Association of genetic variants with level of asthma control in the Arab population

Progress in research on induced sputum in asthma: a narrative review

OBJECTIVE

To explore the clinical significance of induced sputum in asthma through a retrospective analysis of induced sputum in patients with asthma.

DATA SOURCES

The data and references cited in this article were obtained from PubMed, Sci-Hub, and Web of Science.

STUDY SELECTION

Observational studies with reliable data were selected.

CONCLUSIONS

The cytological count, -omics, and pathogen detection of induced sputum are helpful for the clinical diagnosis of asthma and in guiding medication choices.

Drug Metabolizing Enzymes: An Exclusive Guide into Latest Research in Pharmaco-genetic Dynamics in Arab Countries

Drug metabolizing enzymes play a crucial role in the pharmacokinetics and pharmacodynamics of therapeutic drugs, influencing their efficacy and safety. This review explores the impact of genetic polymorphisms in drug-metabolizing genes on drug response within Arab populations. We examine the genetic diversity specific to Arab countries, focusing on the variations in key drug-metabolizing enzymes such as CYP450, GST, and UGT families. The review highlights recent research on polymorphisms in these genes and their implications for drug metabolism, including variations in allele frequencies and their effects on therapeutic outcomes. Additionally, the paper discusses how these genetic variations contribute to the variability in drug response and adverse drug reactions among individuals in Arab populations. By synthesizing current findings, this review aims to provide a comprehensive understanding of the pharmacogenetic landscape in Arab countries and offer insights into personalized medicine approaches tailored to genetic profiles. The findings underscore the importance of incorporating pharmacogenetic data into clinical practice to enhance drug efficacy and minimize adverse effects, ultimately paving the way for more effective and individualized treatment strategies in the region.

CRHR1 polymorphism at rs242941, rs242940, and rs72834580: association of symptoms improvement with intranasal corticosteroids in allergic rhinitis Jordanian patients

OBJECTIVES

Rhinitis is classified into several types with allergic rhinitis (AR) being the most common. AR is among the inflammatory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), in which corticosteroids are administered to overcome the decrease in cortisol production. The treatment options available for AR vary with 1st line treatment being intranasal corticosteroids (INCS). The responsiveness to corticosteroids is due to their binding to corticotropin-releasing hormone receptor-1 (CRHR1). Various studies have studied the responsiveness to corticosteroids treatment in patients with asthma and COPD in association with CRHR1 gene single nucleotide polymorphisms (SNPs).

METHODS

In our study, we investigated the association of three SNPs of CRHR1 gene (rs242941, rs242940, and rs72834580) with symptoms improvement post-treatment in AR patients. Blood samples were collected from 103 patients for DNA extraction and gene sequencing. Those patients started to receive INCS for 8 weeks and their symptoms were assessed, through a questionnaire, before treatment and post-treatment to check for symptoms improvement.

RESULTS

Our data showed that improvement of eye redness is significantly less following INCS treatment in patients with allele (C) (AOR=0.289, p-value-0.028, 95 % CI=0.096-0.873) and genotype (CC) (AOR=0.048, p-value-0.037, 95 % CI=0.003-0.832) of rs242941 SNP. There was no correlation with other genotypes, alleles, or haplotypes of the investigated SNPs.

CONCLUSIONS

Our findings show that there is no correlation between CRHR1 gene polymorphism and symptoms improvement following INCS treatment. Further studies are required to evaluate the association of INCS and symptoms improvement post-treatment with larger sample size.

The impact of using a mobile application to improve asthma patients' adherence to medication in Jordan

The main aim of this study is to assess the effectiveness of using a developed asthma mobile application to enhance medication adherence in Jordan. Asthma patients visiting outpatient respiratory clinics and using inhalers were recruited. Patients were assigned into two groups: intervention and control. The intervention group was instructed to download and use the application. Asthma control was assessed using Asthma Control Test (ACT) at baseline and at follow-up of 3 months for both groups. A total of 171 patients (control, n = 83, and intervention, n = 88) participated in the study. After 3 months of usage, patients in the intervention group achieved a significant improvement in ACT score compared to control (p-value <0.05), and reported a significant satisfaction of the application use. Therefore, the asthma mobile application is found as an effective tool to enhance medication adherence in asthma patients.

