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Pediatric Asthma

Author: Dr. Ran Goldman, Chief Medical Officer, MedSchoolForParents.com
Asthma is the most common chronic inflammatory disease in children and is affecting over 6 million patients under the age of 18 in the US today. Patients and their families know the feeling of an imminent asthma attack – shortness of breath, craving for air, wheezing and rapid chest rise. Long-term control with medications is the goal of most therapy but is difficult to achieve in some children. ‘Severe Persistent Asthma’ is a term used for those who have symptoms throughout the day, wake up multiple times a week during the night despite using puffers (such as short-acting beta-agonists) several times a day. Their normal activity is severely limited. 
Parents and pediatricians know that asthma ’runs in the family’, and that there is a genetic predisposition to have asthma. In a recent study published in The Journal of Clinical Investigation Insight by a group from Southampton in the UK, scientists may have discovered a specific asthma gene called ADAM33 (short for a disintegrin and metalloprotease 33) that promotes local tissue susceptibility to allergic asthma.
Beyond a process of inflammation – the gene was found in high concentration in airways of animals with asthma and played a role in airway remodeling. When the gene was absent, remodeling and inflammation were suppressed after animals were challenged with allergic exposure.
This finding may explain a conundrum never understood by the scientific community. How come allergies are associated with asthma attacks in some people, yet millions of people with allergic reactions to environmental triggers like pollen do not get asthma? Well, it is possible that a combination of allergen exposure together with the newly discovered gene is the trigger for asthma, not the allergen itself.
It is possible then, that in the future taking a pill to block ADAM33 gene (or at least weaken its effect) could prevent asthma. The road is still long, but new discoveries like this one form the UK may pave the way to better breathing.
CDC. Current Asthma Prevalence Percents. 2014. 
Updated: 03/08/2017

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