哮喘联盟

    背景与目的：吸入糖皮质激素可用于治疗慢性阻塞性肺疾病（COPD）和哮喘。近期有报道显示，促肾上腺皮质素释放激素受体1（CRHR1）基因序列突变与哮喘患者吸入糖皮质激素治疗后肺功能改善有关。本试验研究慢性阻塞性肺疾病（COPD）患者糖皮质激素吸入治疗后肺功能的变化与单核苷酸CRHR1多态性之间的关系。
    方法：从韩国11家医院的呼吸科纳入均有吸烟史的慢性阻塞性肺疾病（COPD）患者（n = 87）。采用丙酸氟替卡松和沙美特罗治疗12周，分别检测基线和治疗12周后的肺功能。其中84名患者完成基因型检测。
    结果：71名患者含野生GG基因型，13名患者含GT杂合基因型（位于rs242 941）。治疗12周后，含野生GG基因型的患者FEV1变化[6.0±0.8%的预测FEV1]显著大于含杂合基因型的患者（-0.8±1.8, P = 0.003）。
    结论：慢性阻塞性肺疾病（COPD）患者糖皮质激素和长效β 2-受体激动剂吸入治疗后FEV(1)的改善与CRHR1基因多态性有关。

（刘国梁 审校）
Kim WJ, et al. Respirology. 2008 Dec 11. [Epub ahead of print].

Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPD.

Background and objective: Inhaled corticosteroids are used to treat COPD and asthma. An association between sequence variants in the corticotrophin-releasing hormone receptor 1 (CRHR1) gene and improved lung function in asthmatics treated with inhaled corticosteroids was reported recently. This study investigated the association between the change in lung function in response to inhaled corticosteroids and single-nucleotide CRHR1 polymorphisms in patients with COPD.
Methods: COPD patients (n = 87) with a positive smoking history were recruited from the pulmonary clinics of 11 hospitals in Korea. Patients were treated with fluticasone propionate and salmeterol for 12 weeks and lung function was measured at baseline and after the 12-week treatment. Eighty-four of the 87 subjects were successfully genotyped.
Results: Seventy-one patients with the wild-type GG genotype and 13 patients with the heterozygous GT genotype in rs242 941 were evaluated. After 12-week treatment, the change in FEV(1) was significantly higher in patients with wild-type GG genotype (6.0 +/- 0.8% of predicted FEV(1)) than in GT heterozygotes (-0.8 +/- 1.8, P = 0.003).
Conclusions: Improved FEV(1) following inhaled corticosteroid and a long-acting beta2-agonist was associated with CRHR1 genetic polymorphism in patients with COPD.