Asthma Research

For more than 20 years, the NHLBI Severe Asthma Research Program has transformed our knowledge of severe asthma.  Research  supported through the program has identified sex, race, secondhand smoke, pneumonia, and obesity as key risk factors for asthma. Studies have also found  genetic  variations linked to severe asthma and biomarkers for asthma severity. New therapeutic targets identified through this program are currently in  clinical trials . In addition, NHLBI-funded research has led to treatment recommendations for patients with asthma who are infected by SARS-CoV-2 – the  virus  that causes COVID-19 – and have lung damage. Researchers found serious interactions between asthma treatments and interventions for COVID-19.

The Obstructive Lung Diseases Branch at the Division of Lung Diseases oversees much of the asthma research that the NHLBI supports. The branch's Asthma Program focuses on the contributions and mechanisms of external triggers, as well as the genetic and risk factors, that can lead to abnormal lung  inflammation  and cause shortness of breath in patients with asthma. In addition, the Asthma Program studies the development of novel therapeutic approaches for clinical management of asthma in adults and children.

Current research on asthma treatment

Many people have asthma that is difficult to control, even after adding new medicines or increasing dosage.

Studies are looking at new approaches to improve asthma treatment options, including:

• Repurposing an approved drug to treat severe asthma: An NHLBI-funded project supports reformulation of the drug niclosamide through particle engineering to increase its stability and enable inhaled dosing. Niclosamide is an oral drug approved by the U.S. Food and Drug Administration and has been safely used as an anti-helminth for decades. During a drug screening effort, however, niclosamide was discovered to be an effective inhibitor of an ion channel that plays a key role in asthma development. The NHLBI-funded research may lead to new therapeutic approaches for asthma management.
• Understanding why medicines work: An NHLBI-funded study is assessing how an antibiotic called azithromycin (AZ) reduces severe wheezing in preschool children who are being seen in the emergency room. While prior studies have shown that AZ benefits these children, it is unclear if the beneficial effects are due to the antibacterial activity of AZ or to its anti-inflammatory activity. To help answer this question, this study will compare whether children who have bacteria growing in their throats at the time of their emergency room visit for severe wheezing can benefit from AZ treatment.
• Using personalized medicine: The Precision Interventions for Severe and/or Exacerbation Prone Asthma Network (PrecISE) is conducting clinical trials to identify personalized medicine approaches that treat severe asthma more effectively. It has established 30 locations nationwide where researchers are testing five new or approved treatments based on a patient's specific biology and biomarkers.

Find more NHLBI-funded studies on asthma treatment on the NIH RePORTER.

RESEARCH FEATURE

Learn about one PrecISE study that is looking at treatments that may help support people with severe asthma or asthma that hasn’t responded to traditional treatments: Personalizing treatment for severe asthma.

Current research on asthma biology

Many studies are investigating possible reasons people develop asthma, such as whether different bacteria in a person's body can affect the  immune system  and play a role in developing certain types of the disease.

Other factors also are being studied, including:

• Bacteria in the airways: An AsthmaNet study found that the airways of people with asthma contain different bacteria compared to those without asthma. Some of the observed differences could help predict the response to inhaled steroids. Researchers can request the data through our Biologic Specimen and Data Repository Information Coordinating Center.
• Early life risk factors: NHLBI-funded research is looking at how factors such as nutrition or viral infections in childhood can influence the development of asthma. Scientists will investigate possible mechanisms for wheezing and/or asthma and how they may influence early differences in airway anatomy, gene expression, and other factors. Insight into these mechanisms could lead to breakthroughs in treatment and help prevent asthma and other chronic lung conditions.
• Impact of ventilators on development of asthma in premature babies: The NHLBI-funded Post-Vent study will use data collected from the Prematurity-Related Ventilatory Control (PRE-VENT): Role in Respiratory Outcomes NHLBI Collaborative Program to study long-term health outcomes of babies born pre-term who experience intermittent low  oxygen  levels shortly after birth and must be ventilated. These babies often develop asthma. This study will try to develop strategies to identify which premature babies are most likely to develop asthma.

