Inhaled glucocorticosteroids are the first-line medications for the treatment of bronchial asthma. Metabolism of inhaled glucocorticosteroids involves cytochrome P450 subfamily 3A isoenzymes. Inhaled glucocorticosteroids are also the substrates for the P-glycoprotein. Polymorphism of the genes that encode cytochrome P450 3A and P-glycoprotein (multiple drug resistance gene) can affect the activity of respective proteins. Changes in biotransformation of glucocorticosteroids and their efflux from cells can influence the efficacy and safety of treatment. Action of inhaled glucocorticosteroids can depend on the polymorphism of the other candidate genes which are currently being studied. The authors review the available information about pharmacogenetics of inhaled glucocorticosteroids that can determine interindividual variability of their efficacy and safety in patients with bronchial asthma.
Pharmacogenetics, inhaled glucocorticosteroids, P-glycoprotein, cytochrome P450, bronchial asthma.