Bondarkova A. Management of the patients with bronchial asthma depending on Gln27Glu-polymorphism of the gene of β2-adrenoreceptors

Object of research: asthma of different severity and symptom control; the goal is to increase the effectiveness of management of asthma patients depending on Gln27Glu-polymorphism of the β2-adrenergic receptor by adding tiotropium bromide to treatment with inhaled corticosteroids (ICS) and long-acting β2-agonists (LABA); research methods: clinical, laboratory, instrumental (computerized spirography), anthropometric, medico-genetic (polymerase chain reaction) and statistical analysis (SPSS Statistics 21.0); novelty: scientific data on Gln27Glu-polymorphism of the β2-adrenergic receptors with risk of development, degree of severity and level of control of bronchial asthma (BA) is supplemented; found that in the carriers of the G/G-genotype, the risk of the onset of BA was increased by 2.0 times compared with the carriers of the C/C-genotype; G/G-genotype predominated in patients with mild controlled asthma, C/C-genotype – in patients with severe and uncontrolled asthma course; the risk of development of hypertension is increased 3.9 times in obese patients with G/G-genotype; the phenotyping of patients with asthma according to clinical signs (age, sex, body weight, beginning of the disease, allergic-anamnesis, LFT, level of control) allowed to identify a group of female patients with overweight, early onset, burdened with allergic symptoms, low LFT and uncontrolled course of disease that allows to predict a low clinical efficacy of treatment with IC and LABA; it was found that the carriers of the G/G-genotype had a lower response to the treatment with ICs and LABA compared with the carriers of C/C- and C/G-genotypes; It has been shown that daily addition of 18 micrograms tiotropium bromide for carriers of the G/G-genotype is more effective in achieving control than increasing the dosage of formoterol to 24 micrograms per day. Scope of use – medicine.