Find more NHLBI-funded studies on asthma biology on the NIH RePORTER.

THE NHLBI IN THE PRESS

Adults with asthma may have a higher risk of heart disease and stroke: Study links asthma to cardiovascular disease risks.

Current research on asthma disparities

Puerto Rican and Black or African American people are more likely to develop asthma than White people. Asthma development, treatment, and management are significantly influenced by socioeconomic factors, and research on this topic is part of our broader commitment to addressing health disparities and inequities.

Some of the issues currently being examined include:

• Genetic factors: The Consortium on Asthma among African-Ancestry Populations in the Americas (CAAPA) aims to discover genes that confer asthma risk among individuals of African ancestry and to study genetic diversity in populations of African descent. Read some of the results here or request access to the data on dbGaP.
• Airway illness in minority children: Severe viral infections during early life are associated with the development of asthma, which is more common among Puerto Rican people than other racial or ethnic groups. NHLBI-funded researchers will study how respiratory illness affects the airways in Puerto Rican children from birth to age 3 and identify the viral, genetic, environmental, and social factors that determine a child's risk for developing wheezing and/or asthma. Findings from this research could help change public health policies and facilitate access to comprehensive care for low-income minority children and other people who are at high risk for poor asthma outcomes.
• Race, sex, and socioeconomic factors: The NHLBI recently launched the DECIPHeR program to study differences in heart and lung diseases among groups defined by race and ethnicity, sex and/or gender, and socioeconomic status. The first projects began in September 2020, with one focused on asthma in children living in Colorado. In communities across both rural and urban areas of Colorado, researchers are working with school-based asthma navigators and nurses to test a team approach to asthma control for school children in low-income areas.

Find more NHLBI-funded studies on asthma and health disparities.

THE NHLBI IN THE PRESS

Among Hispanic and Latino adults, those who have asthma are more likely to have chronic obstructive pulmonary disease (COPD): Study identifies asthma, smoking, and chronic sinusitis as COPD risk factors for Hispanic and Latino people in the United States.

The Laboratory of Asthma and Lung Inflammation, located within the Critical Care Medicine and Pulmonary Branch, is focused on developing new treatment approaches for people with severe asthma. Researchers in the lab, which is headed by Stewart J. Levine, M.D., found a new biological pathway that leads to asthma. They continue to study this pathway, as well as an important molecule in it called apolipoprotein E.

• Since 1989, the National Asthma Education and Prevention Program (NAEPP) has worked with medical associations, voluntary health organizations, and community programs to educate patients, healthcare professionals, and the public about asthma.
• The NAEPP’s Expert Panel Report 4 Working Group was established in 2018 to update the 2007 Guidelines for the Diagnosis and Management of Asthma in focused topic areas. The working group members reviewed the latest research, then updated the guidelines on treatments and management of asthma, including the role of immunotherapy, the effectiveness of indoor  allergen  reduction, and the use of fractional exhaled nitric oxide.
  • Read Asthma Management Guidelines: Focused Updates 2020.
• Learn More Breathe Better® is a national health education program for asthma, COPD, and other lung and respiratory diseases. The program raises awareness about asthma and other lung conditions and supports the promotion, implementation, and adoption of evidence-based care. Learn More Breathe Better offers a series of asthma handouts for patients and caregivers, including tips for talking to a healthcare provider.
• The Lung Tissue Research Consortium (LTRC) collected human lung tissues for research use by qualified investigators. The program enrolled patients who were planning to have lung surgery, collected blood and other clinical data from these donors, and stored donated tissue that otherwise would be discarded after the lung surgery. These tissue samples and data are now available to investigators through NHLBI’s BioLINCC Program.
• The Global Initiative for Asthma (GINA) was established in 1993 by the NHLBI and the World Health Organization to increase asthma awareness and translate scientific evidence into improved asthma care worldwide. GINA publishes annual updates to its report on the Global Strategy for Asthma Management and Prevention and summarizes recommendations for clinical practice and supporting evidence.