Genetic Pathway Explains Lack of Response to Asthma Treatment

By monitoring changes in gene expression, clinicians can identify children who will not respond to common asthma medications and may benefit from alternate treatment, according to a study published April 21, in the Journal of Allergy and Clinical Immunology. Nasal expression of the VNN1 gene may be a clinically useful marker to identify a biological cause for difficult-to-treat asthma. Of the seven million children with asthma, it has been reported that nearly twothirds have had at least one attack in the past year. While systemic corticosteroid treatment is considered the most effective medication for controlling chronic asthma and rescue during acute exacerbation, treatment efficacy varies. In the current study, nasal epithelial cells were collected during presentation to the emergency department for an acute asthma attack and again 18 to 24 hours later. Genome-wide expression profiling was performed before and after treatment in 15 children as part of a discovery cohort. Gene expression ratios were analyzed to identify associations with corticosteroid treatment response phenotypes. These potentially discriminatory genes were then tested in a new cohort of 25 patients. The researchers found that VNN1 mRNA expression was lower in the poor responder group versus the good responder group. After treatment, methylation levels […]