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Study breathes new life into figuring out the cause of some childhood asthma



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A new study shows that a common type of childhood asthma has nothing to do with allergens and isn’t even a result of inflammation. Although little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center and SUNY Downstate Medical Center is one step closer to finding out. They have discovered the roots of a common type of childhood asthma, showing that it is very different from other asthma cases.

Their report, published in Science Translational Medicine, reveals that 20 to 30 percent of patients with childhood asthma have an over-active gene that interrupts the synthesis of lipid molecules (known as sphingolipids) that are part of cell membranes found all over the body.

Although the researchers do not yet understand why asthma results from reduced production of sphingolipids, their experiments clearly show a link between loss of these lipids and bronchial hyperactivity, a key feature of asthma, according to the study. The study reveals that this form of asthma is not related to allergens and has nothing to do with inflammation.

“Usually asthma is thought to be an inflammatory disease or a reaction to an allergen. Our model shows that asthma can result from having too little of a type of sphingolipids. This is a completely new pathway for asthma pathogenesis,” says the study’s senior author, Dr. Stefan Worgall, chief of the Pediatric Pulmonology, Allery and Immunology Division at New York-Presbyterian Hospital/Weill Cornell Medical Center.

This is very good news because it will lead to new therapies based on a patient’s genotype, Worgall says. Asthma is a significant Health problem affecting about 7 million children in the United States. Nearly 10 percent of American children 17 and younger have asthma, making it the most common serious respiratory childhood disease. Besides causing suffering, disability and alarm, the economic toll is significant, Worgall says. In 2009, asthma caused 640,000 emergency room visits and 157,000 hospitalizations, plus 10.5 million missed school days.

Yet while it has become increasingly evident that asthma takes several forms, treatment of the disorder is uniform,” he says. “Most therapies are designed to reduce inflammation, but they do not help all sufferers.”

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