Research for Asthma

Researchers are also working to develop new approaches to help prevent and treat asthma. Levine’s team is studying the effects of house dust mites inside the home. While exposing mice to dust mites, the researchers identified a protein in the lung that blocked the development of asthma. With further research, the finding may eventually lead to new approaches for preventing or controlling asthma symptoms in people.

Source: NIH News in Health (NIH)1

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Back to: « Asthma

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Why is the study of Asthma a priority for NIAID?

Asthma costs the United States approximately $56 billion each year in medical costs, lost school and work days, and early deaths. Approximately 24million people in the United States have asthma, including over 6 million children. In the United States, over 10 million people with asthma reported experiencing at least one asthma attack in 2014.

How is NIAID addressing this critical topic?

Since 1971, NIAID has supported targeted research to understand the causes of and develop preventions and treatments for asthma. NIAID research focuses on understanding how the environment, allergens, and genetics interact with the body's immune system to cause the disease and aggravate the symptoms. NIAID-supported investigators are working to prevent asthma from occurring in people and to develop new, better treatments for those who are currently affected.

Source: NIAID (NIH)2

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Asthma Research Goals

NIAID-supported investigators are working to prevent asthma from occurring in people and to develop new, better treatments for those who are currently affected. The pathogenesis, diagnosis, treatment, and prevention of asthma are also major areas of emphasis for NIAID-targeted research programs.

Source: NIAID (NIH)3

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Programs on Asthma in the Inner City

Recognizing that asthma severity in inner-city children is disproportionately high, NIAID has sponsored research to reduce the public health burden that asthma presents in inner-city populations. Beginning in 1991, NIAID has supported three consecutive inner-city asthma research programs, which have been successful in reducing asthma severity in children.

Source: NIAID (NIH)4

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Current Projects

ICAC investigators are currently conducting several projects focused on improving asthma treatment, including the following:

  • An observational study to examine the genetic, environmental, and immune system aspects that play a role in the development of asthma in inner-city children by closely following a cohort of more than 500 children from before birth until age 7
  • An exploration of the use of cockroach extract administered orally under the tongue—called sublingual immunotherapy (SLIT)—as a potential treatment for asthma
  • A study to examine whether children with asthma have epigenetic differences from children with no asthma or allergies
  • A follow-on clinical trial (based on the results of the ICATA trial) using omalizumab during the fall to examine if this will eliminate the seasonal increase in asthma exacerbations

Source: NIAID (NIH)5

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Asthma Research Goals

NIAID-supported investigators are working to prevent asthma from occurring in people and to develop new, better treatments for those who are currently affected. The pathogenesis, diagnosis, treatment, and prevention of asthma are also major areas of emphasis for NIAID-targeted research programs.

Current basic, preclinical, and clinical research aims to

  • Investigate the role of the immune system in the development, treatment, and prevention of asthma
  • Determine how infections and immune responses to infections may contribute to the development or worsening of asthma
  • Identify possible genetic predispositions to the disease and how they may affect disease development
  • Understand the relationship between asthma and upper respiratory diseases such as rhinitis(inflammation of the nose) and rhinosinusitis (inflammation of the nose and sinuses)
  • Improve current treatments and develop new ones that reduce or eliminate the response of the immune system to environmental allergens that trigger asthma
  • Develop and validate biomarkers to measure disease stage, progression, and therapeutic effect
  • Understand the role that environmental allergens and pollution may play in the development and worsening of asthma
  • Define the natural history and unique mechanisms associated with asthma onset and severity, especially in children living in inner-city environments

Source: NIAID (NIH)6

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Asthma Featured Research

Co-Infections With Viruses and Bacteria Linked to Children’s Asthma and Cold Symptoms

Researchers have found that combined viral and bacterial infections are associated with the increase in asthma symptoms that many children experience during the fall. Read more about how co-infections with viruses and bacteria are linked to children’s asthma and cold symptoms.

Reducing Airway Mucus Alleviates Asthma in Mouse Study

Scientists have identified a role for airway mucus, particularly a type called MUC5AC, in allergic asthma in mice. Read about how reducing airway mucus alleviates asthma in a mouse study.

Common Fungus Promotes Airway Sensitivity in Asthma

Scientists have found that an allergy-causing substance, or allergen, from a common fungus triggers a sequence of molecular events that contribute to the airway sensitivity characteristic of asthma. Read more about common fungus that promotes airway sensitivity in asthma.

