GLCCI1基因rs37973位点多态性对ICSs治疗哮喘-慢性阻塞性肺疾病重叠效果的影响  

Influence of GLCCI1 gene rs37973 polymorphism on the efficacy of ICSs in the treatment of asthmachronic obstructive pulmonary disease overlap

作　　者：邱彦 董雅芬[1] 于平 王建[1] 卞晓岚[2] QIU Yan;DONG Yafen;YU Ping;WANG Jian;BIAN Xiaolan(Dept.of Pharmacy,Shanghai Pudong NewArea People’s Hospital,Shanghai 201200,China;Dept.of Pharmacy,Ruijin Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海市浦东新区人民医院药剂科,上海201200 [2]上海交通大学医学院附属瑞金医院药剂科,上海200025

出　　处：《中国药房》2023年第20期2535-2539,共5页China Pharmacy

基　　金：上海市浦东新区卫生健康委员会领先人才培养计划(No.PWRL2020-08)。

摘　　要：目的探讨GLCCI1基因rs37973位点多态性与哮喘-慢性阻塞性肺疾病重叠(ACO)患者使用吸入性糖皮质激素(ICSs)后应答反应的相关性。方法纳入2019年4月1日至2020年12月31日就诊于上海市浦东新区人民医院并首次诊断为ACO的患者173例。所有患者均使用沙美特罗替卡松吸入粉雾剂,每天2次,持续24周。测定患者的rs37973位点基因型和肺功能指标[第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)、FEV_(1)占预计值百分比(FEV_(1)%pred)]及肺功能改善情况(ΔFEV_(1)和ΔFEV_(1)%pre)。结果共有111例患者完成了24周随访及肺功能检测,其中,GLCCI1基因rs37973位点AA型42例、AG型52例、GG型17例。治疗12、24周后,患者的肺功能指标总体情况均显著优于治疗前患者的基线肺功能指标(P<0.05)。治疗24周后,AA型、AG型患者的肺功能改善情况均显著优于GG型,且AA型患者的ΔFEV_(1)%pred显著优于AG型(P<0.05)。治疗12、24周后,吸烟史≤20包年患者的肺功能改善情况均显著优于吸烟史>20包年患者,且吸烟史≤20包年患者中仅AA型患者的ΔFEV_(1)%pred显著优于AG型(P<0.05)。治疗12周后,吸烟史>20包年患者中,AA型和AG型患者肺功能改善情况均显著优于GG型,且AA型患者的ΔFEV_(1)%pred显著优于AG型(P<0.05);治疗24周后,AA型和AG型患者的肺功能改善情况均显著优于GG型(P<0.05)。结论GLCCI1基因rs37973位点GG型ACO患者对ICSs的治疗反应较其他基因型差,其中吸烟史>20包年的患者反应更差。OBJECTIVE To investigate the association between the functional GLCCI1 gene rs37973 polymorphism and inhaled corticosteroids(ICSs)response in patients with asthma-chronic obstructive pulmonary disease overlap(ACO).METHODS Totally 173 newly diagnosed ACO patients were recruited from Shanghai Pudong New Area People’s Hospital during April 1st,2019 to December 31st,2020.All patients were treated with Salmeterol fluticasone inhalation powder,twice a day,for 24 weeks.The genotype of rs37973 locus was determined,and lung function indicators[forced expiratory volume in one second(FEV_(1)),FEV_(1)/forced vital capacity(FVC),the percentage of FEV_(1) to expected value(FEV_(1)%pred)],and lung function improvement(FEV_(1) and FEV_(1)%pred)were all detected.RESULTS Totally 111 patients completed the whole 24-week follow-up and lung function detection.Among them,there were 42 cases of AA genotype,52 cases of AG genotype,and 17 cases of GG genotype.After 12,24 weeks of treatment,lung function indexes of patients were significantly better than baseline lung function indexes before treatment(P<0.05).After 24 weeks of treatment,ACO patients with AA and AG genotypes showed significantly better lung function improvement than GG genotype,and FEV_(1)%pred of AA genotype was significantly better than AG genotype(P<0.05).After 12,24 weeks of treatment,the improvement of lung function in patients with a smoking history≤20 pack year was significantly better than those with a smoking history>20 pack year,and among patients with a smoking history≤20 pack year,only AA genotype had significantly better FEV_(1)%pred than AG genotype(P<0.05).After 12 weeks of treatment,among patients with a smoking history>20 pack year,the improvement of lung function in AA genotype and AG genotype was significantly better than GG genotype,and the FEV_(1)%pred in AA genotype was significantly better than AG genotype(P<0.05).After 24 weeks of treatment,the improvement of lung function of AA genotype and AG genotype was significantly better than GG genotyp

关 键 词：哮喘-慢性阻塞性肺疾病重叠 糖皮质激素诱导转录蛋白1抗体 单核苷酸多态性 吸入性糖皮质激素 

分 类 号：R977.1[医药卫生—药品] R563[医药卫生—药学]