May is Asthma Awareness Month, and the National Institutes of Health emphasizes the scientific progress being made in asthma research, from basic science, such as how lung cells work, to clinical trials on current and future treatments for the disease. NIH-led research includes studies of environmental factors, how the body’s own defense system plays a role, and the microbiome — all the microbial organisms that live in and on the human body.
Asthma is a disease of the lung in which the airways are inflamed. Because of this inflammation, the airways can easily narrow, causing symptoms such as wheezing, coughing, chest tightness, and difficulty breathing. Asthma is estimated to cause millions of urgent medical visits and missed school and work days in the United States each year. In some cases, the disease can be fatal.
Roughly 8 percent of adults and more than 9 percent of children in the United States have asthma, according to the Centers for Disease Control and Prevention.
The three main NIH institutes that support and conduct asthma-related research are the National Institute of Environmental Health Sciences (NIEHS); the National Heart, Lung, and Blood Institute (NHLBI); and the National Institute of Allergy and Infectious Diseases (NIAID). Each institute focuses on a particular area of research, all with the common goal of developing effective strategies to manage and prevent the disease.
Combined, NIH has nearly 600 research projects related to asthma currently underway, including many clinical trials that are recruiting patients. Details on these clinical studies can be found at www.clinicaltrials.gov.
NIEHS research focuses on how environmental factors impact diseases, such as asthma, and how to prevent these diseases. New research has shown that different kinds of air pollution affect asthma differently. For example, ultrafine particles from vehicle emissions get deeper into the lungs where the effects may be more significant. Other studies have shown that being overweight or obese increases sensitivity to indoor air pollution in urban children with asthma. In those cases, weight loss and reducing exposure helped reduce asthma symptoms. Work at NIEHS has also revealed that allergic responses to specific environmental agents such as allergens from pets, pests, and molds, involve many different types of immune cells in the lung. Understanding these cells and how they respond to environmental triggers offers the potential to develop improved therapies that target specific types of asthma.
Research and Risk Factors
NHLBI supports a broad asthma research portfolio that includes studies on risk factors, mechanisms of disease susceptibility and severity, asthma genetics and genomics, and novel and improved therapies and prevention strategies. Current initiatives include addressing asthma disparities through clinical studies, such as the Best African-American Response to Asthma Drugs trial; pushing into new research frontiers such as the microbiome in lung health and disease; and the development of new therapeutics for asthma. NHLBI also supports the National Asthma Education and Prevention Program, which translates research discoveries into improved clinical practice and quality of life for patients with asthma.
Asthma and the Immune System
NIAID-supported research focuses on understanding the immune system’s role in asthma and on identifying new strategies to treat and prevent the disease. For example, studies conducted through NIAID’s Inner-City Asthma Consortium (ICAC) have shown that programs aimed at decreasing exposures to household allergens, such as dust mites, cockroaches, and rodents, and at implementing guidelines-based asthma therapy can reduce disease symptoms and health care visits. ICAC studies also have shown that asthma attacks can be reduced substantially with medications that disrupt the effects of allergy on the airways. ICAC continues to design and implement immune-based therapies for asthma, and conduct studies to define and treat the disease in inner-city children. In addition, NIAID-supported investigators are studying the role of microbial exposures in the development and progression of asthma.