MD Conference Express ATS 2011 - (Page 6)

n F E A T U R E Asthma Phenotypes: Understanding Distinct Subgroups of Asthma Patients Written by Anne Jacobson Asthma is a heterogeneous disease with respect to clinical features, cellular components of airway inflammation, and response to prescribed treatment. To better understand patients who remain symptomatic despite standard treatment with anti-inflammatory drugs and bronchodilators, investigators are exploring the molecular, genetic, and environmental determinants of asthma phenotypes in adults and children with asthma. The goal is to be able to classify patients by asthma phenotype and provide patients with treatment that is most likely to fit their individual needs. Asthma Phenotypes in Children Children who are referred to specialist care for difficult-to-control asthma despite standard firstline therapy are a heterogeneous group. Some children may have an incorrect diagnosis and therefore require a detailed assessment to exclude alternative conditions. Other children may have comorbid conditions that exacerbate asthma symptoms and interrupt asthma drug delivery. Children with true therapy-resistant asthma remain symptomatic even when their basic treatment needs are met. Anne M. Fitzpatrick, PhD, Emory University School of Medicine, Atlanta, Georgia, USA, described new efforts to understand variations in asthma severity and inflammatory responses in children. The National Institutes of Health/National Heart, Lung, Blood Institute (NIH/NHLBI) Severe Asthma Research Program (SARP) is a new initiative that is designed to identify the clinical attributes that define distinct subgroups of childhood asthma severity. Toward this goal, SARP will undertake a detailed clinical characterization (phenotyping) and genetic analysis (genotyping) of children with asthma to understand the range of mechanisms that define the disorder. Preliminary findings from SARP studies are already shedding light on the natural history of asthma in children. In one recent study of 161 children, SARP investigators identified four distinct subgroups of patients, defined by asthma severity, asthma duration, lung function, and other factors. In Group 1 (n=48), children had nearly normal lung function and minimal atopy. In Group 2 (n=52), children had slightly reduced lung function, more atopy, increased symptoms, and increased medication use. Children in Group 3 (n=32) were more likely to have comorbidities, increased bronchial responsiveness, and worse lung function. Finally, children in Group 4 (n=29) had the lowest lung function, most frequent symptoms, and greatest medication use. Each group included children with severe asthma, and no group corresponded fully to the definitions of asthma severity that are provided in current clinical guidelines [Fitzpatrick AM et al. J Allergy Clin Immunol 2011]. Other SARP studies are focused on the molecular phenotypes of severe asthma in children, with an emphasis on identifying novel biomarkers of inflammation and treatment response. For decades, childhood asthma was regarded as a homogenous disorder with a common inflammatory mechanism, a direct association between inflammation and symptoms, and a uniform response to corticosteroid therapy. Findings from SARP studies may refine these assumptions and lead to new definitions of asthma subgroups that benefit from different management strategies. Highlights from the American Thoracic Society 2011 International Conference 6 August 2011 www.mdconferencexpress.com  http://www.mdconferencexpress.com/ http://www.thoracic.org/ http://www.mdconferencexpress.com

Table of Contents for the Digital Edition of MD Conference Express ATS 2011

MD Conference Express ATS 2011
Contents
Obesity: Implications for the Clinical Practice of the Pulmonary, Critical Care and Sleep Physician
Asthma Phenotypes: Understanding Distinct Subgroups of Asthma Patients
Evaluation of a Rifapentine-Containing Regimen for Intensive Phase Treatment of Pulmonary Tuberculosis: TBTC Study 29
Asthma Exacerbations During Pregnancy Are Reduced By Inflammatory Guided Asthma Management
TESRA Study Results
Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus Trial
Intensive Care Physician Versus Qualified Nurse Based Critical Care Transport
Chronic Azithromycin Decreases the Frequency of COPD Exacerbations
Drug Development
Sleep Medicine
Critical Care
Advances in NSCLC
Mechanisms and Advances in COPD Therapy

MD Conference Express ATS 2011

https://www.nxtbook.com/nxtbooks/md_conference_express/ats2011
https://www.nxtbookmedia.com