | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Mary Feeney
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Holger Garn
- Center for Tumor‐ and Immunobiology (ZTI), Institute of Laboratory Medicine and Pathobiochemistry Philipps University of Marburg ‐ Medical Faculty Marburg Germany
| | - Matthew Greenhawt
- School of Medicine, Section of Allergy and Immunology Children's Hospital Colorado, University of Colorado Aurora Colorado
| | - Karin Hoffmann‐Sommergruber
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- University of Cape Town Cape Town South Africa
| | - Kate Maslin
- MRC Lifecourse Epidemiology Unit University of Southampton Southampton UK
| | - Clare Mills
- School of Biological Sciences, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology The University of Manchester Manchester UK
| | - Antonella Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
| | - Isabella Pali
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - Lars Poulson
- Allergy Clinic, Dept. of Skin and Allergy Diseases Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - Imke Reese
- Dietary Counseling and Nutrition Therapy Centre Munich Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Graham C. Roberts
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Newport UK
- NIHR Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units University of Southampton Southampton UK
| | - Peter Smith
- School of Medicine Griffith University Southport Australia
| | - Sylwia Smolinska
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Depts of Medicine and Microbiology APC Microbiome Ireland, National University of Ireland Cork Ireland
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Kapitanović Vidak H, Catela Ivković T, Vidak Z, Kapitanović S. COX-1 and COX-2 polymorphisms in susceptibility to cerebral palsy in very preterm infants. Mol Neurobiol 2016; 54:930-938. [PMID: 26781425 DOI: 10.1007/s12035-016-9713-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 01/11/2016] [Indexed: 12/21/2022]
Abstract
Cerebral palsy (CP) is a nonprogressive motor disorder caused by white matter damage in the developing brain. Recent epidemiological and clinical data suggest intrauterine infection/inflammation as the most common cause of preterm delivery and neonatal complications, including CP. Cyclooxygenases are key enzymes in the conversion of arachidonic acid to prostaglandins. The COX family consists of two isoforms, COX-1 and COX-2. In the brain, COX-2 is constitutively expressed at high levels on pyramidal neurons, while COX-1 is predominantly expressed by microglia and can be upregulated in pathological conditions, such as infection, ischemia and traumatic brain injury. Single nucleotide polymorphisms in the COX-1 and COX-2 gene could have profound effects on COX-1 and COX-2 expression and, directly or indirectly, influence the pathogenesis, development and severity of CP. In this study we investigated the association between single nucleotide polymorphisms of the COX-1 and COX-2 gene and susceptibility to cerebral palsy in very preterm infants. The results of our study showed the association between COX-1 high expression genotype (-842 AA) and COX-1 high expression allele -842A and risk of CP in infants with cystic periventricular leucomalacia (cPVL). Our results support an important role of COX-1 enzyme on microglial activation during neuroinflammation resulting in huge neuroinflammatory response and the proinflammatory mediator overproduction, with the serious white matter damage and CP development as a consequence.
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Affiliation(s)
- Helena Kapitanović Vidak
- Special Hospital for Children with Neurodevelopmental and Motor Difficulties, Goljak 2, Zagreb, Croatia.
| | - Tina Catela Ivković
- Laboratory for Personalized Medicine, Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička c. 54, Zagreb, Croatia
| | - Zoran Vidak
- Department of Obstetrics and Gynecology, Division of Neonatology, Clinical Hospital Merkur, Ivana Zajca 19, Zagreb, Croatia
| | - Sanja Kapitanović
- Laboratory for Personalized Medicine, Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička c. 54, Zagreb, Croatia
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Genetic Variations in Inflammatory Response Genes and Their Association with the Risk of Prostate Cancer. BIOMED RESEARCH INTERNATIONAL 2015; 2015:674039. [PMID: 26788504 PMCID: PMC4691602 DOI: 10.1155/2015/674039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/25/2015] [Accepted: 06/10/2015] [Indexed: 12/14/2022]
Abstract
Prostate cancer is a common cancer in men. Genetic variations in inflammatory response genes can potentially influence the risk of prostate cancer. We aimed to examine the association between PPARG Pro12Ala, NFKB1 -94 ins/del, NFKBIA -826C/T, COX-1 (50C>T), and COX-2 (-1195G>A) polymorphisms on prostate cancer risk. The genotypes of the polymorphisms were ascertained in 543 prostate cancer patients and 753 controls through PCR-RFLP and the risk association was evaluated statistically using logistic regression analysis. The NFKB1 -94 polymorphism was shown to decrease prostate cancer risk in both heterozygous and homozygous comparison models (odds ratios of 0.74 (95% CI = 0.58-0.96) (P = 0.02) and 0.57 (95% CI = 0.42-0.78) (P < 0.01), resp.). An opposite finding was observed for COX-2 (-1195) polymorphism (odds ratios of 1.58 (95% CI = 1.15-2.18) (P < 0.01) for heterozygous comparison model and 2.08 (95% CI = 1.48-2.92) (P < 0.01) for homozygous comparison model). No association was observed for other polymorphisms. In conclusion, NFKB1 -94 ins/del and COX-2 (-1195G>A) polymorphisms may be, respectively, associated with decreased and increased prostate cancer risk in the Chinese population.