Genetic association study of CTLA4 and FCεRIα polymorphisms in asthmatic patients in the southwestern region of Iran

Asthma is a heterogeneous chronic pulmonary disease that develops due to the interaction of genetic and environmental factors. This study aimed to investigate the polymorphisms of CTLA4(SNP-318C > T, SNP + 49A > G) and FCεRIα(SNP-344T > C) genes in asthmatic patients in Southwest Iran. The study enrolled 200 patients with asthma of Arab and Bakhtiary descent and 200 healthy controls, where asthmatic patients and healthy controls were selected based on a spirometry test. Genomic DNA from whole blood samples using the TaqMan assay was used to study the genotypes of patients and healthy controls.The results indicated no statistically significant difference between cases and controls for the SNP-344C > T of the FCεR1α gene and the SNP + 49A > G, SNP-318C > T of the CTLA4 gene. There was a significant correlation between the CTLA4-318C > T allele frequency in both the case and control groups (OR = 1.83; 95%CI, 1.14-2.94; P = 0.01). We stratified genotypes according to age, gender, ethnicity, and smoking status and discovered a significant suggestive association between the SNP + 49A > G of the CTLA4 gene and smoking. Additionally, SNP + 49A > G was found to be associated with gender and age. The results indicated that the SNP-318C > T polymorphism in the CTLA4 gene might contribute to the development of asthma in the studied population. Meanwhile, smoking can exacerbate asthma in individuals with SNP + 49A > G of the CTLA4 gene.Supplemental data for this article is available online at https://doi.org/10.1080/15257770.2021.1964525 .

Genetic Determinants of Poor Response to Treatment in Severe Asthma

Severe asthma is a multifactorial disorder with marked phenotypic heterogeneity and complex interactions between genetics and environmental risk factors, which could, at least in part, explain why during standard pharmacologic treatment, many patients remain poorly controlled and at an increased risk of airway remodeling and disease progression. The concept of “precision medicine” to better suit individual unique needs is an emerging trend in the management of chronic respiratory diseases. Over the past few years, Genome-Wide Association Studies (GWAS) have revealed novel pharmacogenetic variants related to responses to inhaled corticosteroids and the clinical efficacy of bronchodilators. Optimal clinical response to treatment may vary between racial/ethnic groups or individuals due to genetic differences. It is also plausible to assume that epigenetic factors play a key role in the modulation of gene expression patterns and inflammatory cytokines. Remarkably, specific genetic variants related to treatment effectiveness may indicate promising pathways for novel therapies in severe asthma. In this review, we provide a concise update of genetic determinants of poor response to treatment in severe asthma and future directions in the field.

Bronchial Asthma: Genetic Factors Contributing to its Pathogenesis

Researching bronchial asthma (BA)-linked gene polymorphisms can help to clarify heterogeneity of the disease and estimate its severity, which, in turn, will aid in developing an appropriate treatment corresponding to the patient’s unique asthma pathogenesis. The aim of presented review is to analyze the published data on the genetic preconditions of BA and the possible role of different genes polymorphisms in its pathogenesis. We have found that despite the fact that numerous genes are involved in the pathogenesis of BA and their polymorphisms are associated with increased risks for BA, it is important to understand that a combination of factors, both genetic and environmental, triggers BA development and determines its progression. On the other hand, the identification of BA susceptibility genes contributing to asthma pathogenesis and treatment response is the first step toward the development of personalized medicine.

The role of polymorphic variants of arginase genes (ARG1, ARG2) involved in beta-2-agonist metabolism in the development and course of asthma

Asthma is a common severe disease of the respiratory tract, it leads to a significant impairment in the quality of a patient’s life unless effectively treated. Uncontrolled asthma symptoms are a cause of disease progression and development, they lead to an increase in the patient’s disability. The sensitivity to asthma therapy largely depends on the interaction of genetic and epigenetic factors, which account for about 50–60 % of variability of therapeutic response. Beta-2-agonists are some of the major class of bronchodilators used for asthma management. According to published data, allelic variants of the arginase ARG1 and ARG2 genes are associated with a risk of asthma development, spirometry measures and efficacy of bronchodilator therapy. High arginase activity results in a low level of plasma L-arginine and in a decrease in nitric oxide, and, as a result, in an increase in airway inflammation and remodeling. Arginase genetic polymorphisms (rs2781667 of the ARG1 gene, rs17249437, rs3742879, rs7140310 of the ARG2 gene) were studied in 236 children with asthma and 194 unrelated healthy individuals of Russian, Tatar and Bashkir ethnicity from the Republic of Bashkortostan. Association analysis of the studied polymorphisms with asthma development and course, the sensitivity to therapy in patients was carried out. It was found that the rs2781667*C allele of the ARG1 gene is a marker of an increased risk of asthma in Tatars. In Russians, the association of rs17249437*TT and rs3742879*GG genotypes of the ARG2 gene with a decrease in spirometry measures (FEV1, MEF25) was established. In Russians and Tatars receiving glucocorticoid monotherapy or combination therapy, the association of the rs17249437*T allele and rs17249437*TT genotype of the ARG2 gene with a partially controlled and uncontrolled course of asthma was shown.

