What is Asthma?
Asthma is a chronic disease of the airways caused by its constriction and excess production of mucus which can result in difficulty breathing, cough, and wheezing (whistling sound). There are distinct types of asthma and its severity varies from mild to severe. According to the WHO, Asthma leads to the death of 400,000 people worldwide annually. 10% of the population of Sweden has some form of asthma and it is alarmingly on the rise.
Currently, the determination of asthma is made based on your clinical history, blood test, lung function tests, and chest X-rays. Also, determining the type of asthma is no easy thing. Knowing the type of asthma is crucial for better therapy of severe disease. Researchers at Karolinska Institutet have made a significant breakthrough in the field of asthma detection by coming up with a simple yet clear test to diagnose and classify asthma.
Method of the Study
For the study, the researchers at Karolinska Institutet included 400 people who had severe asthma, 100 people who had milder variants of asthma, and 100 people who were healthy controls. The researchers determined the proportion of prostaglandins and leukotrienes-eicosanoid signaling molecules present in urine for diagnosis and classification of the disease. These molecules are acknowledged to be inflammatory mediators of the airways as a consequence of asthma.
Results of the Study
The urine of patients with Type -2 inflammations of airways showed raised levels of metabolites – Prostaglandin D2 and leukotriene C4. The method was able to accurately detect the level of these metabolites and their direct relation to the nature and degree of the disease. The result obtained from the study also showed elevated levels of metabolites in patients with severe disease being treated with corticosteroids. Currently, severe forms of the disease are treated with corticosteroids, thus pointing at the need for alternative treatment modality in such cases.
The results were replicated in a urine test of children suffering from asthma, a study conducted by pediatricians at Karolinska Institutet. The urine of children showed a similar metabolite profile as the adults.
Accurate measurement of the metabolites helps in the determination of the severity of asthma and in choosing the suitable treatment modality. Patients with mild asthma achieved symptom alleviation with steroid inhalers but those having severe asthma require it to be supplemented with corticosteroid tablets. Long-term use of corticosteroids has been proved to cause diabetes, loss of bone density, and eye damages.
Recently developed biological medicines aim at replacing corticosteroids particularly for the treatment of patients with type-2 inflammation of the airways, but these medications are still very expensive. The metabolites present in the urine sample can thus be used effectively to guide treatment in various cases of asthma.