Genetic testing could help children's asthma
8th January 2012 - Testing children with asthma for a specific gene could prevent their condition getting worse by identifying those who do not respond well to a commonly used medication so they may have a more effective alternative, says a new study.
Researchers from the University of Dundee and Brighton and Sussex Medical School say that tens of thousands of children in the UK carry a genetic variation which means they are less likely to be able to control their symptoms using salmeterol and that they should be switched to a different medication instead.
The researchers tested 62 children with the genetic variant - the arginine-16 genotype of the beta-2 receptor (Arg16), which is carried by one in seven people with asthma. All the children had missed school or been treated in hospital or at out-of-hours GP surgeries as a result of their asthma, despite being given regular inhaled steroids.
The children carried on using their usual steroid preventer but were randomly assigned to two treatment groups over the course of a year with the addition of either montelukast or salmeterol.
Quality of life improvements
The children in the study, who all had the Arg16 gene variant, responded better to the alternative anti-inflammatory medicine, montelukast, the research found. They had a better quality of life, their school attendance was better, they wheezed and coughed much less, and needed to resort to their ‘reliever’ treatment less often, compared to the salmeterol users.
At the start of the research, 36% of these children tested needed to use their relievers every day. However, by the end of the study, in the group using montelukast the number of children needing daily reliever use had halved.
In contrast, there was no improvement for the children in the salmeterol group. Overall, salmeterol is still recommended as the preferred medication for children with asthma which is not controlled using inhaled steroids, but this study may lead to a way of helping those who do not respond well.
The researchers describe their results, which are published in the journal Clinical Science, as "a step towards personalised and tailored medicine for asthma".
Malayka Rahman, research communications officer at Asthma UK, says in a statement: "These findings are really encouraging, although more research would be needed to confirm these and establish whether a genetic test for Arg16 should be implemented.
"We are keen to see more research into genes that affect responses to asthma treatments across different populations, as this exciting area of research has the potential to lead to the tailoring of better treatments for an individual based on their own genetic make-up; ultimately keeping more people out of hospital and preventing unnecessary asthma deaths in the long-term."