Monday, February 13, 2023

ASTHMA: The opportunity for precision medicine



The opportunity for precision medicine

This NIH/National Institute of Environmental Health Sciences (NIEHS) study not only confirms the weight of genetic predispositions (and the living environment) in the development of asthma, but calls for a precision medicine approach. Research suggests that subjects with specific variations in certain genes, if exposed to traffic pollution, experience more severe asthma symptoms than those without the same genetic variations. The idea is therefore to identify these specific variations in order to treat them better.
 

A specific genetic profile thus leads to more intense symptoms following exposure to traffic pollution. Conversely, the study also shows, patients who are asthmatic but do not have this genetic profile do not have the same sensitivity to pollution and will not develop symptoms of aggravated asthma. These NIEHS scientists are thus considering the opportunity to apply precision medicine, an emerging field that aims to prevent and treat diseases according to specific factors in the patient, to care.
 

Symptom severity scores are found to be based on genetic variation


 or subtle DNA differences that make each patient unique. "All humans have the same genes, in other words the same basic instructions, but in some people a DNA base pair has been changed," says lead author Dr. Schurman of the NIEHS. "This common type of genetic variation called a single nucleotide polymorphism or SNP can alter the way proteins are made and make individuals more or less susceptible to disease."

The scientists specifically examined 4 SNPs involved


 in a biochemical pathway leading to inflammatory responses in the body. While these SNPs are usually studied one by one, here the researchers looked at the impact of different combinations of SNPs on exposure to pollution. This work thus focused on 2,704 participants suffering from asthma divided into 3 groups:

hyper-responders or hyper-sensitive to air pollution and likely to develop inflammation,
hypo-responders, or insensitive to air pollution and less likely to develop inflammation,
moderate responders.
When the team matched the "SNP" data with data on air pollution levels around participants' homes, they found that hyper-responders living near busy roads had the most severe asthma symptoms, including difficulty breathing, chest pain, cough and wheeze, vs other groups.

Improve the quality of life of people with asthma:


 based on this research, it would indeed be possible to specifically treat hyper-responders, exposed to traffic pollution, with an air purification intervention at home , for example. More theoretically, the study also highlights the importance of gene-environment interactions in disease progression.

Beyond asthma, it is an opportunity to address the prevention and treatment of chronic diseases at the level of each patient. The idea is thus to be more efficient for the patient but also to reduce healthcare costs.

Is asthma a global problem?

Asthma is a globally significant non-communicable disease with major public health consequences for both children and adults, including high morbidity, and mortality in severe cases.

What are 3 interesting facts about asthma?

Asthma rates are highest in Black adults in the U.S. Asthma is more common in female adults than male adults. Around 9.8% of female adults have asthma, compared to 6.1% of male adults. It is a leading chronic disease in children.

What is the impact of asthma on society?

The asthmatic patients often use emergency care, sometimes requiring hospital admission, and have a high number of school days missed and workdays lost. In addition, it can cause early permanent disability and premature death. The economic burden of asthma is an important measure of its effect on society.

What is the new treatment for asthma 2022?

November 18, 2022 - AstraZeneca and Avillion recently teamed up to develop PT027, an asthma rescue inhaler. PT027 is a pressurized metered-dose inhaler that delivers a fixed dose of two combined asthma medications, albuterol — a short-acting beta2-agonist — and budesonide — an anti-inflammatory inhaled corticosteroid.

Will asthma be cured in the future?

No, asthma cannot be cured. Some children with asthma will outgrow it by adulthood. But, for many, asthma is a lifelong condition.

What is the new study on asthma?

Persistent Asthma Linked to Increased Buildup of Plaque in Arteries Leading to the Brain. Nov. 23, 2022 — A new study suggests individuals with persistent asthma have higher levels of inflammation and artery plaque, which may increase heart attack or stroke risk.

Why is asthma research important?

Why We Need Research. Asthma research helps us understand how the disease is caused, how it develops and how it is best treated. Research can also help us understand who is at high risk for developing asthma, certain triggers, and ways to avoid getting asthma.

What is the future treatment of asthma?

In 2022 and beyond, the care of patients with asthma will likely be transformed by novel monoclonal antibodies targeting cytokines, new asthma guidelines emphasizing precision medicine, and real-world evidence on the efficacy of newer asthma drugs.

How might people with asthma benefit from personalized medicine?

Summary: This step-by-step transition would bring to a better approach to severe asthmatic patients as the personalization of their therapeutic strategy would bring to a better patient selection, a more precise endotype-driven treatment, and hopefully to better results in terms of reduction of exacerbation rates, ...



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