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Yucesoy B, Kashon ML, Johnson VJ, Lummus ZL, Fluharty K, Gautrin D, Cartier A, Boulet LP, Sastre J, Quirce S, Tarlo SM, Cruz MJ, Munoz X, Luster MI, Bernstein DI. Genetic variants in TNFα, TGFB1, PTGS1 and PTGS2 genes are associated with diisocyanate-induced asthma. J Immunotoxicol 2015; 13:119-26. [PMID: 25721048 DOI: 10.3109/1547691x.2015.1017061] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Diisocyanates are the most common cause of occupational asthma, but risk factors are not well defined. A case-control study was conducted to investigate whether genetic variants in inflammatory response genes (TNFα, IL1α, IL1β, IL1RN, IL10, TGFB1, ADAM33, ALOX-5, PTGS1, PTGS2 and NAG-1/GDF15) are associated with increased susceptibility to diisocyanate asthma (DA). These genes were selected based on their role in asthmatic inflammatory processes and previously reported associations with asthma phenotypes. The main study population consisted of 237 Caucasian French Canadians from among a larger sample of 280 diisocyanate-exposed workers in two groups: workers with specific inhalation challenge (SIC) confirmed DA (DA(+), n = 95) and asymptomatic exposed workers (AW, n = 142). Genotyping was performed on genomic DNA, using a 5' nuclease PCR assay. After adjusting for potentially confounding variables of age, smoking status and duration of exposure, the PTGS1 rs5788 and TGFB1 rs1800469 single nucleotide polymorphisms (SNP) showed a protective effect under a dominant model (OR = 0.38; 95% CI = 0.17, 0.89 and OR = 0.38; 95% CI = 0.18, 0.74, respectively) while the TNFα rs1800629 SNP was associated with an increased risk of DA (OR = 2.08; 95% CI = 1.03, 4.17). Additionally, the PTGS2 rs20417 variant showed an association with increased risk of DA in a recessive genetic model (OR = 6.40; 95% CI = 1.06, 38.75). These results suggest that genetic variations in TNFα, TGFB1, PTGS1 and PTGS2 genes contribute to DA susceptibility.
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Affiliation(s)
- Berran Yucesoy
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA .,b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | - Michael L Kashon
- b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | | | - Zana L Lummus
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Kara Fluharty
- b CDC/National Institute for Occupational Safety and Health, Health Effects Laboratory Division , Morgantown , WV , USA
| | - Denyse Gautrin
- d Université de Montréal, Hôpital du Sacré-Coeur de Montréal , Montreal , Quebec , Canada
| | - André Cartier
- d Université de Montréal, Hôpital du Sacré-Coeur de Montréal , Montreal , Quebec , Canada
| | | | - Joaquin Sastre
- f Department of Allergy , Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain
| | - Santiago Quirce
- g Department of Allergy , Hospital La Paz-IdiPAZ and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain
| | - Susan M Tarlo
- h Department of Medicine , and.,i Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | - Maria-Jesus Cruz
- j Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain , and
| | - Xavier Munoz
- j Hospitals Vall D'Hebron, Barcelona and CIBER de Enfermedades Respiratorias CIBERES , Madrid , Spain , and
| | - Michael I Luster
- k West Virginia University, School of Public Health , Morgantown , WV , USA
| | - David I Bernstein
- a Division of Immunology , Allergy and Rheumatology, University of Cincinnati College of Medicine , Cincinnati , OH , USA
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Applebaum E, Nackley AG, Bair E, Maixner W, Khan AA. Genetic Variants in Cyclooxygenase-2 Contribute to Post-treatment Pain among Endodontic Patients. J Endod 2015; 41:1214-8. [PMID: 26081267 DOI: 10.1016/j.joen.2015.