الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Background: Inhaled corticosteroids (ICSs) have been shown to control asthma symptoms. Hypothalamic pituitary adrenal axis suppression (HPAS) is the most important systemic side effect associated with ICS therapy.
Aim and objectives: The aim of this study is to assess the frequency of HPAS in asthmatic children on inhaled corticosteroids and to identify the association between rs41423247 gene and HPAS aiming for personalized treatment decisions in asthma therapy.
Subjects and methods: This was a cross-sectional study has been conducted in pediatric chest and outpatient clinics at Children’s Hospital, Ain Shams University, Cairo, Egypt during the period from November 2022 to November 2023. This study was carried out on 85 asthmatic pediatric patients aged from 5 - 17 years old with documented asthma diagnosis. The patients were assessed for adrenal suppression using serum cortisol, serum ACTH and low-dose short synacthen test. Then they were subjected to genotyping for rs 41423247.
Result: The age of group was 5 - 17 years old. The frequency of HPAS in asthmatic children on inhaled corticosteroids was 42.4%. 49 (57.6%) patients had normal adrenal axis and 36 (42.4%) patients had adrenal suppression. Patients were classified according to rs 41423247 into 3 groups mutant CC: 5 (5.9%), heterozygous GC: 23 (27.1%) and wild GG: 57 (67.1%).
Conclusion: The frequency of HPAS in asthmatic children on inhaled corticosteroids was 42.4%. The highest amounts of ACTH were associated with the GC genotype. rs 41423247(GC) of theNR3C1 gene may provide protection against adrenal suppression. If rs41423247 (GC) is validated by more extensive research, it may serve as a marker of HPAS protection, enabling personalized therapy choices for asthma patients.