Researchers Refine How Immune Pathways Contribute to Asthma

A new study has shown that targeting two immune cells—Th2 and Th17—and their downstream, inflammatory effects is better than targeting just one pathway in the context of asthma. Read more about researchers refining how immune pathways contribute to asthma.

Source: NIAID (NIH)7

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Asthma Research: The NIH-NJRC Connection

Among the many ways that NIH supports and promotes asthma research is through its strong relationship with National Jewish Medical Research Center in Denver. National Jewish has been conducting research for more than 80 years and is rated as one of the top 10 independent biomedical research institutions—of any kind—in the world. Asthma is the top disease treated and studied at National Jewish, and NJRC works with four different NIH asthma programs:

National Heart, Lung, and Blood Institute (NHLBI) Childhood Asthma Management Program

NHLBI Childhood Asthma Research and Education Network

NHLBI Asthma Clinical Research Network, and

National Institute of Allergy and Infectious Diseases (NIAID) Inner City Asthma Consortium

NIH funds research all across the globe, and has worked closely with NJRC to supply grants for the important asthma research going on there. Ongoing NJRC projects include investigations of the following:

  • nocturnal asthma,
  • steroid-resistant asthma,
  • pollution and asthma,
  • obesity and asthma,
  • viruses and asthma, and
  • how early life exposures to allergens may help protect children from asthma.

Some of NJRC's most important research addresses the underlying causes of asthma. Erwin Gelfand, M.D., Chairman of Pediatrics, recently received a major NIH grant to do just that. The grant renews a project that initially began almost 20 years ago to focus on mechanisms of the underlying inflammation in asthma. The novel research findings continue to translate into new therapeutic strategies.

Another important study could help physicians decide definitively whether to prescribe antibiotics for asthma patients. (See accompanying story.) In pediatric asthma, doctors are studying and treating the progression of asthma, infant wheezing that leads to asthma, and severe asthma.

Source: MedLinePlus Magazine (NIH)8

Treatment Research for Asthma

Some people with asthma don’t respond well to inhaled corticosteroids, a widely prescribed medicine for asthma control. Scientists have now identified a gene that may help explain why.

Since a poor response to inhaled corticosteroids often runs in families, scientists suspected that genes play a role. To learn more, researchers ran a genome-wide scan of more than 100 children with asthma and their parents. Variation in a gene called GLCCI1 seemed to be linked to a poor response to inhaled corticosteroids.

To double-check the finding, the scientists looked for variant GLCCI1 genes in over 900 additional children and adults with asthma. About 1 in 6 of these patients had 2 copies of the variant gene. Those with 2 variants were more than twice as likely to respond poorly to inhaled corticosteroids than patients with 2 regular copies of the gene.

“This finding helps to explain the genetic basis for the long-standing observation that some people don’t respond well to what is a common asthma treatment,” says Dr. Susan Shurin, acting director of NIH’s National Heart, Lung and Blood Institute. Understanding variant genes might eventually lead to personalized asthma therapy that’s based on each patient’s genetic makeup.

Source: NIH News in Health (NIH)9

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Treating Asthma in Kids

Several medications can help control children’s asthma, but no clinical trials have directly compared them. A new study funded by NIH tested the effectiveness and safety of three common asthma medicines. It found that inhaled corticosteroids are the most effective initial daily therapy for children with mild to moderate persistent asthma.

The researchers divided 285 children, ages 6-14, into 3 groups, each receiving a different daily therapy for their asthma: a low dose inhaled corticosteroid (Flovent); a combination of an even lower dose inhaled corticosteroid along with a bronchodilator (Advair and Serevent); and an oral anti-leukotriene tablet (Singulair).

During the 48 weeks of treatment, the children taking inhaled corticosteroid alone showed better lung function than those in the other two groups. The inhaled corticosteroid alone and combination therapies were similarly effective at controlling symptoms, and both were more effective than the anti-leukotriene. None of the treatments significantly affected children’s growth, a concern for many parents and doctors.

The study shows that inhaled corticosteroids are the most effective therapy for children of this age group with this type of asthma.

Source: NIH News in Health (NIH)10

Research for Asthma

Corticosteroids As Needed: Possible Treatment Changes for Asthma

Some adults with mild persistent asthma may be able to control their asthma by taking corticosteroids only when needed, according to a new study supported by NIH.

Those who took corticosteroids when their symptoms arose had about the same number of severe asthma flare-ups as those taking daily, long-term control medications.

