Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter
  • Published:

Pharmacogenetic association between ALOX5 promoter genotype and the response to anti-asthma treatment

Abstract

Clinically similar asthma patients may develop airway obstruction by different mechanisms1,2. Asthma treatments that specifically interfere with the 5-lipoxygenase (ALOX5) pathway3,4,5 provide a method to identify those patients in whom the products of the ALOX5 pathway (that is, the leukotrienes) contribute to the expression of the asthma phenotype. Failure of an asthma patient to respond to treatment with ALOX5-pathway modifiers indicates that leukotrienes are not critical to the expression of the asthmatic phenotype in that patient. We previously defined a family of DNA sequence variants in the core promoter of the gene ALOX5 (on chromosome 10q11.2) associated with diminished promoter-reporter activity in tissue culture6,7. Because expression of ALOX5 is in part transcriptionally regulated8, we reasoned that patients with these sequence variants may have diminished gene transcription, and therefore decreased ALOX5 product production and a diminished clinical response to treatment with a drug targeting this pathway. Such an effect indicates an interaction between gene promoter sequence variants and drug-treatment responses, that is, a pharmacogenetic effect of a promoter sequence on treatment responses.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Trial outcome stratified by genotype.

Similar content being viewed by others

References

  1. Barnes, P.J. Drug therapy: inhaled glucocorticoids for asthma. N. Engl. J. Med. 332, 868–875 (1995).

    Article  CAS  Google Scholar 

  2. Lemanske, R.F. & Busse, W.W. Asthma. JAMA 278, 1855–1873 (1997).

    Article  Google Scholar 

  3. Busse, W.W. Leukotrienes and inflammation. Am. J. Respir. Crit. Care Med. 157, S210–S213 (1998).

    Article  Google Scholar 

  4. Drazen, J.M., Israel, E. & Obyrne, P.M. Treatment of asthma with drugs modifying the leukotriene pathway. N. Engl. J. Med. 340, 197–206 (1999).

    Article  CAS  Google Scholar 

  5. Obyrne, P.M., Israel, E. & Drazen, J.M. Antileukotrienes in the treatment of asthma. Ann. Intern. Med. 127, 472–480 (1997).

    Article  CAS  Google Scholar 

  6. In, K.H. et al. Naturally occurring mutations in the human 5-lipoxygenase gene promoter that modify transcription factor binding and reporter gene transcription. J. Clin. Invest. 99, 1130–1137 (1997).

    Article  CAS  Google Scholar 

  7. Silverman, E.S. et al. Egr-1 and Sp1 interact functionally with the 5-lipoxygenase promoter and its naturally occurring mutants. Am. J. Respir. Cell Mol. Biol. 19, 316–323 (1998).

    Article  CAS  Google Scholar 

  8. Stankova, J., Rolapleszczynski, M. & Dubois, C.M. Granulocyte-macrophage colony-stimulating factor increases 5-lipoxygenase gene transcription and protein expression in human neutrophils. Blood 85, 3719–3726 (1995).

    CAS  PubMed  Google Scholar 

  9. Mcgill, K.A. & Busse, W.W. Zileuton. Lancet 348, 519–524 (1996).

    Article  CAS  Google Scholar 

  10. Schwartz, H.J., Petty, T., Dube, L.M., Swanson, L.J. & Lancaster, J.F. A randomized controlled trial comparing zileuton with theophylline in moderate asthma. Arch. Intern. Med. 158, 141–148 (1998).

    Article  CAS  Google Scholar 

  11. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am. Rev. Respir. Dis. 136, 225–244 (1987).

  12. Wong, S.L. et al. Pharmacokinetics and pharmacodynamics of single and multiple oral doses of a novel 5-lipoxygenase inhibitor (ABT-761) in healthy volunteers. Clin. Pharmacol. Ther. 63, 324–331 (1998).

    Article  CAS  Google Scholar 

  13. Wong, S.L. et al. Pharmacokinetics of a novel 5-lipoxygenase inhibitor (ABT-761) in pediatric patients with asthma. Eur. J. Clin. Pharmacol. 54, 715–719 (1998).

    Article  CAS  Google Scholar 

  14. Barnes, P.J. Neuropeptides in human airways: function and clinical implications. Am. Rev. Respir. Dis. 136, S77–S83 (1987).

    Article  CAS  Google Scholar 

  15. Smith, L.J. The role of platelet-activating factor in asthma. Am. Rev. Respir. Dis. 143, S100–S102 (1991).

    Article  CAS  Google Scholar 

  16. Wenzel, S.E., Fowler, A.A. & Schwartz, L.B. Activation of pulmonary mast cells by bronchoalveolar allergen challenge. In vivo release of histamine and tryptase in atopic subjects with and without asthma. Am. Rev. Respir. Dis. 137, 1002–1008 (1988).

    Article  CAS  Google Scholar 

  17. Nadel, J.A. & Caughey, G.H. Roles of mast cell proteases in airways. Chest 95, 1328–1330 (1989).

    Article  CAS  Google Scholar 

  18. Nebert, D.W. & Weber, W.W. Pharmacogenetics. in Principles of Drug Action: The Basis of Pharmacology (Churchill Livingston, New York, 1990).

    Google Scholar 

  19. Meyer, U.A. & Zanger, U.M. Molecular mechanisms of genetic polymorphisms of drug metabolism. Annu. Rev. Pharmacol. Toxicol. 37, 269–296 (1997).

    Article  CAS  Google Scholar 

  20. Carson, P.E., Flangan, C.L., Ickes, C.E. & Alving, A.S. Enzymatic deficiency in primaquine sensitive erythrocytes. Science 124, 484–485 (1956).

    Article  CAS  Google Scholar 

  21. Poort, S.R., Rosendaal, F.R., Reitsma, P.H. & Bertina, R.M. A common genetic variation in the 3´-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88, 3698–3703 (1996).

    CAS  PubMed  Google Scholar 

  22. Arranz, M. et al. Association between clozapine response and allelic variation in 5- HT2A receptor gene. Lancet 346, 281–282 (1995).

    Article  CAS  Google Scholar 

  23. Kuivenhoven, J.A. et al. The role of a common variant of the cholesteryl ester transfer protein gene in the progression of coronary atherosclerosis. The Regression Growth Evaluation Statin Study Group. N. Engl. J. Med. 338, 86–93 (1998).

    Article  CAS  Google Scholar 

  24. Hancox, R.J., Sears, M.R. & Taylor, D.R. Polymorphism of the β(2)-adrenoceptor and the response to long-term β(2)-agonist therapy in asthma. Eur. Respir. J. 11, 589–593 (1998).

    CAS  PubMed  Google Scholar 

  25. American Thoracic Society. Standardization of spirometry—1987 update. Am. Rev. Respir. Dis. 136, 1285–1298 (1987).

Download references

Acknowledgements

This study was supported by grants from Abbott Laboratories and the United States National Heart, Lung and Blood Institute (P50-HL-56383).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeffrey M. Drazen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Drazen, J., Yandava, C., Dubé, L. et al. Pharmacogenetic association between ALOX5 promoter genotype and the response to anti-asthma treatment. Nat Genet 22, 168–170 (1999). https://doi.org/10.1038/9680

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/9680

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing