Asthma has long been thought of as an inflammatory disease, with treatments geared towards its reduction. Now, research has turned that idea on its head, and could mean new treatment avenues for sufferers.
Around one in nine, or 2.7 million, Australians live with chronic asthma, causing a huge reduction in quality of life for those people and placing an enormous burden on the healthcare system.
Asthma is more common in children, but can develop at any age, even if you didn’t have the condition in childhood.
What is asthma?
The condition affects the respiratory system, causing airways to become inflamed and close over, making it difficult to breathe. The inflammation also causes the lungs to produce a thick mucous, restricting the airway further. This leads to symptoms such as breathlessness, coughing and wheezing.
Occasionally, asthma symptoms can flare up and become worse than normal, in what is known as an asthma attack. These attacks can be life-threatening and usually require immediate medical attention.
Asthma attacks can be triggered by any number of factors, including pollen or dust in the air, physical activity or even cold weather.
Despite how prevalent asthma is in society, the root causes of the disease are not well understood. Current remedies focus on treating symptoms of asthma after they have already appeared, such as calming inflammation or breaking up mucous.
But these treatments do nothing to prevent asthma attacks from occurring in the first place.
That soon could change though, if the results of research from scientists at King’s College London (KCL) are anything to go by.
The KCL researchers say they have demonstrated that it’s not inflammation and mucous causing the lungs to constrict, but rather the lungs constricting that is causing the inflammation and mucous.
A bit of a mouthful, but they’re saying the cause of an asthma attack isn’t inflammation or mucous, they are merely a byproduct of the condition. But they think they know what the underlying culprit may be.
Epithelial cell death
Epithelial cells are a type of cell common all throughout your body, important for many biological functions.
Your lungs and airways are lined with these cells, and when your lungs begin to constrict during an asthma attack, these cells are forced out of the lungs to die. This process is known as cell extrusion.
Because so many cells are dying during an asthma attack, it damages the fragile airway barriers and your immune system triggers inflammation and mucous production as a result.
Professor Jody Rosenblatt, lead author of the study, says the findings suggest that blocking a process that normally causes epithelial cell death could prevent the damage, inflammation, and mucous seen in an asthma attack.
“Our discovery is the culmination of more than 10 years’ work,” she says.
“As cell biologists who watch processes, we could see that the physical constriction of an asthma attack causes widespread destruction of the airway barrier.
“Without this barrier, asthma sufferers are far more likely to get long-term inflammation, wound healing, and infections that cause more attacks. By understanding this fundamental mechanism, we are now in a better position to prevent all these events.”
How do you block cell extrusion?
In their study, the researchers used the chemical element gadolinium to block cell extrusion in mice whose airways had been artificially constricted to mimic the effects of asthma.
They found the metal was effective at preventing the excess cell extrusion usually seen when airways constrict.
Prof. Rosenblatt says treatments using gadolinium show promise as a new way to treat chronic asthma.
“We found that we can use an inexpensive compound, gadolinium, which is frequently used for MRI imaging, to stop the airway damage in mice models as well as the ensuing inflammation and mucus secretion,” she says.
“Preventing this damage could then prevent the build-up of musculature that cause future attacks.”
The study does note, however, that gadolinium has not been tested on humans at this stage and has therefore not been deemed safe for use. But studies like this show there may be a way forward for chronic asthma sufferers.
Do you or anyone you know suffer from asthma? What treatments have you tried? Let us know in the comments section below.
Also read: How burgers and chips for lunch can worsen your asthma
