Asthma Flashcards
Define Rule of 2
If the patien thas to use their albuterol inhaler more than 2x a week or wakes up more than 2x per week or refill their albuterol more than 2x a year
Role of pharmacogenetics
At each step you are adding different agents and we know info about each one
Beta Receptor Polymorphism
Target of Beta 2 agonists
Mutation affects susceptibility to down regulation in response to beta 2 agonists
With an Arg16 in asthma Patients, the regular use of a SABA
Was detrimental
Ipratropium is a good idea
SOCS/SLICS + LABA
improve if they are gly not arg (arg decrease)
Arg15 was not adversely affected with
LABA + Inhaled glucocorticoids
Glucocorticoids + Asthma
5-10% have a reduced response
Genetic polymorphisms in glucocorticoid receptor and in regulatory feedback loop
Glucocorticoid Receptor Polymorphism
Some decrease binding and activation and other increase sensitivity
Role of the Corticotropin Releasing Hormone Receptor 1
regulation of endogenous cortisol levels
Relationship with corticoid steroids therapy in asthma
If they have decreased receptors, they won’t make enough steroids so you have to give them more
ADULT trial
adults + CRHR1 Polymorph + ICS
CAMP
children + CRHR1 polymorph+ ICS
Patients + CRHR1, which were more sensitive?
Homozygous for the polymorph –> more responsive to the therapy
Genome Wide Association Studies (GWAS)
Case groups + Control Groups –> sequence the entire genomes of the patients –> shows if the SNP is important
Glucocorticoid Induced Transcript 1 (GLCCI1)
Expressed in lungs and immune cells
ICS therapy = increases expression
16% of the population has this mutation
