How does race/ethnicity influence pharmacological response to asthma therapies?

Abstract

Our understanding of whether and/or how ethnicity influences pharmacological response to asthma therapies is still very scarce. A possible explanation for the increased asthma treatment failures observed in ethnic and racial minorities receiving asthma therapies is that some of these groups may have a pharmacogenomic predisposition to either nonresponse or to adverse response with a specific class of drugs. However, the effects of ethnicity on pharmacological response to asthma therapies are also, and mainly, determined by socioeconomic and environmental factors to a varying extent, depending on the ethnic groups. Areas covered: Genetic, socioeconomic and environmental factors that can affect the pharmacotherapeutic responses to asthma medications and their link(s) to race/ethnicity have been examined and critically discussed. Expert opinion: Differences in genetic ancestry are definitely non-modifiable factors, but socioeconomic and environmental disadvantages are all factors that can be modified. It is likely that improved outcomes may be achieved when tailored and multifaceted approaches that include home, school, and clinician-based interventions are implemented. Consequently, it is critical to determine if a clinical intervention programme combined with implementation strategies that attempt to reduce inequalities can reduce asthma disparities, including the influence of ethnicity and race on pharmacological response to asthma therapies.

Pharmacogenetics of inhaled long‐acting beta2‐agonists in asthma: A systematic review

“…In conclusion, there is considerable variability in pharmacogenetic LABA studies due to differences in study design and characteristics of included patients. Environmental conditions, such as socioeconomic factors (income, education), ethnic genetic variants, environmental allergen exposure, psychosocial stressors, behavioral risk factors (smoking, obesity), poor medication adherence, and lack of access to medicines or evidence‐based care, can influence gene expression . ADRB2 rs1042713 has been shown to influence LABA response in children in observational studies.…”

The Emergency Medicine Specimen Bank: An Innovative Approach To Biobanking In Acute Care

“…The critical nature of incapacitated patients makes this patient population particularly important from a research perspective, as many of these patients fail to respond to treatments given in the ED. Additionally, racial and ethnic background can have a major influence on individual response to treatments . Therefore, our goal for the EMSB is to be inclusive of all acute illnesses and as many demographic groups as possible.…”

<p>Pharmacogenomic Response of Inhaled Corticosteroids for the Treatment of Asthma: Considerations for Therapy</p>

“…Data from the NHLBI Severe Asthma Research Program suggest that several genetic polymorphisms, such as rs17142727 in GLCCI1 and rs1429032 and rs6867762 in FBXL7 in non-Hispanic Whites, and rs1476823 in GLCCI1 , rs7801671 and rs7801671 in CYP3A4 , rs4701641 and rs12152734 in FBXL7 , and rs17689966 in CRHR1 in African-Americans could be associated with changed ICS responsiveness. 85 Apparently, the polymorphism rs37972 of GLCCI1 gene rs37972 is less common in populations of African descent compared with a European population. 68 A GWAS in asthmatic Hispanic/Latino and African-American children and young adults was unable to find any consistent association with ICS response of 22 SNPs previously associated with this response in another GWAS.…”

“…There is often a link between the frequency of a SNP and race/ethnicity. 85 Actually, SNPs cluster within groups and are more likely to share a common region of origin or ancestral lineage. Data from the NHLBI Severe Asthma Research Program suggest that several genetic polymorphisms, such as rs17142727 in GLCCI1 and rs1429032 and rs6867762 in FBXL7 in non-Hispanic Whites, and rs1476823 in GLCCI1 , rs7801671 and rs7801671 in CYP3A4 , rs4701641 and rs12152734 in FBXL7 , and rs17689966 in CRHR1 in African-Americans could be associated with changed ICS responsiveness.…”