Abstract

Introduction. The constant increase in the prevalence of bronchial asthma in children and adolescents raises concerns about a parallel increase in obesity-related asthma and suggests that obesity alters asthma towards a phenotype that is more difficult to control. The development of multifactorial diseases (asthma and obesity) is based on complex intergenic interactions that must be taken into account when predicting the risk of developing an unfavorable course of the pathological process.Aim. To study the contribution of polymorphic variants of the metabolism genes rs1042713 (Arg16Gly) and rs1042714 (Gln27Glu) of the β2-adrenoceptor gene (ADRB2), rs4994 Trp64Arg of the β3-adrenoceptor gene (ADRB3), rs1801282 of the PPARG gene, rs1799883 Ala54Thr of the FABP2 gene using Multifactor Dimensionality Reduction (MDR) in patients with asthma and obesity to identify significant intergenic interactions.Materials and methods. 161 children withasthma were examined, including 59 patients with obesity of 1-3 degrees. The examination included general clinical, laboratory, and functional methods. The level of asthma control was determined according to the GINA criteria (2018). The study of gene polymorphisms was carried out by real-time polymerase chain reaction using sets of “Metabolism” (Research and Production Company “Litekh”, Moscow) on the CFX-96 Biorat device (USA).Results. When comparing groups of children with asthma associated with obesity, a significant model of the interaction of the ADRB3 and FABP2 genes was determined. This two-locus model of intergenic interaction. According to this model, children with bronchial asthma with the following genotypes have an increased risk of obesity: Trp64Arg ADRΒ3 and Ala54Thr FABP2; Trp64Arg ADRΒ3 and Thr 54Thr FABP2; Trp64 Trp ADRΒ3 and Ala54Thr FABP2; Trp64 Trp ADRΒ3 and Thr 54Thr FABP2. In patients with AD associated with obesity and lack of disease control, we identified another statistically significant two-locus model of the interaction of the rs1042713 genes of the ADRB2 gene and PPARG. According to this model, children with the following genotypes have an increased risk of lack of disease control in patients with obesity-associated asthma: Arg16Gly ADRB2 and Pro12Ala PPARG; Arg16Gly ADRB2 and Ala12Ala PPARG; Gly16Gly ADRB2 and Pro12Ala PPARG; Gly16Gly ADRB2 and Ala12Ala PPARG.Conclusion. The obtained results of the analysis of intergenic interactions indicate that a key role in the formation of predisposition to obesity in asthma patients belongs to the association of polymorphic variants of the ADRB3 (rs4994) and FABP2 (rs1799883) genes, and the risk of uncontrolled asthma in obese children are patients with a combination of polymorphisms rs1042713 of the ADRB2 gene and rs1801282 of the PPARG gene, as evidenced by revealed two-locus models of intergenic interactions that determine the predisposition to obesity in children with asthma and affect the course of the disease. Identification of genetic predictors of both asthma and obesity is important for identifying individuals with an increased risk of developing this disease, and requires further study in the search for probable cause-and-effect relationships and the creation of personalized programs depending on polymorphic gene variants.

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