An investigation of the association between ADRB2 gene polymorphisms and asthma in Kazakh population

INTRODUCTION

Beta-2-adrenergic receptor (ADRB2) is present in the cells of the respiratory tract, including bronchial smooth muscle cells and bronchial epithelium, and is a target for endogenous catecholamines and drugs used to treat the obstructive lung diseases.

OBJECTIVES

This study aimed to investigate the possible association of the Arg16Gly and Gln27Glu polymorphisms of the ADRB2 gene with asthma and its endophenotypes in the Kazakh population.

METHODS

A total of 70 asthmatic patients and 80 healthy controls were genotyped for Arg16Gly and Gln27Glu polymorphisms of the ADRB2 gene by using quantitative real-time polymerase chain reaction. Statistical analysis was performed with the Graph Pad InStat 7 Software.

RESULTS

No associations between the asthma patients and healthy individuals were found when the allele and genotype distribution of Arg16Gly and Gln27Glu single nucleotide polymorphisms were compared. Analysis of the haplotype frequencies showed statistically significant differences between patients with asthma and controls for Arg16Gly/Gln27Gln and Arg16Gly/Gln27Glu haplotypes (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 0.87-5.16 and OR = 2.25, 95% CI = 0.89-5.67 respectively). The Arg16 allele and Arg16Arg genotype frequencies were higher in patients with uncontrolled asthma than in controls (χ² = 5.17, df = 1, P = 0.02 and χ² = 5.36, df = 1, P = 0.02 respectively).

CONCLUSION

The results of this study support the possible involvement of Arg16Gly polymorphism in the development of uncontrolled asthma, and indicate that Arg16Gly/Gln27Gln and Arg16Gly/Gln27Glu haplotypes are more common in asthma patients in the Kazakh population.

Asthma Control and Its Predictive Factors in Adult Asthma Patients

BACKGROUND

Asthma is a highly prevalent condition that remains difficult to control, as its associated factors remain poorly understood. Thus, the primary aim of the present investigation was to determine the prevalence of uncontrolled asthma in hospital units in south Jordan and to evaluate the risk factors that may contribute to uncontrolled asthma.

METHODS

This was a cross-sectional study involving 93 patients aged 40.5 ± 13.6 years that met the criteria of the Global Initiative for Asthma (GINA). Relevant patient data were collected via a questionnaire and through a review of medical records. The questionnaire comprised of sections pertaining to sociodemographic and clinical characteristics, as well as pharmacological asthma treatment, asthma severity and asthma control. Asthma severity was determined in line with the GINA guidelines, whereby the patients were classified into four groups (intermittent, mild persistent, moderate persistent or severe persistent). Moreover, based on the findings yielded by the asthma control questionnaire (ACQ), patients were divided into three levels, whereby those diagnosed with partly controlled and uncontrolled asthma were combined into one group, denoted as "poorly controlled asthma", with "uncontrolled asthma" and "controlled asthma" as the remaining two groups. Atopy was defined as one or more positive reactions (A/H ratio > 1) on a skin prick test.

RESULTS

Asthma control was achieved in 45.2% of the sample. Moreover, older age, severe asthma according to the GINA guidelines, longer duration of asthma, atopy, being on treatment for asthma and history of allergic rhinitis were identified as the main risk factors contributing to poorly controlled asthma. Multivariate analyses, however, revealed that only atopy to two or more allergens and having severe asthmatic attacks were statistically significantly associated with poorly controlled asthma, for which the odds ratio Mantel-Haenszel (ORMH) of 17.2 and 2.2 was obtained, respectively.

CONCLUSION

Our findings indicate that severe asthma and atopy to two or more allergens are the main risk factors for uncontrolled asthma. However, further studies with larger sample sizes are needed to confirm these results.