A 5-year-old boy performs a Covid-19 self-test by inserting a swab stick into his nose.
Summary:
A recent study introduces a test that can distinguish between different types of asthma using a nasal swab. Researchers aim to utilize this test to match patients with more effective treatments. The study concentrated on Black and Puerto Rican children, who face higher rates of asthma and asthma-related fatalities compared to white children. Diagnosing and treating asthma in children can be complex due to its various forms. The disease, affecting over 4.6 million U.S. children, is commonly categorized into “T2-high” asthma caused by T helper 2 immune cells, and “T2-low” asthma, a general term for other forms. Current testing methods are limited, often only detecting T2-high asthma. To address this, researchers at the University of Pittsburgh developed a precise diagnostic approach by analyzing RNA in nasal swabs. By examining specific gene expressions related to inflammation, the study successfully identified different asthma subtypes. Published in JAMA, the study involved over 450 children and teens from Puerto Rico and Pittsburgh, revealing accurate diagnoses of asthma subtypes and the prevalence of “T2-low” asthma among participants. This research contributes to advancing personalized asthma treatments, moving beyond standard steroid inhalers to newer FDA-approved drugs for moderate to severe cases.
Research led by Dr. Juan Celedón has shed light on the potential of nasal swab testing in distinguishing between different types of asthma, particularly T2-high and T2-low asthma. Celedón highlighted the significance of this breakthrough, emphasizing the possibility of tailoring treatments to individuals based on their specific asthma type. This targeted approach could revolutionize asthma care, moving away from the one-size-fits-all model towards personalized medicine.
Speaking on the inclusivity of the study, Dr. Gurjit Hershey commended the research for including children from diverse racial backgrounds, a demographic often underrepresented in asthma studies. Hershey, the director of the asthma research division at Cincinnati Children’s Hospital, lauded the focus on Puerto Rican and Black children as a crucial step towards addressing existing disparities in medical research.
Despite the promising implications of the nasal swab test, both Celedón and Hershey highlighted that further steps are necessary before its widespread adoption. Celedón stressed the importance of FDA approval, underlining the need for regulatory validation prior to clinical implementation. Hershey echoed this sentiment, emphasizing the need for additional research to ascertain the consistency of asthma types in children over time, particularly in relation to environmental factors like pollution and allergens.
Dr. Jessica Hui, a pediatric allergist at National Jewish Health, added a note of caution regarding the practicality of genetic sequencing in this context. Hui underscored the complexity and cost associated with analyzing RNA data, emphasizing the specialized expertise required for accurate interpretation. While acknowledging the exciting potential of this advancement, she emphasized the need for a cautious and thorough approach to evaluate its real-world applicability.
In conclusion, the study led by Dr. Celedón represents a significant stride towards personalized asthma management, offering new insights into the differentiation of asthma types through nasal swab testing. The involvement of children from diverse backgrounds underscores the importance of inclusive research practices, while also highlighting the need for further validation and exploration before clinical integration. As the medical community navigates the evolving landscape of asthma treatment, the potential of tailored interventions based on individual asthma profiles holds promise for improving patient outcomes and advancing the field of respiratory medicine.