This finding needs to be confirmed in a larger study, but it suggests that some patients may be able to safely avoid the expense and inconvenience of daily medication.

For this study, the researchers put 255 adult patients into three treatment groups. Two groups took asthma control medication twice a day—either an inhaled corticosteroid or another type of asthma medication in pill form. The third received a placebo (inactive) medication. All were given additional medicines with clear instructions on how to use them to treat symptoms if they appeared.

After one year, the three groups were similar in measurements of lung air flow, the number of severe asthma attacks, and quality-of-life tests. Those in the daily inhaled steroid group, however, did have significantly more symptom-free days than those in the other two treatment groups.

An expert panel will soon consider whether to change treatment recommendations for adults with mild persistent asthma. For those with more frequent symptoms or more severe asthma, these new findings don’t apply. If you have asthma, however severe, work with your health care provider to develop and follow an asthma treatment plan.

Source: NIH News in Health (NIH)11

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NHALES study: Understanding Asthma from the Inside Out

NIH study looks at the microbiome’s role

Three NIH institutes fund asthma studies to improve treatment and learn more about what causes this widespread illness: the National Institute of Allergy and Infectious Diseases (NIAID); the National Heart, Lung, and Blood Institute (NHLBI); and the National Institute of Environmental Health Sciences (NIEHS).

NIH MedlinePlus magazine sat down with pulmonologist Stavros Garantziotis, M.D. to discuss one such study. He is a lead researcher on the Natural History of Asthma with Longitudinal Environmental Sampling (NHALES) trial. The trial is supported by NIEHS. Dr. Garantziotis and his team still need people to participate in this study, which is based in North Carolina.

What are the goals of the NHALES study?

There are two goals, both scientific and community-based. The scientific side is to try to understand the microbiome, or the microbial makeup of our environment and our bodies, and how that affects asthma activity. We gather samples from participants’ homes and their bodies, including phlegm, saliva, and stool samples. We are following asthma patients over a long period of time, five years at the minimum. These patients include those who have recurrent symptoms and have moderate to severe asthma. We offer free care and free medications for study participants. In that way, we can also give back to the community through the study.

https://medlineplus.gov/magazine/issues/fall17/articles/fall17pg24.html

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Biosensors: The Future of Asthma Monitoring

With so many pollutants indoors and outdoors, determining what triggers asthma in children is not easy.

Now, NIH-supported researchers are developing technology to help identify those triggers more easily.

New research supported by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) uses biosensors to gather data about environmental and other factors involved in childhood asthma. Biosensors are devices that detect and measure biochemical changes within the body. Technology then turns those signals into helpful data, which experts can analyze to learn about our health.

These asthma biosensor systems monitor what children are exposed to and their body’s reactions. Zhenyu Li, Ph.D., a biomedical engineer at George Washington University, is engaged in the research.

He and his team are developing a sensor that can be worn on a child’s wrist to detect formaldehyde, an air pollutant that can trigger asthma.

“Researchers don’t have tools at the moment that can monitor environmental triggers, physiological responses, and behavior without interrupting normal activities,” Dr. Li said. He expects to have a wearable sensor prototype that can be tested soon.

Dr. Li’s team is also working on a device that can be placed in a child’s home to detect multiple air pollutants, like those found in tobacco smoke and some manufactured wood products, such as flooring and furniture.

SOURCES: NIH News in Health and National Institute of Biomedical Imaging and Bioengineering (NIBIB)

https://medlineplus.gov/magazine/issues/fall17/articles/fall17pg23.html

Prevention Research for Asthma

NIEHS also partnered with NIH’s National Institute of Allergy and Infectious Diseases to develop a cost-effective program aimed at reducing asthma severity among predominantly African-American and Hispanic children in low socioeconomic areas. The study, called the Inner-City Asthma Study, showed that a program to reduce allergens in the home can result in fewer asthma symptoms in children.

Source: NIH News in Health (NIH)12

Causal Research for Asthma

To learn more about the link between mold and childhood asthma, researchers visited the homes of nearly 300 infants who were about 8 months old. The scientists looked and smelled for evidence of mold. They also measured levels of 36 different types of mold in dust samples from each home.

Once the kids reached age 7, the researchers found, nearly 1 in 4 had developed asthma. The risk of asthma was greater for kids whose original homes had higher “mold scores.”

Three particular species of mold were most associated with asthma. These species—Aspergillus ochraceus, Aspergillus unguis and Penicillium variabile—are common to water-damaged buildings.

