Pharmacogenetic approaches have already become useful in other pulmonary diseases to identify individuals most likely to respond to costly biologic therapies. One example is the discovery of ivacaftor for treatment of cystic fibrosis related to CFTR Gly551Asp gene. Is asthma next? It is possible that variants in in IL4RA gene could serve as biomarkers for biologic drugs currently under development, such as dupilumab.
DNA should be collected in drug trial cohorts and made available for pharmacogenetic studies. In time, the costs of high-throughput genotyping and DNA sequencing will continue to decrease, while the expanding volume of genetic data will be deciphered by different analytic methods that take into account genetic ancestry, gene–gene interactions, and rare variant effects. An integrated approach will be critical for the development of genetic profiles based on the complex molecular mechanisms underlying treatment responses to eventually deliver truly precise and personalized medicine to an individual asthmatic.
Asthma pharmacogenetics and the development of genetic profiles for personalized medicine. Victor E Ortega, Deborah A Meyers, and Eugene R Bleecker. Pharmgenomics Pers Med. 2015; 8: 9–22, free full text.