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) have a well-established analgesic efficacy for inflammatory pain. These drugs exert their effect by inhibiting the enzyme cyclooxygenase (COX) and are commonly used for the management of pain after endodontic treatment. There are 2 distinct isoforms of COX: COX-1, which is constitutively expressed, and COX-2, which is primarily induced by inflammation. Previous studies have shown that functional human genetic variants of the COX-2 gene may explain individual variations in acute pain. The present study extends this work by examining the potential contribution of the 2 COX isoforms to pain after endodontic treatment. METHODS Ninety-four patients treated by endodontic residents at the University of North Carolina School of Dentistry were enrolled into a prospective cohort study. Data on potential predictors of post-treatment pain were collected, and all patients submitted saliva samples for genetic analysis. Nonsurgical root canal therapy was performed, and participants recorded pain levels for 5 days after. RESULTS In this study, 63% of patients experienced at least mild pain after root canal therapy, and 24% experienced moderate to severe pain. The presence of pretreatment pain was correlated with higher post-treatment pain (P = .01). Elevated heart rate (P = .02) and higher diastolic blood pressure (P = .024) were also correlated with decreased post-treatment pain. Finally, we identified genetic variants in COX-2 (haplotype composed of rs2383515 G, rs5277 G, rs5275 T, and rs2206593 A) associated with post-treatment pain after endodontic treatment (P = .025). CONCLUSIONS Understanding the genetic basis of pain after endodontic treatment will advance its prevention and management.
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Affiliation(s)
- Elizabeth Applebaum
- Private Practice, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Andrea G Nackley
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Eric Bair
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - William Maixner
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Asma A Khan
- Center for Pain Research and Innovation, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
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Narayanankutty A, Reséndiz-Hernández JM, Falfán-Valencia R, Teran LM. Biochemical pathogenesis of aspirin exacerbated respiratory disease (AERD). Clin Biochem 2012; 46:566-78. [PMID: 23246457 DOI: 10.1016/j.clinbiochem.2012.12.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/14/2012] [Accepted: 12/04/2012] [Indexed: 12/30/2022]
Abstract
Aspirin exacerbated respiratory disease (AERD) is a distinct clinical entity characterized by eosinophilic rhinosinusitis, asthma and often nasal polyposis. Exposure to aspirin or other nonsteroid anti-inflammatory drugs (NSAIDs) exacerbates bronchospasms with asthma and rhinitis. Disease progression suggests a skewing towards TH2 type cellular response along with moderate to severe eosinophil and mast cell infiltration. Alterations in upper and lower airway cellular milieu with abnormalities in eicosanoid metabolism and altered eicosanoid receptor expression are the key features underlying AERD pathogenesis. Dysregulation of arachidonic acid (AA) metabolism, notably reduced prostaglandin E2 (PGE2) synthesis compared to their aspirin tolerant counterpart and relatively increased PGD2 production, a TH2/eosinophil chemoattractant are reported in AERD. Underproduced PGE2 is metabolized by overexpression of 15 prostaglandin dehydrogenase (15-PGDH) to inactive products further reducing PGE2 at real time. This relives the inhibitory effect of PGE2 on 5-lipoxygenase (5-LOX) resulting in overproduction of cysteinyl leukotrienes (CysLTs). Diminished formation of CysLT antagonists called lipoxins (LXs) also augments CysLTs responsiveness. Occasional intake of NSAIDs favors even more 5-LOX product formation, further narrowing the bronchoconstrictive bottle neck, resulting in acute asthmatic exacerbations along with increased mucus production. This review focuses on abnormalities in biochemical and molecular mechanisms in eicosanoid biosynthesis, eicosanoid receptor dysregulation and associated polymorphisms with special reference to arachidonic acid metabolism in AERD.
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Affiliation(s)
- Arun Narayanankutty
- Department of Immunoallergy and Asthma, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Calzada de Tlalpan 4502, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico.
