The role of pharmacogenomics in improving the management of asthma

Abstract

There is a large amount of interindividual variability in both therapeutic and adverse responses to asthma therapies. Genetic variability can account for 50% to 60% of this variability. Pharmacogenomics holds out the promise of allowing clinicians to prospectively choose therapies that have the greatest likelihood to be effective for individual patients and to avoid those that might have a high likelihood of producing adverse effects. In this article we review the principles of pharmacogenomic investigation. We explore the data developed from the early pharmacogenomic studies with the most common asthma therapies. Furthermore, we explore the potential use of pharmacogenomics, as well as caveats in interpreting such information.

Fig 1

Change in AM and PM PEF with regular use of albuterol from placebo (X axis) in B16 Arg/Arg vs. B16 Gly/Gly patients. Regular use of albuterol resulted in a decline in AM PEF in Arg/Arg patients while it produced an improvement in AM PEF in Gly/Gly individuals. Similar deteriorations in FEV1, symptoms, and reliever medication use were seen in Arg/Arg patients, while Gly/Gly patients improved (data not shown). Reference (18)

Figure 2

Improvement in FEV1 in association with different haplotypes of CRHR1. (49)