Statement of Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases, Elizabeth G. Nabel, M.D., Director, National Heart, Lung, and Blood Institute, and Linda S. Birnbaum, Ph.D., D.A.B.T., A.T.S., Director, National Institute of Environmental Health Sciences and National Toxicology Program
Today, on World Asthma Day, we at 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), components of the National Institutes of Health, stand together with the international community to renew our dedication to understand the causes of asthma and to find better ways to treat, prevent and manage this disease.
Asthma, a chronic lung disease and significant public health burden, affects approximately 300 million people worldwide. In the United States, more than 22 million people have asthma, and nearly 7 million are children under age 6. Young children, especially those with allergies, are at particularly high risk for developing asthma.
Asthma disproportionately affects people living in lower-income, inner-city environments. In addition, ethnic and racial disparities in asthma burden persist, with the disease having a significant impact on African-American and Puerto Rican communities that have a higher prevalence of asthma and more severe disease.
Currently, there is no way to prevent or cure asthma. Existing treatments for asthma focus on optimizing control of disease symptoms and preventing potentially life-threatening exacerbations. Despite these efforts, asthma exacerbations result in about 10 million missed work days and almost 13 million missed school days each year in the United States. Central to NIAID, NHLBI and NIEHS efforts in asthma research is the goal of reducing the burden that asthma presents to all Americans. We at NIH support basic research aimed at understanding the causes of disease and the factors that contribute to its progression, and conduct clinical trials to develop improved treatment strategies.
Over the past 40 years, NIAID and NHLBI-supported investigators have conducted groundbreaking research that has led to an appreciation for the role of allergy in asthma, the importance of indoor allergens and air pollution, and the importance of particular immune cells and signaling pathways in asthma and their role as targets for developing new treatments.
Current NIAID studies focus on the role of the innate (inborn) and adaptive (acquired) immunity in asthma and allergic diseases. Investigations are under way to determine the changes in the immune system that lead to the development and worsening of asthma and how these changes are influenced by infections, pollution, environmental allergens and genetics. NIAID also supports research programs tailored to children living in inner-city areas, including a variety of immune system interventions aimed at reducing asthma exacerbations and improving control of the disease.
A new landmark collaboration led by NHLBI is developing a large genetics data resource for asthma researchers—first in the United States and then internationally—to facilitate identification of genetic targets for asthma prevention and for treatment and prevention of exacerbations, as well as to tailor treatment choices to individual genetic profiles. In addition, results from NHLBI's asthma clinical research networks continue to change practice, including the use of inhaled corticosteroids in children, the comparative benefits of different asthma treatments, and the understanding of variations in treatment response.
To accelerate the translation of research discoveries into patient benefits, NHLBI supports the National Asthma Education and Prevention Program which in 2009 launched a four-year National Asthma Control Initiative (NACI). The NACI is a dynamic national effort to control asthma through expanded partnerships, an asthma champions program, demonstration projects and a new communications infrastructure.
NIEHS is pleased to join with our sister institutes at NIH as well as partners across the world as we become more united in our efforts to understand, prevent and treat respiratory diseases such as asthma. From research, we now know with great certainty that asthma results from complex interactions between genes and the environment.
NIEHS research is helping to identify the specific indoor allergens and outdoor pollutants that can lead to the development or the exacerbation of asthma. We are accomplishing this through a multi-pronged approach that includes the support of basic, clinical and translational research. We are especially looking forward to the expansion of our clinical research effort when we soon open the doors of our new clinical research unit at NIEHS and work directly with our patients to reduce the burden of asthma.
NIAID, NHLBI and NIEHS remain committed to working with individuals, families and healthcare providers to improve the quality of life for people with asthma around the world. We commend the NIH-supported investigators and their research teams who have made and continue to make significant progress in the field of asthma research, working actively to address this significant public health concern. We also take this opportunity to express our gratitude to the individuals and families who have participated in NIH-sponsored asthma research studies. Without their active involvement in research, many of these advances would not have been made.