• Lama Elbahlawan, Saeed Binaei, Michael L Christensen, Qing Zhang, Michael W Quasney, and Mary K Dahmer.
• St. Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis, TN, USA
• Pediatr Crit Care Me. 2006 Jan 1; 7 (1): 15-8.

BackgroundThe beta2-adrenergic receptor plays a central role in the bronchodilator response to beta2-agonists in patients with asthma. Genetic polymorphisms within the gene coding for this receptor influence responsiveness of the receptor. A number of these polymorphisms differ in frequency in the African American and white populations.ObjectiveTo determine the frequency of specific beta2-adrenergic receptor polymorphisms in African American children with status asthmaticus and to examine whether a specific genotype is associated with the clinical response to therapy.DesignCohort of African American children diagnosed with status asthmaticus.SettingTertiary care children's hospital.PatientsA total of 31 African American children with status asthmaticus.InterventionBlood samples were obtained from children at admission. Genotypes were determined by polymerase chain reaction amplification and restriction enzyme digestion.Main Outcome MeasuresThe requirement for admission to the pediatric intensive care unit, need for mechanical ventilation, institution of various therapies, and length of stay.ResultsThe genotypes of the polymorphic sites at amino acid positions 16 and 27 in the beta2-adrenergic receptor were determined. There were no significant differences between the various genotypes in the percentage of children requiring pediatric intensive care unit admission, mechanical ventilation, terbutaline treatment, or length of stay. However, in children heterozygous for Glu at position 27 of the beta2-adrenergic receptor, the percentage of patients requiring aminophylline treatment, in addition to beta2-agonist therapy, was significantly higher than that seen in patients homozygous for Gln at that position (5/10 [50%] vs. 1/21 [5%], respectively; p = .002).ConclusionsAfrican American children with status asthmaticus who have the Gln/Glu genotype at amino acid position 27 of the beta2-adrenergic receptor may benefit from aminophylline treatment in addition to beta2-agonist therapy.

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