CRHR1基因rs1876828位点的多态性与支气管哮喘患儿吸入性糖皮质激素疗效的相关性研究

Association between CRHR1 gene(rs1876828)polymorphism and the effect of inhaled corticosteroids in children with bronchial asthma

目的分析促肾上腺皮质激素释放激素受体1(corticotropin releasing hormone receptor 1,CRHR1)基因rs1876828位点的多态性与支气管哮喘患儿吸入性糖皮质激素(inhaled corticosteroids,ICS)疗效的相关性。方法2018年1月至2019年6月于哈尔滨医科大学附属第一医院儿科诊治的中度持续性哮喘患儿60例为研究对象。应用Sanger测序法,检测哮喘患儿的CRHR1基因rs1876828位点。根据基因位点碱基序列的不同,将患儿分为TT基因型组(TT组)和CC基因型组(CC组)。其中TT组22例(36.7%),CC组38例(63.3%)。两组患儿均予ICS雾化吸入及对症治疗。观察治疗前及治疗后3 d、10 d、30 d的临床症状及体征并评分,记录症状及体征完全消失所需天数。结果治疗3 d后,TT组及CC组患儿临床症状及体征均获得一定程度的改善,但组间差异无统计学意义(P>0.05)。治疗后10 d、30 d两组患儿病情恢复均较3 d时更好,TT组改善程度明显优于CC组,差异有统计学意义(P<0.05)。TT组及CC组症状及体征完全缓解时间分别为(8.68±7.42)d和(16.21±7.82)d,差异有统计学意义(P<0.01)。结论支气管哮喘患儿存在CRHR1基因rs1876828位点的多态性,表现为TT基因型和CC基因型,其中CC基因型占多数。哮喘患儿CRHR1基因rs1876828位点的多态性与ICS疗效相关。TT基因型患儿的ICS疗效优于CC基因型患儿。

Objective To analyze the association between CRHR1 gene(rs1876828)polymorphism and the effect of inhaled corticosteroids(ICS)in children with bronchial asthma.Methods A total of 60 children with moderate persistent asthma who were treated in the Department of Pediatrics of the First Affiliated Hospital of Harbin Medical University from January 2018 to June 2019 were included.The CRHR1 gene rs1876828 locus in children with asthma was detected by Sanger sequencing.The children were divided into TT genotype group(TT group)and CC genotype group(CC group)according to the different base sequences of gene loci.There were 22 cases in TT group(36.7%)and 38 cases in CC group(63.3%).Both groups were given aerosol inhalation of ICS and symptomatic treatment.Clinical symptoms and signs were observed and scored before and after treatment for 3d,10d and 30d,and the days required for complete disappearance of symptoms and signs were recorded.Results After 3d of treatment,clinical symptoms and signs of TT group and CC group were improved to a certain extent,but there was no statistical significant difference between two groups(P>0.05).At 10d and 30 d after treatment,the recovery of the two groups was better than that at 3d,and the improvement degree of the TT group was significantly better than that of the CC group,with statistical significance(P<0.05).The time of complete remission of symptoms and signs in TT group and CC group was(8.68±7.42)d and(16.21±7.82)d;the difference was statistically significant(P<0.01).Conclusion There is a polymorphism of CRHR1 rs1876828 locus in children with bronchial asthma,which manifests as TT genotype and CC genotype,and CC genotype is the majority.The polymorphism of CRHR1 gene rs1876828 in asthmatic children is associated with the efficacy of ICS.The efficacy of ICS in children with TT genotype is better than that of CC genotype.