Sometimes homes that at first seemed to have no mold had high mold scores according to the dust sample analyses. Other studies have found that many homes with high mold scores have undetected mold problems. Fixing these problems can improve asthma in children.

The link between the 3 molds and asthma doesn’t prove that the molds cause asthma on their own. But it does provide evidence that indoor mold can contribute to the development of asthma.

“Previous scientific studies have linked mold to worsening asthma symptoms, but the relevant mold species and their concentrations were unknown,” says lead researcher Dr. Tiina Reponen of the University of Cincinnati. Preventing home water damage and growth of these molds might help relieve some problems with asthma.

Source: NIH News in Health (NIH)13

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Co-Infections With Viruses and Bacteria Linked to Children’s Asthma and Cold Symptoms

NIAID-funded researchers have found that combined viral and bacterial infections are associated with the increase in asthma symptoms that many children experience duri?ng the fall. Children infected with rhinovirus, which causes colds, and certain types of bacteria were most likely to experience asthma attacks and cold symptoms. While rhinovirus infection is widely thought to be the main contributor to fall asthma attacks, this study suggests that bacterial infections also play a role. The results are published in the May 2014 issue of the Journal of Allergy and Clinical Immunology.

Source: NIAID (NIH)14

Causal Research for Asthma

Household Allergens: NIH scientists and their colleagues examined survey results from nearly 2,500 people in 75 locations across the country. The researchers looked at how allergen levels in homes were related to asthma. The allergens included those from dog, cat, mouse, cockroach, dust mite and a common indoor fungus.

The research team found that most U.S. households have several types of indoor allergens. Just over half of homes had at least 6 detectable allergens. Nearly half had increased levels of 3 or more allergens.

The scientists found that a quarter of the households had at least one person who had been diagnosed with asthma. Higher levels of at least 4 allergens were found in 23% of the homes of people with asthma, compared with 16% of homes where no asthmatic people lived.

Source: NIH News in Health (NIH)15

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Indoor Allergens: From 1998 to 2002, NIEHS scientists, along with researchers from the Department of Housing and Urban Development, conducted an extensive survey to assess how widespread these indoor allergens are in American homes. The results of this survey, the National Survey of Lead and Allergens in Housing, showed that more than 46% of the homes surveyed had levels of dust mite allergens high enough to produce allergic reactions, and nearly a quarter had levels high enough to trigger asthma symptoms in genetically susceptible people.

The survey also showed that nearly two-thirds of U.S. homes have detectable levels of cockroach allergens, with higher levels in high-rise apartments, urban settings, older homes and homes of low-income households. About 10% had cockroach allergen levels above the threshold for triggering asthma symptoms.

“One of the most surprising findings from the national survey was that 100% of homes had detectable levels of dog and cat allergen, even though dogs were present in only 32% of the surveyed homes, and cat ownership was reported in only 24%,” says Dr. Darryl Zeldin, a scientist with NIEHS and senior author of the study.

https://newsinhealth.nih.gov/2006/July/docs/01features_01.htm

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Outdoor Allergens: While much asthma research has focused on indoor allergens, scientists are realizing that outdoor pollutants also play a major role. NIEHS-funded researchers at the University of Southern California’s Keck School of Medicine studied air pollution levels in 10 Southern California cities and found that the closer children live to a freeway, the greater their chances of being diagnosed with asthma. They saw a relationship between higher levels of asthma and certain pollutants that come from the burning of fossil fuels (like the exhaust of a car or truck), as well as from emissions from industrial plants.

https://newsinhealth.nih.gov/2006/July/docs/01features_01.htm

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Endotoxins: Bacteria in Dust Linked to Asthma

Asthma and wheezing may be triggered by a chemical from bacteria that lurk in household dust, according to a large nationwide study by researchers at NIH’s National Institute of Environmental Health Sciences and the University of Iowa.

Scientists studied more than 2,500 dust samples from bedroom, kitchen and living room floors and from bedding and upholstered furniture in 831 homes across the United States. The researchers found that bacterial chemicals called endotoxins—in particular, on bedroom floors and in bedding—are linked to increased breathing problems in adults.

Adults in households with higher levels of endotoxin had more diagnosed asthma, asthma symptoms, asthma medication use and wheezing, whether or not they had allergies. The likelihood of recent asthma symptoms was nearly 3 times greater for people exposed to high levels of endotoxin in the bedroom.

