Asthma
Asthma is an inflammatory condition which affects the bronchial
tubes in the lungs. People with asthma have sensitive or hyperactive
airways which narrow in response to certain stimuli. The narrowing is
due to inflammation and swelling of the lining, tightening of the
airway muscles (spasm) and production of excess mucus. This reduces the
airflow in and out of the lungs.
Asthma is a widespread and chronic health problem in Australia with
over 2 million Australians suffering from it. Asthma affects up to 14%
of children and up to 12% of adults and is estimated to cost the
community $700m per year in direct costs. The prevalence of asthma in
Australia has risen significantly through the 1980s and 1990s and
remains high by international standards. As management has improved,
fewer people die from asthma (around 300 a year currently) but it is
still a common reason for hospital admission and emergency department
visits in children.
Nearly 25% of people with asthma are smokers and 40% of children with asthma live with people who smoke.
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The symptoms of asthma may vary from person to person, and from time
to time. Some people may have all these symptoms while other people may
only have a wheeze or cough.
- Tightness in the chest
- Shortness of breath
- Wheezing – a high pitched raspy sound on breathing
- A dry, irritating, persistent cough, particularly at night, early
morning, with exercise or activity
The causes of asthma are still not clearly understood, but genetic
and environmental factors come into play. There is often a family
history of asthma, eczema and/or hay fever or other allergies. Children
with one asthmatic parent are three to six times more likely to develop
asthma. In 2004, two asthma genes were discovered on chromosome 7p, as
well as a protein-coupled receptor for asthma susceptibility.
However, inheriting genes for asthma does not necessarily mean you
will get it. It is the combination of genetic susceptibility and
environmental factors that is thought to trigger asthma:
- Inhaled allergens such as pollen or dust mites and irritants such
as perfumes or cleaning fluids
- Exposure to cigarette smoke (either in utero or in childhood)
- Infection with a cold or flu
- Changes in temperature or weather
Nearly 25% of people with asthma are smokers, and approximately 40%
of asthmatic children live with someone who smokes. Vigorous exercise
can also trigger the symptoms of asthma (known as exercise-induced
asthma).
Asthma management, treatment and education have all improved
enormously over past years, however unfortunately there is still no
cure. Avoidance of exposure to triggers and development of an asthma
action plan, in consultation with a GP or specialist, are critical. The
plan sets out day-to-day procedures to maintain health, typically
through the regular use of inhaled or oral preventive medication to
lessen the sensitivity of the airways and dry up mucus. The plan will
also include measures to take when a cold or infection strikes or at
the first signs of asthma, which usually involves the use of inhaled
medication for quick relief of symptoms. Combined preventative and
relief (symptom controlling) medication also exist in the same delivery
device. The aim is to achieve optimal control of asthma for each person
and the best quality of life possible.
The Garvan Institute is a partner in the Cooperative Research Centre
for Asthma and Airways (CRCAA), established in 2005. The CRCAA’s
research program is focused on understanding the key pathways in asthma
and identifying unique sets of genes, inflammatory molecules and
proteins that can be used to intervene in the process of asthma. For
example, a chemical called aP2, initially thought to be only present in
fat cells, has been discovered to also be present in very high amounts
in allergic lungs. It plays an important role in controlling asthma,
and thus is a potential asthma drug development target.
Garvan is also looking into developing new therapeutic approaches
for asthma, such as monoclonal antibodies as a treatment to reduce
inflammation in the airways of asthma patients.
Research into diagnostics is also important: more effective tools to
identify which patients will respond best to which treatments. Research
at Garvan, together with the CRCAA, will lead to more effective use of
existing treatments and the development of novel and improved
therapies.
Related Research Groups
Asthma
