鼻用糖皮质激素的基因组学研究状况

Research advance on pharmacogenomics of intranasal corticosteroids

变应性鼻炎是一种常见的过敏性疾病,鼻用糖皮质激素作为一线用药用于变应性鼻炎的临床治疗。然而患者的激素治疗效果存在显著个体差异,部分患者激素治疗无效,称为激素抵抗性变应性鼻炎。随着"变应性鼻炎-哮喘综合征""一个气道、一种炎症"等概念的提出,很多研究者认为影响吸入用糖皮质激素治疗效果的基因会对鼻用糖皮质激素的疗效产生影响。糖皮质激素相关的基因多态性是导致激素抵抗的重要因素,本文综述糖皮质激素药物基因组学的相关研究,期待能为基因检测指导的变应性鼻炎糖皮质激素个体化治疗提供证据支持。

Allergic rhinitis（ AR） is a common inflammatory allergic disease. Intranasal corticosteroids are used in clinical treatment as recommended first- line regimen. However,there are individual differences in the clinical efficacy. And glucocorticoid is not useful in some AR patients which called steroid resistant allergic rhinitis. Glucocorticoid gene polymorphism is a significant contributor to steroid resistance. With the concepts of ＂allergic rhinitis- asthma syndrome＂ ＂one airway,one inflammation＂put forward,many researchers think that some genes may have impact on the efficacy of intranasal corticosteroids. This paper reviews the researches of glucocorticoid pharmacogenomics,expecting to provide evidences to support the glucocorticoid individualized treatment of allergic rhinitis guided by genetic testing.