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Decreased cyclooxygenase inhibition by aspirin in polymorphic variants of human prostaglandin H synthase-1. Pharmacogenet Genomics 2012; 22:525-37. [PMID: 22513397 DOI: 10.1097/fpc.0b013e32835366f6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Aspirin (ASA), a major antiplatelet and cancer-preventing drug, irreversibly blocks the cyclooxygenase (COX) activity of prostaglandin H synthase-1 (PGHS-1). Considerable differences in ASA effectiveness are observed between individuals, and some of this variability may be due to PGHS-1 protein variants. Our overall aim is to determine which, if any, of the known variants in the mature PGHS-1 protein lead to functional alterations in COX catalysis or inhibition by ASA. The present study targeted four PGHS-1 variants: R53H, R108Q, L237M, and V481I. METHODS Wild-type human PGHS-1 and the four polymorphic variants were expressed as histidine-tagged, homodimeric proteins in insect cells using baculovirus vectors, solubilized with a detergent, and purified by affinity chromatography. The purified proteins were characterized in vitro to evaluate COX and peroxidase (POX) catalytic parameters and the kinetics of COX inhibition by ASA and NS-398. RESULTS Compared with the wild type, several variants showed a higher COX/POX ratio (up to 1.5-fold, for R108Q), an elevated arachidonate Km (up to 1.9-fold, for R108Q), and/or a lower ASA reactivity (up to 60% less, for R108Q). The decreased ASA reactivity in R108Q reflected both a 70% increase in the Ki for ASA and a 30% decrease in the rate constant for acetyl group transfer to the protein. Computational modeling of the brief ASA pulses experienced by PGHS-1 in circulating platelets during daily ASA dosing predicted that the 60% lower ASA reactivity in R108Q yields a 15-fold increase in surviving COX activity; smaller, approximately two-fold increases in surviving COX activity were predicted for L237M and V481I. NS-398 competitively inhibited COX catalysis of the wild type (Ki=6 µmol/l) and inhibited COX inactivation by 1.0 mmol/l ASA in both the wild type (IC50=0.8 µmol/l) and R108Q (IC50=2.1 µmol/l). CONCLUSION Of the four PGHS-1 variants examined, R108Q exerts the largest functional effects, with evidence for impaired interactions with a COX substrate and inhibitors. As Arg108 is located on the protein surface and not in the active site, the effects of R108Q suggest a novel, unsuspected mechanism for the modulation of the PGHS-1 active site structure. The lower intrinsic ASA reactivity of R108Q, V481I, and L237M, combined with the rapid hydrolysis of ASA in the blood, suggests that these variants decrease the antiplatelet effectiveness of the drug. These PGHS-1 variants are uncommon but ASA is used widely; hence, a considerable number of individuals could be affected. Further examination of these and other PGHS-1 variants will be needed to determine whether PGHS-1 genotyping can be used to personalize anti-COX therapy.
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Bondar’ TN, Kravchenko NA. Polymorphism of the cyclooxigenase-1 gene and aspirin resistance. CYTOL GENET+ 2012. [DOI: 10.3103/s0095452712040044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Genetic association analysis of TAP1 and TAP2 polymorphisms with aspirin exacerbated respiratory disease and its FEV1 decline. J Hum Genet 2011; 56:652-9. [PMID: 21796142 DOI: 10.1038/jhg.2011.75] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aspirin exacerbated respiratory disease (AERD) induces bronchoconstriction in asthmatic patients characterized with a clinical condition of severe decline in forced expiratory volume in one second (FEV1) after ingestion of aspirin. Two genes consisting a heterodimer, transporter 1 and 2, ATP-binding cassette, sub-family B (MDR/TAP) (TAP1 and TAP2) within the major histocompatibility complex (MHC) region, have been implicated in immunodeficiency and bronchiectasis development. To investigate the associations of TAP1 and TAP2 genetic polymorphisms with AERD and phenotypic FEV1 decline, a total of 43 common single-nucleotide polymorphisms (SNPs) including 12 SNPs of TAP1 and 31 SNPs of TAP2 were genotyped in 93 AERD patients and 96 aspirin-tolerant asthma controls. Interestingly, regression analysis revealed that polymorphisms and haplotypes of TAP2 were associated with FEV1 decline by aspirin provocation (P=0.002-0.04), with about twofold decline rate of FEV1 in most of minor homozygotes compared with major homozygotes. In addition, nominal evidences of association between TAP2 and AERD development were observed (P=0.02-0.04). However, TAP1 polymorphisms showed no relations to both AERD and FEV1 decline after aspirin challenge (P>0.05). Although further functional evaluations and replications are required, our preliminary findings provide supporting information that variants of TAP2 might be predisposing factors for FEV1 decline-related symptoms.
