ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2017-2-20-31ssmu-873Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESФармакогенетика и индивидуализированный подход к терапии бронхиальной астмыPharmacogenetics and individualized approach to the therapy of bronchial asthmaБалаболкинИ. И.BalabolkinIvan I.

д-р мед. наук, профессор, член-корреспондент РАН, гл. науч. сотрудник, отделение пульмонологии и аллергологии

119991, г. Москва, Ломоносовский пр., 2/1 

DM, Professor, Corresponding Member of RAS, Chief Scientific Researcher, Department of Pulmonology and Allergology

2/1, Lomonosovsky Аv., Moscow, 119991

БулгаковаВ. А.BulgakovaVilya A.

д-р мед. наук, гл. науч. сотрудник, отдел прогнозирования и планирования научных исследований

119991, г. Москва, Ломоносовский пр., 2/1 

DM, Chief Scientific Researcher, Department of Frecasting and Planning of Scientific Research

2/1, Lomonosovsky Аv., Moscow, 119991

irvilbulgak@mail.ruПинелисВ. Г.PinelisVsevolod G.

д-р мед. наук, профессор, гл. науч. сотрудник, лаборатория нейробиологии и фундаментальных основ развития мозга

119991, г. Москва, Ломоносовский пр., 2/1 

DM, Professor, Chief Scientific Researcher, Laboratory of Neurobiology and of the Fundamentals of Brain Development

2/1, Lomonosovsky Аv., Moscow, 119991

ТюменцеваЕ. С.TyumentsevaElena S.

д-р мед. наук, профессор кафедры молекулярной и клеточной генетики

117997, г. Москва, ул. Островитянова, 1 

DM, Professor, Department of Molecular and Cellular Genetics of Medico-biological Faculty

1, Ostrovitianov Str., Moscow, 117997

Национальный научно-практический центр здоровья детей (ННПЦЗД)РоссияNational Scientific and Practical Center of Children’s HealthRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова (РНИМУ им. Н.И. Пирогова)РоссияPirogov Russian National Research Medical UniversityRussian Federation2017120720171622031Copyright © Балаболкин И.И., Булгакова В.А., Пинелис В.Г., Тюменцева Е.С., 20172017Балаболкин И.И., Булгакова В.А., Пинелис В.Г., Тюменцева Е.С.Balabolkin I.I., Bulgakova V.A., Pinelis V.G., Tyumentseva E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/873

Бронхиальная астма – хроническое воспалительное заболевание дыхательных путей, которое при неадекватном лечении может значительно снижать качество жизни пациентов. В данной статье представлен обзор современных научных исследований, посвященных изучению генетической детерминированности ответа на лечение ингаляционными глюкокортикостероидами, β2-агонистами короткого действия и антагонистами лейкотриеновых рецепторов у больных бронхиальной астмой. Рассматривается вклад генетических факторов в вариабельность терапевтического ответа пациентов на каждый класс указанных противоастматических лекарственных средств. Приводятся данные об участии аллеля Gly16 в формировании фенотипа с тяжелым течением бронхиальной астмы и толерантностью к терапии β2-агонистами и ингаляционными глюкокортикостероидами. В исследованиях установлена ассоциация генотипа Gly16Gly гена β2-адренергического рецептора со сниженным эффектом бронхолитической терапии β2-адреномиметиками короткого действия. Показано, что различный ответ на антилейкотриеновые препараты может быть связан с полиморфизмом промотора гена ALOX5. На основании обзора исследований сделан вывод о том, что полиморфные варианты генов могут изменять ответ больных бронхиальной астмой на проводимую терапию и их определение может быть использовано для пред- сказания индивидуальной реакции на конкретные противоастматические медикаментозные средства. Авторы считают, что проведение фармакогенетического тестирования может помочь идентифицировать пациентов, торпидных к лечению. 

Bronchial asthma is a chronic inflammatory disease of the airways. Ineffective treatment can significantly reduce the quality and duration of life of the patients. The article presents a review of current research devoted to the study of genetic determinism of the response to the treatment with inhaled corticosteroids, β2 -agonists of short-effect and antagonists of leukotriene receptors in patients with bronchial asthma. The contribution of genetic factors to the variability of therapeutic response in patients in each class of these antiasthmatic drugs is discussed in this article.

Data describing Gly16 allele participation in phenotype formation with poor bronchial asthma course and decreased effectiveness of β2 -agonists therapy and inhaled glucocorticosteroids are also presented. The association of Gly16 genotype gene of β2 -adrenergic receptor with the decreased effect of broncholith therapy of β2 -adrenomimetric receptor of short effect has been determined in this study. It was shown that ALOX5 gene promotor polymorphism is linked with variations of response to antileukotriene drugs. Thus, it can be concluded that multiform gene variants can change the bronchial asthma patients’ response to the conducted therapy and the genetic information can be used to determine the probable prognoses of individuals’ reactions to definite anti-asthmatic remedies. The authors consider the pharmacogenetic test to help to identify the patients that are torpid to the treatment.

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The authors declare that there are no conflicts of interest present.