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      A Genome-wide Association and Admixture Mapping Study of Bronchodilator Drug Response in African Americans with Asthma

      research-article
      , BS 1 , , PhD 2 , , PhD 3 , 4 , 5 , , MS 2 , , BS 2 , , PhD 6 , , MD, PhD 7 , , PhD, MS 2 , , MD, MAS 8 , , MD, MPH 2 , , MD 1 , 2 , 9 , , PhD 2 , , PhD, MPH 2 , , PhD 7 , , MD, PhD 7 , , MA, MPH 10 , , MD, MS 11 , , MD, MSPH 12 , , MD 13 , , MD 14 , , MD 15 , 16 , , MD 17 , , MD 18 , , MD 19 , , MD 20 , , MD 21 , , MD 22 , , MD 23 , 24 , 24 , , PhD 25 , , PhD 26 , , MD 27 , , PhD 27 , , MD, MPH 28 , 29 , , PhD 1 , 30 , 31 , , PhD 2 , , MD, MPH 1 , 2
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          Abstract

          Short-acting β 2-adrenergic receptor agonists (SABAs) are the most commonly prescribed asthma medications worldwide. Response to SABAs is measured as bronchodilator drug response (BDR), which varies among racial/ethnic groups in the U.S 1, 2 . However, the genetic variation that contributes to BDR is largely undefined in African Americans with asthma 3 . To identify genetic variants that may contribute to differences in BDR in African Americans with asthma, we performed a genome-wide association study (GWAS) of BDR in 949 African American children with asthma, genotyped with the Axiom World Array 4 (Affymetrix, Santa Clara, CA) followed by imputation using 1000 Genomes phase III genotypes. We used linear regression models adjusting for age, sex, body mass index (BMI) and genetic ancestry to test for an association between BDR and genotype at single nucleotide polymorphisms (SNPs). To increase power and distinguish between shared vs. population-specific associations with BDR in children with asthma, we performed a meta-analysis across 949 African Americans and 1,830 Latinos (Total=2,779). Lastly, we performed genome-wide admixture mapping to identify regions whereby local African or European ancestry is associated with BDR in African Americans. We identified a population-specific association with an intergenic SNP on chromosome 9q21 that was significantly associated with BDR (rs73650726, p=7.69×10 −9). A trans-ethnic meta-analysis across African Americans and Latinos identified three additional SNPs within the intron of PRKG1 that were significantly associated with BDR (rs7903366, rs7070958, and rs7081864, p≤5×10 −8). Our results failed to replicate in three additional populations of 416 Latinos and 1,615 African Americans. Our findings indicate that both population specific and shared genetic variation contributes to differences in BDR in minority children with asthma, and that the genetic underpinnings of BDR may differ between racial/ethnic groups.

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          Most cited references49

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          Genomics for the world.

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            Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program.

            Severe asthma causes the majority of asthma morbidity. Understanding mechanisms that contribute to the development of severe disease is important. The goal of the Severe Asthma Research Program is to identify and characterize subjects with severe asthma to understand pathophysiologic mechanisms in severe asthma. We performed a comprehensive phenotypic characterization (questionnaires, atopy and pulmonary function testing, phlebotomy, exhaled nitric oxide) in subjects with severe and not severe asthma. A total of 438 subjects with asthma were studied (204 severe, 70 moderate, 164 mild). Severe subjects with asthma were older with longer disease duration (P or = 12 years) was associated with lower lung function and sinopulmonary infections (P < or = .02). Severe asthma is characterized by abnormal lung function that is responsive to bronchodilators, a history of sinopulmonary infections, persistent symptoms, and increased health care utilization. Lung function abnormalities in severe asthma are reversible in most patients, and pneumonia is a risk factor for the development of severe disease.
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              Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. American Thoracic Society.

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                Author and article information

                Journal
                101083949
                22416
                Pharmacogenomics J
                Pharmacogenomics J.
                The pharmacogenomics journal
                1470-269X
                1473-1150
                28 June 2018
                12 September 2018
                13 March 2019
                : 10.1038/s41397-018-0042-4
                Affiliations
                [1. ]Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, 94158
                [2. ]Department of Medicine, University of California, San Francisco, San Francisco, CA, 94158
                [3. ]Research Unit, Hospital Universitario N.S. de Candelaria, Universidad de La Laguna, Tenerife, Spain, 38010
                [4. ]CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain, 28029
                [5. ]Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna (Tenerife), Spain, 38010
                [6. ]Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
                [7. ]Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston Salem, NC. 27157
                [8. ]Department of Pediatrics, University of California, San Francisco, San Francisco, CA, 94143
                [9. ]Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, 94158
                [10. ]UCSF Benioff Children’s Hospital Oakland, Center for Community Health and Engagement
                [11. ]Ann & Robert H. Lurie Children’s Hospital of Chicago, Pediatrics, Chicago, Illinois, 60614
                [12. ]Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, 77030
                [13. ]UCSF Benioff Children’s Hospital Oakland, Oakland, California
                [14. ]Division of Allergy-Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611
                [15. ]Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY, 10461
                [16. ]Albert Einstein College of Medicine, Pediatrics, Bronx, New York
                [17. ]Bay Area Pediatrics, Oakland, CA, 94609
                [18. ]Department of Allergy & Immunology, Kaiser Permanente-Vallejo Medical Center, Vallejo, CA, 94589
                [19. ]Veterans Caribbean Health System, San Juan, Puerto Rico, 00921
                [20. ]Department of Pediatrics, David Geffen School of Medicine at ULCA, Olive View-UCLA Medical Center, Sylmar, CA, 91342
                [21. ]Centro de Neumologia Pediatrica, San Juan, Puerto Rico, 00917
                [22. ]Columbia University, New York, NY, 21205
                [23. ]Instituto Nacional de Enfermedades Respiratorias, Mexico City, MX, 14080
                [24. ]National Laboratory of Genomics for Biodiversity (LANGEBIO), CINVESTAV, Irapuato, Guanajuato, MX, 36821
                [25. ]Department of Pediatrics, National Jewish Health, Denver, CO, 80206
                [26. ]Basic Research Laboratory, National Cancer Institute, Leidos Biomedical Research, Frederick National Laboratory, Frederick, MD, 21701
                [27. ]Department of Medicine, The University of Arizona, Tucson, Arizona, 85724
                [28. ]Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202
                [29. ]Department of Internal Medicine, Henry Ford Health System, Detroit, MI, 48202
                [30. ]California Institute for Quantitative Biosciences (QB3), University of California, San Francisco, CA, 94158
                [31. ]Institute for Human Genetics, University of California, San Francisco, CA, 94158
                Author notes
                Corresponding author: Esteban G. Burchard, MD, MPH, Department of Bioengineering & Therapeutic Sciences and Medicine, University of California, San Francisco, 1550 4th St. RM584B, San Francisco, CA 94158, Telephone: (415) 514-9677, Fax: 415-514-4365, esteban.burchard@ 123456ucsf.edu
                Article
                NIHMS976586
                10.1038/s41397-018-0042-4
                6414286
                30206298
                603726a0-b58c-4b0c-ad21-08602be4a4bf

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                Pharmacology & Pharmaceutical medicine
                Pharmacology & Pharmaceutical medicine

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