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Cyclooxygenase polymorphisms in gastric and colorectal carcinogenesis: are conclusive results available? Eur J Gastroenterol Hepatol 2009; 21:76-91. [PMID: 19060633 DOI: 10.1097/meg.0b013e32830ce7ba] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Cyclooxygenases (COX) are important enzymes not only in the maintenance of mucosal integrity but also in pathological processes, namely in inflammation and tumor development in the gastrointestinal tract. Our goal was to understand whether there is a clear role for COX polymorphisms in gastric and colorectal carcinogenesis. METHODS A systematic review was conducted on observational studies assessing the involvement of COX polymorphisms at the onset of gastric or colorectal lesions, retrieved through a MEDLINE database search by May 2008. The dominant genetic model was assumed for each polymorphism and a random-effect model was used for pooling results. RESULTS Twenty-two studies were retrieved reporting a total of 26 COX polymorphisms (nine in COX1 and 17 in COX2 genes). Carriers of -1329A, -899C alleles, and *429TT genotype revealed increased risk for gastric cancer [odds ratio (OR)=1.83; 95% confidence interval (CI): 1.07-3.10, OR=2.02; 95% CI: 1.00-4.10 and OR=1.34; 95% CI: 1.06-1.71, respectively). For colorectal lesions, the -899G>C and -1329G>A polymorphisms also showed an increased risk for cancer (OR=1.35; 95% CI: 1.01-1.81 and OR=1.36; 95% CI: 1.11-1.66, respectively). Furthermore, C allele carriers of V102V single nucleotide polymorphisms presented a decreased risk for colorectal adenoma onset (OR=0.77; 95% CI: 0.58-1.03). CONCLUSION Although further studies, namely cohorts and/or adequately matched case-control studies, are required to unravel the impact of most COX polymorphisms, clearly there are evidences that support the involvement of -899G>C and -1329G>A COX2 polymorphisms in either gastric or colorectal carcinogenesis. These markers could be used to optimize management strategies (follow-up and/or chemoprevention).
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Arisawa T, Tahara T, Shibata T, Nagasaka M, Nakamura M, Kamiya Y, Fujita H, Yoshioka D, Arima Y, Okubo M, Hirata I, Nakano H. Genetic polymorphisms of cyclooxygenase-1 (COX-1) are associated with functional dyspepsia in Japanese women. J Womens Health (Larchmt) 2008; 17:1039-43. [PMID: 18582172 DOI: 10.1089/jwh.2007.0720] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prostaglandins (PGs), catalyzed from arachidonic acid by cyclooxygenase (COX), are involved in a variety of physiological processes in the stomach. COX-1 has been regarded as a constitutively expressed enzyme that generates prostaglandins for gastrointestinal integrity. We investigated the association between the potentially functional polymorphism T-1676C in the COX-1 gene promoter and functional dyspepsia (FD) in the Japanese population. METHODS The study was performed in 272 subjects (185 with no upper abdominal symptoms and 87 with FD). We employed the PCR-SSCP method to detect the gene polymorphism. RESULTS Overall, female sex had a 2-2.5-fold risk for the development of FD compared with male sex, whereas the COX-1 gene polymorphism and Helicobacter pylori infection were not associated with susceptibility to FD. However, in female subjects, -1676T allele carriers had a significantly increased risk for the development of FD (OR 2.70, 95%CI 1.04-6.99, p = 0.041), especially the epigastric pain syndrome (EPS) subgroup (OR 4.07, 95%CI 1.15-14.4, p = 0.029). CONCLUSIONS Our results provide the first evidence that the COX-1 gene polymorphism is significantly associated with the development of the EPS subgroup of FD in female subjects.
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Affiliation(s)
- Tomiyasu Arisawa
- Department of Gatroenterology, Fujita Health University School of Medicine 1-98, Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan.
