Transcriptome analysis in patients with asthma after inhaled combination therapy with long-acting β2-agonists and corticosteroids

• Published in: International journal of medical sciences Vol. 19; no. 12; pp. 1770 - 1778
• Main Authors: Liang, Ya-Ru, Tzeng, I-Shiang, Hsieh, Po-Chun, Kuo, Chan-Yen, Huang, Shiang-Yu, Yang, Mei-Chen, Wu, Yao-Kuang, Lan, Chou-Chin
• Format: Journal Article
• Language: English
• Published: Wyoming Ivyspring International Publisher Pty Ltd 01.01.2022
• Subjects: Allergens; Asthma; Blood tests; Combination therapy; Diabetes; Emergency medical care; Genes; Genomes; Health care; Hypertension; Inflammation; Lung diseases; Steroids; United States > US
• DOI: 10.7150/ijms.76013
• ISSN: 1449-1907

Introduction: Asthma is one of the major public health problems that imposes a great burden on societal, financial, and healthcare around the world. Asthma poorly affects the health-related quality of life and daily activities of patients. Treatment of asthma, including inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), mainly aims to improve the lung function and reduce symptoms and exacerbations. Current treatment regimens are symptom-based strategies, and the status of airway inflammation after treatment is yet unknown. We conducted this study to understand the comprehensive inflammation or airway remodeling status of patients after ICS-LABA treatment through RNA transcriptome analysis.Materials and methods: Eight newly diagnosed asthmatic patients and two healthy subjects were recruited in this study. Asthmatic patients underwent blood tests, lung function test, and RNA transcriptome analysis before and after ICS-LABA treatment.Results: In comparison with healthy subjects, pretreatment asthmatic patients had higher expression of protein tyrosine kinase and related signaling pathways. After ICS-LABA treatment, the expression of nuclear receptor transcription coactivator, N-acetyltransferase, protein tyrosine kinase, nuclear receptor, and RNA polymerase II-activating transcription factor were downregulated. However, the post-treatment asthmatic patients still had higher expression of cysteine-type endopeptidase, endodeoxyribonuclease, apolipoprotein, and unfolded protein was still upregulated than healthy subjects.Conclusions: The combination of ICS/LABAs decreased airway inflammatory and remodeling pathways. However, allergen stimulation-related pathways were still upregulated in patients after ICS/LABA treatment. The combination of medication and allergen removal is a complete strategy for asthma.