Minority Children Failed By Asthma Inhalers: Genomic Analysis Reveals Why

UCSF Highlights Need for More Precision Medicine Research in Underserved Populations

University of California San Francisco researchers report that the largest-ever whole-genome sequencing study of drug response in minority children has revealed new clues about why the front-line asthma drug albuterol does not work as well for African-American and Puerto Rican children as it does for European American or Mexican children.

Asthma is the most common chronic childhood disease in the world, according to World Health Organization estimates. Children with asthma experience difficulty breathing as a result of chronic inflammation of the airways. This inflammation can be alleviated by inhaling drugs called bronchodilators that make the muscles lining the airways relax, allowing them to reopen.

Albuterol is the most commonly prescribed bronchodilator in the world, and often the only medication available to minority children in lower income settings.

Minority Children Respond Least

However, albuterol and other inhaler drugs do not work equally well for all children. In the U.S., Puerto Rican and African-American children – who also have the highest prevalence of asthma nationwide – respond least well to these life-saving drugs.

This may contribute to the four- to fivefold higher rate of death from asthma among these groups, compared to European Americans and Mexicans. Read more of the complete report at UCSF website.

What Researchers Said

“Despite the much higher impact of asthma among African-American and Puerto Rican populations, over 95 percent of studies of lung disease have been performed on people of European descent,” Angel Mak, PhD said. Mak is the UCSF Asthma Collaboratory’s director of genetic research. He was one of the lead authors on the team’s newest study, published in an early online version on March 6, 2018 in the pulmonology journal, American Journal of Respiratory and Critical Care Medicine.

The lab conducted the first large-scale whole genome sequencing study of asthma drug response in African Americans and Latinos. The researchers’ aim was to discover the genetic factors contributing to reduced albuterol response more than was possible in previous association studies.

The test group were a diverse lineup of 1,441 children with asthma who had either very high or very low response to the drug. The genome sequencing was provided courtesy of Trans-Omics for Precision Medicine (TOPMed) Program of the National, Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

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