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Background: Glucocorticoid (GC)-resistant asthma, a complex disease phenotype, has a high morbidity and mortality and takes up a disproportionate share of healthcare costs. The aim of this work was to assess serum 25-hydroxyvitamin D (25(OH)VD) levels in steroid-resistant, steroid-sensitive patients with asthma and in healthy controls, and to investigate the association between the vitamin D receptor gene (VDR) FokI and ApaI polymorphisms and GC resistance in patients with asthma. Methods:This case-control study included 70 patients with severe bronchial asthma and 30 apparently healthy controls. Atopic status was determined by skin-prick test reaction to the most common locally-encountered allergens. A GC reversibility test was performed to differentiate between GC-sensitive and GC-resistant asthma. For all subjects, analysis of the VDR FokI and ApaI polymorphisms by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and measurement of serum 25(OH)VD levels by enzyme-linked immunosorbent assay (ELISA) were performed. Results:The frequencies of FokI polymorphism genotypes and alleles differed significantly between patients with asthma and controls. The frequencies of the TT genotype and T allele carriers were significantly higher among patients with asthma than among controls, and also among GC-resistant patients with asthma than among GC-sensitive patients with asthma. Additionally, serum 25(OH)VD levels differed significantly among the 3 VDR FokI polymorphic genotypes in GC-resistant patients with asthma; the highest level was detected in the TT genotype. No significant differences in ApaI were found. Conclusion:We found a possible association between the FokI T allele and GC resistance in patients with asthma. Variations in VDR FokI might also play a role in 25(OH)VD levels. C 2019 ARS-AAOA, LLC. How to Cite this Article:Mohamed NA, Abdel-Rehim ASM. Influence of vitamin D receptor gene FokI and ApaI polymorphisms on glucocorticoid response in patients with asthma. Int Forum Allergy Rhinol. 2020;10:556-563.

BackgroundGlucocorticoid receptor gene polymorphism (NR3C1 646 C>G) may play an important role in the development of severe bronchial asthma and resistance to glucocorticoids (GCs).ObjectiveThe aim of the present study was to determine the relation between the 646 C>G polymorphism of the glucocorticoid receptor gene (NR3C1) and resistance to GCs with development of severe bronchial asthma.Material and methodsThis case-control study included 40 patients with severe bronchial asthma and 20 apparently healthy controls. Atopic status was determined by skin prick test reaction to the most common locally-encountered allergens. GCs reversibility test was performed to differentiate between GCs sensitive and GCs resistant asthma. For all subjects, analysis of the glucocorticoid receptor gene polymorphism (NR3C1 646 C>G) was done using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP).ResultsThe frequencies of NR3C1 646 C>G genotypes and alleles differed significantly between asthmatic patients and controls. The frequencies of the CC genotype and C allele carriers were significantly higher among asthmatics than among controls, and also among GCs sensitive asthmatics than among GCs resistant asthmatics. However, NR3C1 646 C>G genotypes and alleles frequencies did not differ significantly according to the atopic status in asthmatics.ConclusionsThe too small sized of the investigated groups is a shortcoming of this study. Nevertheless, the observed variations demonstrate a marked association of NR3C1 646 C>G CC genotype with the development of bronchial asthma and a higher frequency of the C allele among GCs sensitive asthmatics. Large-scale studies are required to investigate the association between polymorphisms of the NR3C1 gene and GCs resistance among asthmatic patients.

Studies proposed a link between gut microbiota and airway tract. Study the diversity and density of gut microbiota in healthy and asthmatic patients. Semi-quantitative stool cultures were performed from fecal samples collected from 80 adult asthmatic patients and 40 healthy individuals. Data on gender, age, dietetic history, clinical examination and investigations as skin prick test and pulmonary function testing were also collected. were found to be higher among patient group than control group. density was statistically higher in patient than control group. No significant difference was detected between male and female patients or controls. were statistically more prevalent in stool culture of male cases than that of male controls. No difference was found between female cases and controls. There was no relationship between type of microbial growth and disease related parameters including age, duration of illness, number of allergens and pulmonary function test in cases. Atopic asthma is significantly associated with gut microbiota and. It is important to determine the organism involved, to focus on microbiome-driven disease and therapies.

Background: Well-known allergy tests are used to evaluate and diagnose allergic diseases. The aim of this study was to assess the role of serum level diamine oxidase (DAO) enzyme as a diagnostic marker in respiratory allergy.Methods: This case-control study included 40 patients with respiratory allergies (atopic asthma and allergic rhinitis) as well as 40 age-and sex-matched controls. A detailed past medical history of allergy was collected from each participant including family history of allergy. Physical examination, pulmonary function test (PFT) and measurement of serum levels of total immunoglobulin E (IgE) and DAO were performed. Skin-prick test and specific IgE to common aeroallergens were also carried out.Results: DAO levels were higher in patients than controls. There was a positive correlation between severity of disease and DAO. No significant association was found between DAO level and age, type of respiratory allergy, duration of disease, PFT, eosinophilia, and total IgE. DAO had a high negative predictive value (94.7%) and high sensitivity (97.5%). Conclusion: DAO may be helpful in the assessment of severity and in ruling out respiratory allergy. C 2019 ARS-AAOA, LLC.R espiratory allergy is growing significantly. Estimations worldwide reveal that 5% to 12% of the population are asthmatic, whereas 20% have allergic rhinitis, which is the leading cause of decreased individual productivity. One study showed that around 45% of patients had not yet been diagnosed and that respiratory allergies were underdetermined. 1 Accurate screening and early diagnosis are crucial in the management of respiratory allergy.Mast cells are the main contributor of a typical allergic inflammatory reaction. These cells are activated by exposure to allergens, which, in turn, results in the release of many mediators including histamine, leukotrienes, and specific cytokines. 2 Histamine is the main biomarker of the