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Shi J, Misso NL, Kedda MA, Horn J, Welch MD, Duffy DL, Williams C, Thompson PJ. Cyclooxygenase-2 gene polymorphisms in an Australian population: association of the -1195G > A promoter polymorphism with mild asthma. Clin Exp Allergy 2008; 38:913-20. [PMID: 18489027 DOI: 10.1111/j.1365-2222.2008.02986.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cyclooxygenase (COX)-2 is an inducible enzyme responsible for catalysing the formation of prostaglandins (PGs) in settings of inflammation. Single nucleotide polymorphisms (SNPs) of the COX-2 gene may influence gene transcription and PG production in the asthmatic airway. OBJECTIVE To evaluate the frequencies of COX-2 SNPs in an Australian Caucasian population, and determine potential associations between common COX-2 promoter SNPs and asthma, asthma severity and aspirin-intolerant asthma (AIA). METHODS The frequencies of 25 COX-2 SNPs were determined in a random population (n=176). The SNPs with a minor allele frequency of >10% were then studied in asthmatic (n=663), non-asthmatic controls (n=513) and AIA subjects (n=58). Genotype, allele and haplotype associations were assessed. Functional assessment of SNPs was performed by transfection into HeLa cells measured using the luciferase dual-reporter assay system. RESULTS Eighteen COX-2 SNPs were not detected, five were rare and two promoter SNPs, -1195G>A (rs689465), and -1290A>G (rs689466), were further studied. The A allele of the -1195 SNP was present at a significantly higher frequency among all asthmatic subjects (P=0.012). Over 60% of the asthmatic individuals were -1195A homozygotes compared with 54.6% of the control subjects (odds ratio, 1.35; 95% CI, 1.06-1.72, P=0.03). After classifying for severity, the mild asthmatics represented 64.6% of -1195AA individuals, the highest of all the asthma groups compared with 54.6% of the control subjects (odds ratio, 1.5; 95% CI, 1.12-2.02, P=0.02). The -1290A/-1195G/-765G haplotype was associated with a reduced incidence of asthma (odds ratio, 0.76; 95% CI, 0.61-0.95, P=0.017). CONCLUSION The -1195G>A polymorphism appears to be associated with asthma, and in particular with mild asthma.
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Affiliation(s)
- J Shi
- Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, The University of Western Australia, Perth, WA, Australia
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Lee CR, Bottone FG, Krahn JM, Li L, Mohrenweiser HW, Cook ME, Petrovich RM, Bell DA, Eling TE, Zeldin DC. Identification and functional characterization of polymorphisms in human cyclooxygenase-1 (PTGS1). Pharmacogenet Genomics 2007; 17:145-60. [PMID: 17301694 PMCID: PMC2041861 DOI: 10.1097/01.fpc.0000236340.87540.e3] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Cyclooxygenase-1 (COX-1, PTGS1) catalyzes the conversion of arachidonic acid to prostaglandin H2, which is subsequently metabolized to various biologically active prostaglandins. We sought to identify and characterize the functional relevance of genetic polymorphisms in PTGS1. METHODS Sequence variations in human PTGS1 were identified by resequencing 92 healthy individuals (24 African, 24 Asian, 24 European/Caucasian, and 20 anonymous). Using site-directed mutagenesis and a baculovirus/insect cell expression system, recombinant wild-type COX-1 and the R8W, P17L, R53H, R78W, K185T, G230S, L237M, and V481I variant proteins were expressed. COX-1 metabolic activity was evaluated in vitro using an oxygen consumption assay under basal conditions and in the presence of indomethacin. RESULTS Forty-five variants were identified, including seven nonsynonymous polymorphisms encoding amino acid substitutions in the COX-1 protein. The R53H (35+/-5%), R78W (36+/-4%), K185T (59+/-6%), G230S (57+/-4%), and L237M (51+/-3%) variant proteins had significantly lower metabolic activity relative to wild-type (100+/-7%), while no significant differences were observed with the R8W (104+/-10%), P17L (113+/-7%), and V481I (121+/-10%) variants. Inhibition studies with indomethacin demonstrated that the P17L and G230S variants had significantly lower IC50 values compared to wild-type, suggesting these variants significantly increase COX-1 sensitivity to indomethacin inhibition. Consistent with the metabolic activity data, protein modeling suggested the G230S variant may disrupt the active conformation of COX-1. CONCLUSIONS Our findings demonstrate that several genetic variants in human COX-1 significantly alter basal COX-1-mediated arachidonic acid metabolism and indomethacin-mediated inhibition of COX-1 activity in vitro. Future studies characterizing the functional impact of these variants in vivo are warranted.