Previous studies have shown that house dust contains endotoxin. Pets, pests, humidifiers and kitchen compost bins can all increase the level of endotoxin in a home. Interestingly, early life exposure to household endotoxin protects children against the development of allergies. In contrast, this new research shows that adult exposure to endotoxin raises the risk of asthma. A growing understanding of how asthma is triggered will eventually help in the prevention and treatment of this disease.

https://newsinhealth.nih.gov/2005/October2005/docs/02capsules.htm

Genetics Research for Asthma

Armed with a better understanding of asthma’s environmental triggers, NIEHS researchers want to learn more about which genes make people susceptible to developing asthma when they encounter these triggers. Using a technique called gene expression profiling, researchers will screen thousands of genes at once to identify which genes are activated when a patient’s airways become obstructed or inflamed.

“Once we learn more about how these genes differ from one person to another, we may be able to explain why some people develop asthma while others remain unaffected,” Schwartz says.

A better understanding of how asthma develops will help researchers design more effective strategies for prevention and treatment. In the meantime, talk to your doctor or use the resources listed here to learn more about how you can prevent asthma symptoms.

Source: NIH News in Health (NIH)16

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Pharmacogenomics is affecting many other fields of medicine as well. Researchers supported by NIH have found variations in genes that affect how people with asthma respond to a type of inhaled medicine. These genes might one day tell doctors which medicines will work best on a given patient.

Source: NIH News in Health (NIH)17

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The search for specific asthma genes is ongoing. Assisting in this international human effort are model organisms such as mice, which have similar chromosomal architecture to our chromosome 5 site on their chromosomes 11, 13, and 18. Further study of the genes in these areas (and others) of the human genome will implicate specific genes involved in asthma and perhaps also suggest related biological pathways that play a role in the pathogenesis of asthma.

Source: NCBI, Genes and Disease (NCBI/NIH)18

Clinical Trials for Asthma

Clinical Trials

The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.

NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has uncovered some of the causes of chronic lung diseases, as well as ways to prevent and treat these diseases.

Many more questions remain about chronic lung diseases, including asthma. The NHLBI supports research to help improve the control of asthma and quality of life for people who have the disease. For example, the AsthmaNet is a clinical research network with ongoing studies of different asthma treatments in children and adults.

Much of this research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions.

Source: NHLBI (NIH)19

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Clinical Trials and Asthma

The National Heart, Lung, and Blood Institute (NHLBI) supports studies that explore:

  • How new technologies can improve asthma care
  • How certain medicines and other therapies can help treat asthma and improve quality of life
  • What factors cause asthma to develop

For more information about clinical trials related to asthma, talk with your doctor. You also can visit the following websites to learn more about clinical research and to search for clinical trials:

  • www.nih.gov/health/clinicaltrials/
  • www.clinicaltrials.gov
  • www.nhlbi.nih.gov/studies/index.htm
  • www.researchmatch.org

For more information about clinical trials for children, visit the NHLBI's Children and Clinical Studies Web page.

Source: MedLinePlus Magazine (NIH)20

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References

  1. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ jun2014/ feature1
  2. Source: NIAID (NIH): niaid.nih.gov/ diseases-conditions/ asthma
  3. ibid.
  4. ibid.
  5. Source: NIAID (NIH): niaid.nih.gov/ diseases-conditions/ inner-city-asthma-programs
  6. Source: NIAID (NIH): niaid.nih.gov/ diseases-conditions/ asthma-research-goals
  7. Source: NIAID (NIH): niaid.nih.gov/ diseases-conditions/ asthma-featured-research
  8. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall07/ articles/ fall07pg17.html
  9. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ nov2011/ capsule1
  10. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2007/ March/ docs/ 02capsules.htm
  11. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2005/ June2005/ docs/ 02capsules.htm
  12. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2006/ July/ docs/ 01features_01.htm
  13. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ sep2012/ capsule1
  14. Source: NIAID (NIH): niaid.nih.gov/ diseases-conditions/ co-infections-linked-child-asthma-and-cold-symptoms
  15. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2008/ April/ docs/ 02capsules.htm
  16. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2006/ July/ docs/ 01features_01.htm
  17. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2005/ June2005/ docs/ 01features_01.htm
  18. Source: NCBI, Genes and Disease (NCBI/NIH): ncbi.nlm.nih.gov/ books/ NBK22181/ 
  19. Source: NHLBI (NIH): nhlbi.nih.gov/ health/ health-topics/ topics/ asthma/ trials
  20. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall13/ articles/ fall13pg12-13.html

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.