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Asthma
Latest findings on asthma
Last updated: Tuesday, May 02, 2006
More and more people are diagnosed with asthma every year. But, fortunately, the disease is much better understood than a decade ago. On World Asthma Day (2 May), we take a look at the latest research findings.

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Understanding the causes
Like with all things in life, prevention is better than cure. And scientists are finding that lowering one's risk of asthma might be as simple as early intervention with probiotic supplements. Probiotics are the "good" bacteria that live in the intestine.

This theory is tied to what experts call the "hygiene hypothesis", which states that babies who are born in sanitised hospitals and come home to sparkling clean homes may be more prone to develop allergies and asthma.

Preliminary research shows that vaginal flora (the bacteria present in the vaginal tract) during pregnancy can play a role in whether a child develops asthma by the age of five.

The research seems to indicate that this risk is specifically linked to a lack of the probiotic Lactobacilli and an overabundance of Staphylococci in the vaginal flora – a situation that can easily be remedied by taking a good probiotic supplement during the last four weeks of pregnancy.

Research also shows that children who are exposed to even one course of antibiotics during their first year of life may be at increased risk for developing asthma. It is a well-known fact that antibiotics can have an inhibiting effect on the good, probiotic bacteria in the intestine. So, there might be a link here too.

Another recent finding in terms of the causes of asthma is that immune system cells, long thought to cause asthma, may not be the primary culprits behind the disease. Researchers found that asthma is caused not by T-helper 2 cells as was previously thought, but by a novel class of cells called natural killer T cells.

At present, none of the available asthma therapies are focused on targeting the natural killer T cells. A logical next step would be for researchers to develop therapies that can eliminate these cells from the lungs.

Towards better treatment
While more is understood about the causal factors, approximately 10% of the world population still suffer from asthma – and these people need to gain better control of the condition in order to live life to its full capacity.

Asthmatics can do this by educating themselves about currently available and future treatment methods. Take a look at some of the latest findings:

1.) In a recent British study, it was found that a well-known rheumatoid arthritis drug, which reduces high levels of an inflammatory protein, could be a means of fighting severe asthma.

Researchers found that people with severe asthma have higher-than-normal concentrations of an inflammation-linked cytokine, called "tumour necrosis factor alpha" (TNFa). Reducing the levels using a TNF-inhibiting drug, etanercept, reduced asthma symptoms in people with refractory (hard to manage) disease.

2.) Interestingly, when it comes to asthma, antibiotics seem to be a double-edged sword. While they could possibly increase a person's risk, research is also showing that antibiotics may be of help to people who struggle with acute asthma flare-ups.

British researchers found that giving the antibiotic telithromycin significantly reduced asthma symptoms in people having a flare-up, which is also sometimes called an exacerbation. But the therapy isn't ready to become a standard feature of care yet, according to a report on HealthDayNews.

3.) A treatment that combines two drugs could restore normal breathing in people with asthma and chronic bronchitis, says a study by US researchers.

Their research in mice suggests that the combination of the two drugs inhibits cells in the airway that cause overproduction of mucus, which harms airway function, the Associated Press recently reported.

Currently, there are no therapies to treat excess mucus build-up in people with breathing problems. Experts are hoping that this combination would prove to be effective.

Treatment here and now
At the moment, however, the standard treatment for asthma is still preventer medication, which includes leukotriene receptor antagonists and theophylinnes, and reliever medications, which includes long-acting and short-acting beta-agonists – or a combination of both.

In terms of other medication, the verdict, at the moment, is as follows:

  • Antihistamines can be used for other allergic conditions such as hay fever, but are not considered to be standard asthma medication.
  • Antibiotics are rarely necessary as viral infections are by far the most common triggers of asthma attacks. The decision on whether to use them or not will rest with the physician.
  • Cough mixtures offer no benefit in asthma management, as the cough is most often a sign of poor asthma control. Specific asthma medicines are required to treat this condition.

According to Dr Corli Gravett, who runs an asthma and allergy clinic, asthma patients should always use their preventer medication, and aim to use their reliever medication as little as possible.

"If the patient frequently needs his reliever medication, he isn't controlling his asthma properly," Gravett says. – (Carine van Rooyen, Health24)

Read more in our Asthma Disease Centre.
 
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