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Affiliation(s)
- Craig R. Lee
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
- Division of Pharmacotherapy and Experimental Therapeutics, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Frank G. Bottone
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Joseph M. Krahn
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Leping Li
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Harvey W. Mohrenweiser
- Biology and Biotechnology Research Program, Lawrence Livermore National Laboratory, Livermore, California
- Center for Research in Occupational Toxicology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Molly E. Cook
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Robert M. Petrovich
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Douglas A. Bell
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Thomas E. Eling
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
| | - Darryl C. Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park
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Polonikov AV, Ivanov VP, Solodilova MA, Khoroshaya IV, Kozhuhov MA, Panfilov VI. Promoter polymorphism G-50T of a human CYP2J2 epoxygenase gene is associated with common susceptibility to asthma. Chest 2007; 132:120-6. [PMID: 17475630 DOI: 10.1378/chest.07-0371] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Cytochrome P-450 2J2 (CYP2J2) has recently been shown to be an important enzyme in the metabolism of epoxygenase-derived eicosanoids that play important functional roles in pulmonary physiology and may contribute to the pathogenesis of asthma. STUDY OBJECTIVE The focus of our pilot study was to evaluate whether common polymorphism G-50T within the proximal promoter of human CYP2J2 gene is associated with the susceptibility to bronchial asthma. DESIGN AND PARTICIPANTS A total of 429 unrelated Russian subjects were recruited in this case-control study, including 215 sex-matched and age-matched patients with asthma and 214 healthy control subjects. The blood samples were analyzed for genetic polymorphism G-50T in the CYP2J2 gene by polymerase chain reaction followed by restriction fragment length polymorphism analysis. RESULTS The frequency of variant allele -50T of the CYP2J2 gene was significantly higher in asthmatic patients than in healthy subjects (odds ratio [OR], 5.04; 95% confidence interval [CI], 1.99 to 12.77; p = 0.0003). In addition, the heterozygous genotype -50GT of the CYP2J2 gene was found to be significantly associated with susceptibility to allergic asthma (OR, 5.40; 95% CI, 2.05 to 14.26; p = 0.0003) as well as nonallergic asthma (OR, 5.77; 95% CI, 1.84 to 18.10; p = 0.004). The associations of the CYP2J2 gene G-50T polymorphism with asthma remained significant after adjustment for age and gender using multiple logistic regression analysis. CONCLUSIONS Our data demonstrate for the first time that the CYP2J2 gene might be considered as a novel candidate gene for common susceptibility to asthma and highlight the importance of the P-450 epoxygenase pathway of metabolism of arachidonic acid in the pathogenesis of the disease.
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Zhang Q, Thomas M, Wisniewski T, Sazonov Kocevar V, Price D. Treatment and outcomes in patients with asthma and allergic rhinitis in the United kingdom. Int Arch Allergy Immunol 2006; 142:318-28. [PMID: 17135763 DOI: 10.1159/000097501] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Accepted: 08/21/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Since allergic rhinitis in asthma patients is associated with worse asthma control, the treatment of the comorbid condition may improve outcomes. METHODS A 1-year retrospective study using the UK Mediplus database (2001-2004) included asthmatic patients aged 15-55 with allergic rhinitis. Patients starting therapy based on the Global Initiative for Asthma guidelines, defined as an increase in inhaled corticosteroids (high-dose inhaled corticosteroids, hdICS), or the addition of montelukast (ICS+MON) or long-acting beta-agonists (ICS+LABA) to ICS, were studied. Univariable and multiple logistic regressions evaluated asthma-related outcomes. RESULTS Among 2,596 asthma and allergic rhinitis patients, 83.2% initiated ICS+LABA, 12.1% hdICS and 4.7% ICS+MON. The mean age was 34 years and 60% were female. ICS+MON patients had more moderate-severe asthma (p = 0.04). Approximately 84% of the ICS+LABA patients experienced an asthma control failure compared to 50% in the other groups (p < 0.0001). The proportions of patients requiring treatment change were 73.8, 22 and 27.3% in the ICS+LABA, hdICS and ICS+MON groups, respectively (p = 0.001). Asthma-related resource use was similar among all groups. The ICS+MON group received fewer mean prescriptions for oral corticosteroids (p = 0.024) than the other groups (p = 0.026). CONCLUSIONS In asthma and allergic rhinitis, treatment with ICS+MON or hdICS was associated with lower rates of asthma control failure and fewer treatment changes than the ICS+LABA group. MON users also required fewer oral corticosteroids.
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Affiliation(s)
- Qiaoyi Zhang
- Merck & Co., Whitehouse Station, NJ 08889-0100, USA.
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Current World Literature. Curr Opin Allergy Clin Immunol 2006. [DOI: 10.1097/01.all.0000244802.79475.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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