title: Neutrophil elastase gene polymorphisms: modulators of response to therapy in childhood bronchiectasis?
abstract: BACKGROUND
  The aim of this study was to investigate polymorphisms in the promoter region of the neutrophil elastase (ELANE) gene as potential modulators of the therapeutic response in children with idiopathic bronchiectasis.
  
  
  METHODS
  The study included 48 children between 5 and 17 years old who were diagnosed with idiopathic bronchiectasis based on high-resolution computed tomography of the thorax. In all patients therapy included administration of antibiotics, anti-inflammatory drugs, expectorants, and postural drainage. Response to therapy was evaluated by the change in FeNO levels before and after administration of therapy. The ELANE promoter region polymorphisms were analyzed by PCR-direct DNA sequencing.
  
  
  RESULTS
  According to the predicted activity of ELANE genotypes, subjects were divided into two groups: low/intermediate activity (n = 18) and high activity (n = 30). Subjects in the group with high-activity genotype had higher initial FeNO levels and this difference was statistically significant (t = 2.906; p = 0.006). The difference between FeNO levels before and after therapy was also statistically significantly higher in children with high-activity genotype (t = 3.329; p = 0.002). Statistically significant correlation was observed between the change in FeNO levels and ELANE genotypes (r = 0.350; p = 0.015).
  
  
  CONCLUSIONS
  Children with high-activity genotype had higher initial FeNO levels and showed better response to therapy than children with low/intermediate-activity genotypes.
authors.affiliation: Institute of Molecular Genetics and Genetic Engineering, Vojvode Stepe 444A, PO Box 23, 11010, Belgrade, Serbia, aleksni@imgge.bg.ac.rs.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Nikolic
authors.forename: Katarina
authors.initials: K
authors.lastname: Milosevic
authors.forename: Srdjan
authors.initials: S
authors.lastname: Boskovic
authors.forename: Branimir
authors.initials: B
authors.lastname: Nestorovic
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001944:Breath Tests; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000201:enzymology / Q000235:genetics* / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D005100:Expectorants / Q000627:therapeutic use; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D019272:Leukocyte Elastase / Q000235:genetics*; D008168:Lung / Q000503:physiopathology; D008297:Male; D010641:Phenotype; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D011401:Promoter Regions, Genetic; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005100:Expectorants; D019272:Leukocyte Elastase