Роль гена VDR в формировании клинических проявлений, осложнений и ответа на терапию при бронхиальной астме

Abstract

Objective. To study the associative relation between genetic variants (c.1206T>C, c.1175-9G>T, c.152T>C, c.1174+283G>A) of the VDR gene with clinically significant manifestations of bronchial asthma, complications and response to therapy. Patients and methods. The analysis of variants of FokI, TaqI, BsmI of the VDR gene was carried out in 160 patients with bronchial asthma. Results. The combination of asthma and allergic rhinitis was more often observed with genotypes AA and GA c.1174+283G>A compared with GG (p = 0.021), allele A compared with G (p = 0.023), TT and CT c.1206T>C(A>G) TaqI vs. CC (p = 0.003), allele T compared to C (p = 0.003). The combination of symptoms of the "atopic march" was more often recorded in TT genotype c.1206T>C(A>G) TaqI compared to TC and CC (p = 0.046), AA and GA c.1174+283G>A versus GG (p = 0.017) and allele A compared to G (p = 0.021). The protective effect on the severity of asthma is expressed in the CC genotype c.1206T>C(A>G) TaqI compared to TC and TT (p = 0.035), the C allele versus T (p = 0.040), as well as in relation to the control for CC and CT compared to TT c.1206T>C(A>G) TaqI (p = 0.048) and allele C vs T (p = 0.024). The risk of omalizumab administration is lower for CC and TC genotypes c.1206T>C(A>G) TaqI compared to TT (p = 0.037) and for the C allele compared to T (p = 0.035). Vitamin D availability is lower for TT and TC genotypes c.152T>C FokI compared to CC genotype (p = 0.045). Conclusion. The genetic risk of realization of phenotypic manifestations of asthma – severity, level of control, combination of symptoms of "atopic march" and response to therapy for all studied polymorphic variants of the VDR gene is described. Key words: asthma, VDR gene, vitamin D, inflammation, children, 25(OH)D