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Asthma pharmacogenetics: responding to the call for a personalized approach

Ortega, Victor E.; Wechsler, Michael E.

Current Opinion in Allergy and Clinical Immunology: August 2013 - Volume 13 - Issue 4 - p 399–409
doi: 10.1097/ACI.0b013e3283630c19
PHARMACOTHERAPY AND EVIDENCE BASED MEDICINE: Edited by David Khan and Enrico Compalati

Purpose of review Asthma is a chronic, complex disease that is treated with a combination of different therapies. However, interindividual variability in clinical responses to different therapies complicates asthma management. A personalized approach to asthma management could identify appropriate responders to specific agents or those that might be at an increased risk for adverse responses.

Recent findings Pharmacogenetic studies of genes from the leukotriene, glucocorticoid, and beta2-adrenergic receptor pathways have improved our understanding of how gene variation determines therapeutic responses to different classes of antiasthma therapies. Such studies have previously been limited to retrospective analyses of candidate genes in the leukotriene, glucocorticoid, and beta2-adrenergic receptor pathways in trial cohorts. However, prospective genotype-stratified trials in asthma have recently been done and recent genome-wide association studies have identified novel pharmacogenetic loci.

Summary It will be important to replicate previous genotypic associations in large clinical trial cohorts as future pharmacogenetic studies continue to focus on genome-wide approaches and the study of novel therapeutic pathways. This review of the pharmacogenetics of asthma highlights the contributions of genomics research to the future of personalized medicine in asthma and draws attention to the role of genetic biomarkers in predicting clinical responses to specific therapies.

aCenter for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina

bDepartment of Medicine, National Jewish Health, Denver, Colorado, USA

Correspondence to Victor E. Ortega, MD, Assistant Professor, Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Tel: +1 336 716 4649; fax: +1 336 716 7277; e-mail: vortega@wakehealth.edu

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.