A new nose swab test may help doctors identify asthma subtypes in children, improving treatment options and outcomes.
Researchers at the University of Pittsburgh have developed a new, noninvasive nose swab test. This test can identify different asthma subtypes in kids, which was previously only possible through a more invasive procedure called bronchoscopy.
Their study, published in the Journal of the American Medical Association, is a game-changer. It’s the first to find specific genes linked to asthma subtypes using this nose swab method.
Juan Celedón, a pediatric professor at Pitt, highlighted that asthma is the most common chronic respiratory issue in kids worldwide. In the U.S., about 6 million children are affected, with Puerto Rican and Black children facing the toughest challenges.
In Allegheny County, a recent health report showed that Black kids aged 5 to 17 had asthma rates six times higher than their white peers. This new research could explain why some kids don’t respond well to existing treatments.
Asthma biologics are becoming popular because they target specific inflammation pathways, unlike traditional inhalers. But they don’t work for everyone. The researchers aim to personalize treatments for asthma patients, similar to how breast cancer treatments are tailored based on specific subtypes.
To conduct their study, the team swabbed the noses of 460 kids aged 9 to 20, including many from Pittsburgh. They sequenced the DNA to determine the type of asthma each child had.
This nasal swab method is a much easier alternative to bronchoscopy, which requires sedation and is not suitable for most kids with mild to moderate asthma.
Celedón noted that true severe asthma in kids is rare, affecting only about 5% of them. Most kids have mild to moderate asthma, which is more common.
From the nasal samples, researchers focused on genes related to T cells, which play a role in the immune response and inflammation. They identified two asthma subtypes linked to T cells.
T2-high asthma is often triggered by allergens and irritants, leading to a strong immune response. Treatments like antibody shots work well for this group.
On the other hand, T2-low asthma isn’t usually related to allergens and is more common in people with obesity or those over 65. This might explain why antibody treatments sometimes miss the mark for these individuals.
The study also discovered another subtype called T17-high, linked to a specific immune marker. They found that T2-high patients were often Puerto Rican, while T17-high patients were more likely to be Black.
Celedón believes that environmental and socioeconomic factors, like air pollution and obesity, contribute to these disparities.
He emphasized that understanding how genes and the environment interact can lead to better prevention and treatment strategies.
The research team is planning a long-term study to see if asthma subtypes change as kids grow up. They’re also checking in with one group to track their health over time.
They want to dig deeper into what causes different asthma subtypes, as the genes involved are also linked to cancer risk and other health issues.
Questions remain about the connections between obesity, air pollution, and asthma subtypes, and the team is eager to explore these for better prevention and treatment options.
