The signs and symptoms of severe asthma may look the same, but when it comes to treatments, new research shows that one size doesn’t fit all.
A team of scientists headed by immunologists and pulmonologists at the University of Pittsburgh, which collaborated with Stanford University has specified immune profiles of patients with severe asthma. The discovery, according to a press release draws “a new appreciation for the complexity of disease mechanisms” and can also spur the development of better treatments for the chronic illness.
“We started this study to better understand immune mediators of inflammation in asthma,” lead author Dr. Matthew Camiolo, Ph.D., a clinical instructor of medicine at Pitt, said in a statement. “We found that despite being grouped broadly as ‘clinically severe,’ these asthma patients actually had very different and distinct immune profiles.”
Asthma is a condition in which the airways constrict and swell, which could result in extra mucus. That leads to coughing, wheezing and shortness of breath. According to the Mayo Clinic, the respiratory issue often changes over time. It also affects people differently, ranging from a trivial annoyance to a significant problem that hinders daily activities. It can also be so severe that it could cause a potentially deadly asthma attack.
An incurable condition, asthma can be treated with medications including inhaled corticosteroids, combination inhalers and oral medications called leukotriene modifiers. There is also Theophylline, a daily pill that relaxes the muscles surrounding the airways, which helps them remain open.
These current treatment standards are effective for most patients, but according to the Pitt-led scientific team, there’s a lack of clinical markers that can help classify patients who face a likelihood of resistance to treatment.
“Although breakthroughs in asthma therapy have greatly improved our ability to treat patients, many people still continue with disease that greatly diminishes their quality of life,” fellow lead author Dr. Sally Wenzel, director of Pitt’s Asthma and Environmental Lung Health Institute, and chair of Pitt Public Health’s Department of Environmental and Occupational Health, said in a statement.
Using technology including RNA-sequencing and machine learning, the research team established a unique algorithm that tied together immune cells and cellular pathways that are possibly associated to disease development.
“We have identified two clusters of severe asthma patients with very similar biomarkers but with strikingly distinct immune profiles and associated biological pathways,” senior author Anuradha Ray, Ph.D., professor of medicine and immunology at Pitt said. “These findings identify new targets for therapy, which are distinct in the two subgroups of severe asthma patients who otherwise would be indistinguishable based on biomarker profiles.”
Ray also noted that the team hopes the research can help the creation of new treatments for severe asthma patients “and also allow improved stratification of patients for better efficacy of existing therapies.”
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