Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma

Wendy Gould; Edward L. Peterson; Gloria Karungi; Amanda Zoratti; John Gaggin; Ghazwan Toma; Shiqing Yan; Albert M. Levin; James J. Yang; Karen Wells; Mingqun Wang; Robert R. Burke; Kenneth Beckman; Danijela Popadic; Susan J. Land; Rajesh Kumar; Max A. Seibold; David E. Lanfear; Esteban G. Burchard; L. Keoki Williams

doi:10.1016/j.jaci.2010.08.002

Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma

Wendy Gould, Edward L. Peterson, Gloria Karungi, Amanda Zoratti, John Gaggin, Ghazwan Toma, Shiqing Yan, Albert M. Levin, James J. Yang, Karen Wells, Mingqun Wang, Robert R. Burke, Kenneth Beckman, Danijela Popadic, Susan J. Land, Rajesh Kumar, Max A. Seibold, David E. Lanfear, Esteban G. Burchard, L. Keoki Williams

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Abstract

Background: African American patients disproportionately experience uncontrolled asthma. Treatment with an inhaled corticosteroid (ICS) is considered first-line therapy for persistent asthma. Objective: We sought to determine the degree to which African American patients respond to ICS medication and whether the level of response is influenced by other factors, including genetic ancestry. Methods: Patients aged 12 to 56 years who received care from a large health system in southeast Michigan and who resided in Detroit were recruited to participate if they had a diagnosis of asthma. Patients were treated with 6 weeks of inhaled beclomethasone dipropionate, and pulmonary function was remeasured after treatment. Ancestry was determined by genotyping ancestry-informative markers. The main outcome measure was ICS responsiveness defined as the change in prebronchodilator FEV₁ over the 6-week course of treatment. Results: Among 147 participating African American patients with asthma, average improvement in FEV₁ after 6 weeks of ICS treatment was 11.6%. The mean proportion of African ancestry in this group was 78.4%. The degree of baseline bronchodilator reversibility was the only factor consistently associated with ICS responsiveness, as measured by both an improvement in FEV₁ and patient-reported asthma control (P = .001 and P = .021, respectively). The proportion of African ancestry was not significantly associated with ICS responsiveness. Conclusions: Although baseline pulmonary function parameters appear to be associated with the likelihood to respond to ICS treatment, the proportion of genetic African ancestry does not. This study suggests that genetic ancestry might not contribute to differences in ICS controller response among African American patients with asthma.

Original language	English (US)
Pages (from-to)	1131-1138
Number of pages	8
Journal	Journal of Allergy and Clinical Immunology
Volume	126
Issue number	6
DOIs	https://doi.org/10.1016/j.jaci.2010.08.002
State	Published - Dec 2010

Bibliographical note

Funding Information:
Supported by grants from the Fund for Henry Ford Hospital ; the American Asthma Foundation ; the National Institute of Allergy and Infectious Diseases ( AI79139, AI61774 ); the National Heart, Lung, and Blood Institute ( HL79055 ); and the National Institute of Diabetes and Digestive and Kidney Diseases ( DK64695 ), National Institutes of Health (L. K. W.). E. G. B. receives support from the National Institutes of Health ( HL078885, HL088133, ES015794 ), the Robert Wood Johnson Foundation Amos Medical Faculty Development Program , and the Flight Attendant Medical Research Institute (FAMRI). R. K. receives support from the National Institutes of Health ( K23HL093023-01 ).

Funding Information:
Disclosure of potential conflict of interest: E. L. Peterson receives research support from the National Institutes of Health (NIH). R. Kumar receives research support from the NIH , is a member of the American Thoracic Society, and is president of the Illinois Society of Allergy & Immunology. The rest of the authors have declared that they have no conflict of interest. Asthma and lower airway disease

Keywords

Inhaled corticosteroids
ancestry
asthma
continental population groups
race-ethnicity
urban health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Gould, W., Peterson, E. L., Karungi, G., Zoratti, A., Gaggin, J., Toma, G., Yan, S., Levin, A. M., Yang, J. J., Wells, K., Wang, M., Burke, R. R., Beckman, K., Popadic, D., Land, S. J., Kumar, R., Seibold, M. A., Lanfear, D. E., Burchard, E. G., & Williams, L. K. (2010). Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma. Journal of Allergy and Clinical Immunology, 126(6), 1131-1138. https://doi.org/10.1016/j.jaci.2010.08.002

Gould, W, Peterson, EL, Karungi, G, Zoratti, A, Gaggin, J, Toma, G, Yan, S, Levin, AM, Yang, JJ, Wells, K, Wang, M, Burke, RR, Beckman, K, Popadic, D, Land, SJ, Kumar, R, Seibold, MA, Lanfear, DE, Burchard, EG & Williams, LK 2010, 'Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma', Journal of Allergy and Clinical Immunology, vol. 126, no. 6, pp. 1131-1138. https://doi.org/10.1016/j.jaci.2010.08.002

