FYI from the NHLBI Index

September 2007: Vol. 8, Issue 2
Feature Articles

Asthma Guidelines Updated

NHLBI Working Group on Research in Marfan Syndrome and Related Disorders

Asthma Guidelines Updated

The National Asthma Education and Prevention Program (NAEPP) has issued the first comprehensive update in a decade of clinical guidelines for the diagnosis and management of asthma, emphasizing the importance of asthma control and introducing new approaches for monitoring asthma.

Asthma is a chronic, treatable disease that causes narrowing of the airways, which makes breathing difficult. According to the Centers for Disease Control and Prevention, more than 22 million people in the United States have asthma, including 6.5 million children under age 18, and an estimated 4,000 Americans die from asthma exacerbations each year.

Coordinated by the NHLBI, the NAEPP convenes an expert panel when new scientific information warrants a rigorous, systematic review of the published medical literature to ensure that the asthma guidelines remain up to date.

“Asthma is one of the most common health problems in the United States – and it can significantly affect patients' lives – at school, at work, at play, and at home,” said NHLBI Director Elizabeth G. Nabel, M.D. “It is essential that asthma patients benefit from the best available scientific evidence, and these guidelines bring such evidence to clinical practice.”

Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma – Full Report, 2007 provides new guidance for selecting treatment based on a patient's individual needs and level of asthma control. The guidelines emphasize that while asthma can be controlled, regular monitoring of the patient's level of function and periodic adjustments in the treatment regimen are needed, as the condition can change over time.

NHLBI Working Group on Research in Marfan Syndrome and Related Disorders

A Working Group was convened on April 30, 2007, in New York in conjunction with a meeting of the National Marfan Foundation to discuss the current state of knowledge about Marfan syndrome (MFS) and related conditions, identify opportunities and barriers to advancing the research agenda, and make recommendations to the NHLBI about areas the Institute should consider pursuing.

MFS and related conditions, such as Loeys-Dietz and Ehlers-Danlos syndromes, have in common the potential for thoracic aortic aneurysm, which can occur in relatively young individuals who are genetically predisposed. Life-threatening aortic dissection and rupture may ensue. The prognosis and clinical outcome for people with MFS have improved steadily over the last three decades, but prospective data that permits correlation of multiple complex determinants of outcomes is needed to enable continued progress.

The Working Group made several recommendations consistent with the NHLBI Strategic Plan, including expanding existing registries and developing new ones, incorporating tissue sample collection into clinical research programs, developing an Aortic Aneurysm Clinical Trials Network to test surgical and medical therapies, identifying new therapeutic targets and biomarkers, and exploring the developmental underpinnings of apparently acquired phenotypes.

A formal report will be published by the Working Group and will be posted on the NHLBI public web site. The anticipated publication date is early 2008.

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