The NHLBI supports a broad asthma research program that spans basic research, genomics, proteomics, epidemiology, clinical trials and demonstration projects. This support has advanced our understanding of the mechanisms of asthma and improved patient care. For example, the NHLBI-funded Asthma Clinical Research Network recently demonstrated that tiotropium bromide, an anticholinergic drug that helps reduce airway contraction, was an effective add-on therapy to inhaled corticosteroids for adults with poorly controlled asthma.
Several current NHLBI research programs are addressing the problem of recurrent asthma flare-ups in people with otherwise good day-to-day asthma control. These programs include studying new treatment approaches for flare-ups in infants and school-age children, as well as genome-wide association studies investigating the genetic factors that make some patients prone to worsening of asthma symptoms. The NHLBI will soon launch a network of six clinical centers that will integrate molecular, cellular and clinical studies of severe asthma to better predict when serious complications of asthma will occur and identify new targets for therapy.
Because asthma was the most common underlying health condition among those hospitalized in the United States with 2009 H1N1 influenza infection during the 2009-2010 influenza season, NHLBI and NIAID conducted a collaborative study to establish safe and effective strategies to vaccinate children and adults with mild to severe asthma against the 2009 pandemic H1N1 influenza virus. The results of this study showed that the 2009 pandemic H1N1 influenza virus vaccine is safe and can produce appropriate antibody levels in people with asthma.
The NHLBI is exploring ways to prevent asthma from developing, including an ongoing study examining whether vitamin D supplements given to pregnant women could prevent their children from developing asthma.
The NHLBI also supports the National Asthma Education and Prevention Program (NAEPP), a partnership among professional, voluntary health and lay organizations as well as federal agencies to improve clinical guidelines-based care. The NAEPP’s National Asthma Control Initiative aims to strengthen collaboration among health care providers, patients and families, and other stakeholders committed to improving asthma management.
NIAID’s program in asthma research focuses on understanding how allergens, pollutants, infections and genetics interact with the immune system to cause and aggravate asthma. It also centers on developing strategies to treat and prevent the disease. NIAID funds three multi-site asthma clinical research programs and many individual grants in support of these efforts.
NIAID-funded researchers have greatly increased our understanding of asthma by studying inner-city children, who are at a disproportionately high risk for the disease. Initial studies identified a strong association between environmental allergic sensitization and asthma and showed that removing household allergens reduced asthma symptoms and health care visits. Environmental pollution also can aggravate asthma and increase susceptibility to allergic diseases, and NIAID-supported researchers are investigating the mechanisms behind this association. Similarly, major efforts are under way to understand how viral infections can worsen asthma, and how obesity may affect the disease.