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title = "Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma",

abstract = "Background: African American patients disproportionately experience uncontrolled asthma. Treatment with an inhaled corticosteroid (ICS) is considered first-line therapy for persistent asthma. Objective: We sought to determine the degree to which African American patients respond to ICS medication and whether the level of response is influenced by other factors, including genetic ancestry. Methods: Patients aged 12 to 56 years who received care from a large health system in southeast Michigan and who resided in Detroit were recruited to participate if they had a diagnosis of asthma. Patients were treated with 6 weeks of inhaled beclomethasone dipropionate, and pulmonary function was remeasured after treatment. Ancestry was determined by genotyping ancestry-informative markers. The main outcome measure was ICS responsiveness defined as the change in prebronchodilator FEV1 over the 6-week course of treatment. Results: Among 147 participating African American patients with asthma, average improvement in FEV1 after 6 weeks of ICS treatment was 11.6%. The mean proportion of African ancestry in this group was 78.4%. The degree of baseline bronchodilator reversibility was the only factor consistently associated with ICS responsiveness, as measured by both an improvement in FEV1 and patient-reported asthma control (P = .001 and P = .021, respectively). The proportion of African ancestry was not significantly associated with ICS responsiveness. Conclusions: Although baseline pulmonary function parameters appear to be associated with the likelihood to respond to ICS treatment, the proportion of genetic African ancestry does not. This study suggests that genetic ancestry might not contribute to differences in ICS controller response among African American patients with asthma.",

keywords = "Inhaled corticosteroids, ancestry, asthma, continental population groups, race-ethnicity, urban health",

author = "Wendy Gould and Peterson, {Edward L.} and Gloria Karungi and Amanda Zoratti and John Gaggin and Ghazwan Toma and Shiqing Yan and Levin, {Albert M.} and Yang, {James J.} and Karen Wells and Mingqun Wang and Burke, {Robert R.} and Kenneth Beckman and Danijela Popadic and Land, {Susan J.} and Rajesh Kumar and Seibold, {Max A.} and Lanfear, {David E.} and Burchard, {Esteban G.} and Williams, {L. Keoki}",

note = "Funding Information: Supported by grants from the Fund for Henry Ford Hospital ; the American Asthma Foundation ; the National Institute of Allergy and Infectious Diseases ( AI79139, AI61774 ); the National Heart, Lung, and Blood Institute ( HL79055 ); and the National Institute of Diabetes and Digestive and Kidney Diseases ( DK64695 ), National Institutes of Health (L. K. W.). E. G. B. receives support from the National Institutes of Health ( HL078885, HL088133, ES015794 ), the Robert Wood Johnson Foundation Amos Medical Faculty Development Program , and the Flight Attendant Medical Research Institute (FAMRI). R. K. receives support from the National Institutes of Health ( K23HL093023-01 ). Funding Information: Disclosure of potential conflict of interest: E. L. Peterson receives research support from the National Institutes of Health (NIH). R. Kumar receives research support from the NIH , is a member of the American Thoracic Society, and is president of the Illinois Society of Allergy & Immunology. The rest of the authors have declared that they have no conflict of interest. Asthma and lower airway disease ",

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AU - Peterson, Edward L.

AU - Karungi, Gloria

AU - Zoratti, Amanda

AU - Gaggin, John

AU - Toma, Ghazwan

AU - Yan, Shiqing

AU - Levin, Albert M.

AU - Yang, James J.

AU - Wells, Karen

AU - Wang, Mingqun

AU - Burke, Robert R.

AU - Beckman, Kenneth

AU - Popadic, Danijela

AU - Land, Susan J.

AU - Kumar, Rajesh

AU - Seibold, Max A.

AU - Lanfear, David E.

AU - Burchard, Esteban G.

AU - Williams, L. Keoki

N1 - Funding Information: Supported by grants from the Fund for Henry Ford Hospital ; the American Asthma Foundation ; the National Institute of Allergy and Infectious Diseases ( AI79139, AI61774 ); the National Heart, Lung, and Blood Institute ( HL79055 ); and the National Institute of Diabetes and Digestive and Kidney Diseases ( DK64695 ), National Institutes of Health (L. K. W.). E. G. B. receives support from the National Institutes of Health ( HL078885, HL088133, ES015794 ), the Robert Wood Johnson Foundation Amos Medical Faculty Development Program , and the Flight Attendant Medical Research Institute (FAMRI). R. K. receives support from the National Institutes of Health ( K23HL093023-01 ). Funding Information: Disclosure of potential conflict of interest: E. L. Peterson receives research support from the National Institutes of Health (NIH). R. Kumar receives research support from the NIH , is a member of the American Thoracic Society, and is president of the Illinois Society of Allergy & Immunology. The rest of the authors have declared that they have no conflict of interest. Asthma and lower airway disease

PY - 2010/12

Y1 - 2010/12

N2 - Background: African American patients disproportionately experience uncontrolled asthma. Treatment with an inhaled corticosteroid (ICS) is considered first-line therapy for persistent asthma. Objective: We sought to determine the degree to which African American patients respond to ICS medication and whether the level of response is influenced by other factors, including genetic ancestry. Methods: Patients aged 12 to 56 years who received care from a large health system in southeast Michigan and who resided in Detroit were recruited to participate if they had a diagnosis of asthma. Patients were treated with 6 weeks of inhaled beclomethasone dipropionate, and pulmonary function was remeasured after treatment. Ancestry was determined by genotyping ancestry-informative markers. The main outcome measure was ICS responsiveness defined as the change in prebronchodilator FEV1 over the 6-week course of treatment. Results: Among 147 participating African American patients with asthma, average improvement in FEV1 after 6 weeks of ICS treatment was 11.6%. The mean proportion of African ancestry in this group was 78.4%. The degree of baseline bronchodilator reversibility was the only factor consistently associated with ICS responsiveness, as measured by both an improvement in FEV1 and patient-reported asthma control (P = .001 and P = .021, respectively). The proportion of African ancestry was not significantly associated with ICS responsiveness. Conclusions: Although baseline pulmonary function parameters appear to be associated with the likelihood to respond to ICS treatment, the proportion of genetic African ancestry does not. This study suggests that genetic ancestry might not contribute to differences in ICS controller response among African American patients with asthma.

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KW - Inhaled corticosteroids

KW - ancestry

KW - asthma

KW - continental population groups

KW - race-ethnicity

KW - urban health

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Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma

Abstract

Bibliographical note

Keywords

UN SDGs

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