Immunogenetics and pharmacogenetics of allergic asthma in Africa

Tshegofatso Mabelane; Refiloe Masekela; Collet Dandara; Sabelo Hadebe

doi:10.3389/falgy.2023.1165311

Immunogenetics and pharmacogenetics of allergic asthma in Africa

Front Allergy. 2023 May 9:4:1165311. doi: 10.3389/falgy.2023.1165311. eCollection 2023.

Authors

Tshegofatso Mabelane¹, Refiloe Masekela², Collet Dandara^{3

4}, Sabelo Hadebe⁵

Affiliations

¹ Department of Medicine, Sefako Makgatho Health Science University, Ga-Rankuwa, South Africa.
² Department of Paediatrics, Nelson Mandela School of Medicine, Inkosi Albert Luthuli Hospital, University of KwaZulu-Natal, Durban, South Africa.
³ Division of Human Genetics, Department of Pathology, Faculty of Health Sciences and Institute of Infectious Diseases Molecular Medicine, University of Cape Town, Cape Town, South Africa.
⁴ Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town, South Africa.
⁵ Division of Immunology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Abstract

Asthma is a common chronic condition in children and in an African setting is often highly prevalent in urban areas as compared to rural areas. Asthma is a heritable disease and the genetic risk is often exacerbated by unique localised environmental factors. The Global Initiative for Asthma (GINA) recommendation for the control of asthma includes inhaled corticosteroids (ICS) alone or together with short-acting β₂-agonists (SABA) or long-acting β₂-agonists (LABA). While these drugs can relieve asthma symptoms, there is evidence of reduced efficacy in people of African ancestry. Whether this is due to immunogenetics, genomic variability in drug metabolising genes (pharmacogenetics) or genetics of asthma-related traits is not well defined. Pharmacogenetic evidence of first-line asthma drugs in people of African ancestry is lacking and is further compounded by the lack of representative genetic association studies in the continent. In this review, we will discuss the paucity of data related to the pharmacogenetics of asthma drugs in people of African ancestry, mainly drawing from African American data. We will further discuss how this gap can be bridged to improve asthma health outcomes in Africa.

Keywords: Africa; asthma; genetics; pharmacogenetics; th2 (type-2) immune responses.

Publication types

Review