For some asthmatics, inhaler may not be helping

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© Klaus Tiedge/Corbis

© Klaus Tiedge/Corbis

Asthmatic children with a particular gene variation may get little relief from inhalers that dispense the popular medications salbutamol (Ventolin) and salmeterol, (an ingredient in Advair), according to a pair of studies from researchers at the U.K.’s Brighton and Sussex Medical School and the University of Dundee. A 2006 study found that the Arg16 variation in the gene that produces the molecules that bind to salmeterol may undermine the drug’s efficacy; a study published this month by the Academy of Allergy, Asthma and Immunology expands on the earlier research to include more patients using salbutamol, with similar results.

This latest research shows that patients with the Arg16 variation who regularly took salbutamol had a 30% higher risk for asthma attacks than patients without the gene change who used the same treatment. (Of the roughly 1 million children in the U.K. with asthma, some 100,000 have this gene variation, the researchers say.) Among asthmatic patients with two copies of Arg16—roughly 13% of the U.K.’s asthmatic children—the likelihood of experiencing no response to the drug was twice that of their peers without the gene change.

Together the two studies included 1,182 asthmatics between the ages of 3 and 22, and analyzed the severity and frequency of asthmatic episodes, use of medications to control their respiratory conditions, and overall lung function. The findings may be particularly relevant in parts of the world like India, where the Arg16 gene variation is more common, the researchers say, and may also open the door for research into treatment regimes more tailored to patients’ particular genetic makeups. While those possibilities are explored, however, the researchers are careful to emphasize that patients with asthma should continue to take their prescribed medications—and discuss any concerns about their treatment with their doctors.

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