Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Asthma Could be Several Diseases Masquerading as One

09.01.2004


Age at Onset and Inflammatory Cells Define Patient Subsets, Guide Treatment



People who develop asthma as children may have a different disease than those who develop it as an adult. A study in the January issue of The Journal of Allergy and Clinical Immunology adds to the growing body of evidence that asthma is not a single disease, but a group of syndromes with different origins and biological characteristics. The research team, led by Sally Wenzel, M.D., a pulmonologist at National Jewish Medical and Research Center, also found that the absence or presence of inflammatory cells, called eosinophils, helped distinguish differences among asthma patients.

"We found that patients whose asthma began in childhood were more frequently allergic than those whose asthma began as adults, while adult-onset asthma was associated with more rapid loss of lung function," said Wenzel. "We were surprised to find that many patients showed no signs of inflammation, generally considered a hallmark of the asthma, yet they still had severe airflow limitation and many asthma symptoms."


The study represents the first time that a research team has combined information from a detailed questionnaire with extensive biological data to define subsets of asthma patients. This data should help physicians better diagnose and treat their asthma patients and make better predictions about the course of their disease. The data may also help guide the search for genetic causes of the disease.

The researchers studied 80 patients with severe asthma who had been referred to National Jewish Medical and Research Center because high doses of inhaled or oral steroids had failed to control their symptoms. Patients were divided into those whose asthma developed before 12 years of age and those whose asthma developed later. The early-onset group developed asthma at the mean age of 2.6 years, while the late-onset group developed asthma at the mean age of 27. They were evaluated for differences in allergic responses, symptoms, lung function and pathology.

More than 75% of patients who developed asthma before the age of 12 reported that they wheezed "most or all of the time" when exposed to dust or pollens, while less than 40% of patients whose asthma developed after 12 did so. Patients with early-onset asthma were also more likely to respond positively to allergens in a skin test and to have had eczema, an allergic skin disease.

Although early-onset patients had had the disease, on average, almost twice as long as the late-onset patients, lung function was slightly worse in the late-onset group. That suggests that patients with late-onset disease suffer a more rapid loss of lung function.

The pattern of inflammation also differed depending upon the age of onset. Late-onset patients were more likely than early-onset patients to have inflammatory cells known as eosinophils in their airways, in spite of treatment with powerful oral steroids. Early-onset patients also showed a pattern of inflammation more frequently associated with allergies than did late-onset patients.

"Asthma has traditionally been very broadly defined in terms of symptoms rather than underlying biological processes," said Wenzel. "Our research helped us divide these severe asthma patients into four subsets, based on age of onset and presence or absence of eosinophils. We believe these subsets represent different biological processes and mechanisms of steroid resistance."

The definition of these subsets could help guide diagnosis, treatment and future research. For example, since early-nset patients were more often allergic than late-onset patients, treatments would be more likely to include an anti-allergy component. Late-onset patients without eosinophils, may well have a completely different disease associated with infection or gastroesophageal reflux.

These subsets might also help guide a search for genes associated with asthma, which has, so far, proven difficult. Different phenotypes could be influenced by different genes, said Wenzel. If so, then searches focusing on specific patient subsets might uncover stronger genetic influences in asthma.

William Allstetter | NJMRC
Further information:
http://www.nationaljewish.org/news/phenotypes_wenzel.html

More articles from Health and Medicine:

nachricht Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>