Personalised treatment for patients with severe asthma

According to a study presented at the European Respiratory Society ( ERS ) Annual Congress in Barcelona, patients suffering from severe asthma are less responsive to treatment than those with moderate asthma. Investigators hope to better understand the pathology of this respiratory disorder and discover new therapies.

Asthma is one of the most common respiratory diseases; it affects more than 300 million people worldwide. Asthma is a chronic respiratory disease with symptoms such as dyspnea, cough and wheezing;  asthma attacks can be triggered by various factors such as cold, effort , pollen, dust , emotions etc. Although there is no cure, there is treatment to relieve symptoms, which consists of bronchodilators, oral corticosteroids, oral leukotriene antagonists and mast cell stabilizers; it must be said that these drugs are classified into fast -acting and long -acting categories, depending on the time of action. A common asthma attacks can be stopped using a drug called salbutamol, which is a short -acting beta2- adrenoceptor agonists ( SABA ). People with moderate or severe asthma require long-term treatment that consists of long -acting beta- adrenoceptor agonists ( LABA ) such as salmeterol, oral or inhaled corticosteroids ( beclomethasone ), leukotriene antagonists, mast cell stabilizers ( such as cromolyn ), etc.

It is not known why some people are affected by mild asthma while others suffer by moderate asthma or severe asthma. Therefore, researchers at the European Lung Foundation conducted a project (EU- Funded U- BIOPRED ) to investigate why severe asthma differs from one person to another. They also want to classify this disease into several subgroups and develop a personalized treatment for patients with asthma.

The results of the study conducted showed that there are some common characteristics among children and adults with severe asthma. Thus the investigators found that 55 % of adults with severe asthma take oral corticosteroids but still have greater airway obstruction than those with moderate asthma / easy. Also, it was found that patients with severe asthma have exacerbations and severe symptoms despite high doses of corticosteroids. David Gibeon , lead author of this study from Imperial College, London , said that they want to understand why people with severe asthma are less responsive to the effects of corticosteroids.

According to Gibeon, asthmatics may become less responsive to treatment with steroids through different molecular pathways. If scientists understand the molecular pathways they will be able to develop in the future more effective, personalized therapies for patients with asthma. “In order for us to help improve the lives of these people, we need to make a full biological and clinical “fingerprint” of each patient, by embarking on a huge analysis of data including a wide-range of samples from CT scans, to sputum samples, analysis of a person’s genetics and results from bronchoscopies”, explained Peter Sterk, project lead for U-BIOPRED.