IL4Rα and ADAM33 as genetic markers in asthma exacerbations and type-2 inflammatory endotype

H. Sunadome, H. Matsumoto, G. Petrova, Y. Kanemitsu, Y. Tohda, T. Horiguchi, H. Kita, K. Kuwabara, K. Tomii, K. Otsuka, M. Fujimura, N. Ohkura, K. Tomita, A. Yokoyama, H. Ohnishi, Y. Nakano, T. Oguma, S. Hozawa, T. Nagasaki, I. ItoT. Oguma, H. Inoue, T. Tajiri, T. Iwata, Y. Izuhara, J. Ono, S. Ohta, T. Hirota, M. Tamari, T. Yokoyama, A. Niimi, K. Izuhara, M. Mishima

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Background: Genetic markers of susceptibility to asthma exacerbations in adults remain unclear. Objective: To identify genetic markers of asthma exacerbations, particularly in patients with type-2 inflammatory endotype. Methods: In this observational study of patients enrolled in the Kinki Hokuriku Airway disease Conference multicenter study, frequency of exacerbations requiring systemic corticosteroids during 2 years after enrolment and associated risk factors was determined. For genetic marker analysis, interleukin-4 receptor α (IL4RA) rs8832 and a disintegrin and metalloprotease 33 (ADAM33) S_2 (rs528557), T_1 (rs2280091), T_2 (rs2280090), and V_4 (rs2787094) variants were included. Elevated serum periostin levels at enrolment (≥95 ng/mL, defined as type-2 inflammatory endotype) were considered in the analysis. Results: Among 217 patients who were successfully followed up for 2 years after enrolment, 60 patients showed at least one asthma exacerbation during the 2 years. Airflow limitation (%FEV1 <80%) and recent exacerbations but not genetic variants were identified as risk markers of exacerbations. A total of 27 patients showed type-2 inflammatory endotype (serum periostin ≥95 ng/mL at enrolment) and subsequent exacerbations; risk factors in these patients were airflow limitation (odds ratio, 6.51; 95% confidence interval (CI): 2.37–18.6; P=.0003), GG genotype of IL4RA rs8832 (odds ratio, 4.01; 95% CI: 1.47–11.0; P=.007), and A allele of ADAM33 T_2 (odds ratio, 2.81; 95% CI: 1.05–7.67; P=.04) by multivariate analysis. In addition, GG genotype of IL4RA rs8832 was associated with type-2 endotype, whereas A allele of ADAM33 T_2 was associated with mixed type of eosinophilic/type-2 and neutrophilic inflammations. Conclusions and Clinical Relevance: IL4RA and ADAM33 variants may be risk markers of asthma exacerbations in type-2 inflammatory endotype. Precise endotyping may facilitate the identification of genetic risk markers of asthma exacerbations.

元の言語English
ページ(範囲)998-1006
ページ数9
ジャーナルClinical and Experimental Allergy
47
発行部数8
DOI
出版物ステータスPublished - 08-2017

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

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    Sunadome, H., Matsumoto, H., Petrova, G., Kanemitsu, Y., Tohda, Y., Horiguchi, T., Kita, H., Kuwabara, K., Tomii, K., Otsuka, K., Fujimura, M., Ohkura, N., Tomita, K., Yokoyama, A., Ohnishi, H., Nakano, Y., Oguma, T., Hozawa, S., Nagasaki, T., ... Mishima, M. (2017). IL4Rα and ADAM33 as genetic markers in asthma exacerbations and type-2 inflammatory endotype. Clinical and Experimental Allergy, 47(8), 998-1006. https://doi.org/10.1111/cea.12927