Acute asthma stops responding to treatment: Study

According to a new research, patients suffering from acute asthma fail to react to the mainstay treatment of the disease – high doses of corticosteroids, which work perfectly in low doses only on those who suffer from low level asthma.

In case of acute asthma, the patient’s airways get swollen and narrow to harm the breathing. Dr. Anuradha Ray, an Indian-origin scientist who is the professor of medicine in Pitt School of Medicine and led the research said that “about 10 percent of asthma patients” have an acute form of the illness, “but they account for up to half of asthma costs in the U.S. and Europe.”

She added that acute asthma patients require to be frequently taken to the emergency room or be admitted to hospital “when they have an acute asthma episode.”


Photo Credit: Jmarchn

Researchers acquired lung cell samples of patients who took part in the Severe Asthma Research Program (SARP), a National Heart, Lung and Blood Institute of the National Institutes of Health- supported program aiming to help in the better understanding of severe asthma.

They noticed that CD4 T-cells – the immune cells, present in the airways of acute asthma patients secreted different swell-rousing proteins than those with the milder form of the disease. This scrutiny helped them to prepare a mouse model of the illness by presenting an allergen and a bacterial product to stimulate the immunization and airway hyper-reactivity that were poorly managed by corticosteroids – as in human beings with acute asthma problems.

When the mice that lacked the interferon gamma gene were subjected to the acute asthma model, the researchers found that the mice couldn’t be provoked to build up acute asthma. With the help of computer modeling, they studied the links between interferon gamma and asthma-related genes, and discovered that as the interferon gamma levels expanded, secretory leukocyte protease inhibitor (SLPI) levels– a protein, dropped.

However, in round-up experiments the researcher team found that enhancing SLPI levels decreased the airway hyper-reactivity in the animal model. Dr. Anuradha Ray said that besides wanting to understand better “why severe asthma occurs in most people right from the start,” they would also want to “find agents that can raise SLPI levels for clinical use.”

The study was conducted as part of the doctoral thesis of Mahesh Raundhal, a graduate student in the laboratory of Prabir Ray who is also a professor of medicine in Pitt School of Medicine and co-author of the research. Sally Wenzel who is the director of the University of Pittsburgh Asthma Institute of UPMC, acted as the Pitt SARP principal examiner.

Dr. Anuradha Ray and Wenzel were recently awarded a five-year, 8 million dollars grant from the National Institute of Allergy and Infectious Diseases (NIAID), a part of the National Institute of Health (NIH) as well for their new project that aims to continue studying the immune reaction and genetic roots of acute asthma in 120 patients and in animal models.

The research was published in the Journal of Clinical Investigation (JCI).

According to World Health Organization (WHO) Global Asthma Report 2014, 334 million people may get affected due to asthma. Low and middle-income nations are most prone to catching this disease. WHO has started a campaign called “Global Asthma Network” that aims at reducing acute asthma by 50 percent by 2025 – by providing better and improved asthma care especially in low and middle-income countries.

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