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In 2016, asthma affected 340 million people worldwide

National Institutes of Health NIH

NIH
statement on World Asthma Day
2019

On World Asthma Day 2019, the National Institutes of Health stands with patients, families, advocates, researchers and health care professionals around the globe to raise awareness about this common chronic respiratory disease.

Asthma can profoundly affect quality of
life and financial and emotional health

In 2016, asthma affected 26 million Americans and nearly 340 million people worldwide, according to the Global Burden of
Disease study. The disease can profoundly affect quality of life and financial
and emotional health and is a major cause of missed time from school and work.
Severe asthma attacks may require emergency room visits and hospitalizations,
and can be fatal.

Asthma
flares result when the airways of the lungs become inflamed by a variety of
triggers in the air, such as indoor pollutants and allergens from dust mites
and mold, as well as outdoor air pollution. This inflammation narrows and
obstructs the airways, causing symptoms like wheezing, coughing, chest tightness
and difficulty breathing.

NIH-funded
research has greatly increased knowledge of asthma and led to better treatment
and prevention options. Implementing what we know in clinical and community
settings, however, still needs urgent attention. Putting into practice proven
strategies for asthma prevention, control and care not only will help reduce
the burden of the disease, it also will help address health disparities that
have resulted in asthma’s disproportionate impact on racial and ethnic minorities
and families living at or below the poverty line.

Three NIH
institutes support and conduct studies on asthma — the National Heart, Lung,
and Blood Institute (NHLBI); the National Institute of Allergy and Infectious
Diseases (NIAID); and the National Institute of Environmental Health Sciences
(NIEHS). This research portfolio reflects the complexity of medical,
environmental, social and economic factors that influence the causes,
management, treatment and prevention of this condition.

The NHLBI’s
Division of Lung Diseases, which is celebrating its 50th anniversary this year, leads the efforts to understand the
biology of asthma development, progression and severity and to optimize
treatment for patients. Despite significant research strides, many people continue
to have poorly controlled asthma, which underscores the importance of improving
the adoption of current evidence-based interventions and developing new ones.

As it has
improved therapies and prevention for patients, NHLBI’s research has
contributed to a better understanding of asthma as a complex disease with a
broad range of genetic and biological variability. This heterogeneity affects
individual patients’ responses to triggers and treatment, posing a challenge to
managing the condition and calling for more personalized methods.

Funded by
the NHLBI, the Precision Interventions for Severe and/or Exacerbation Prone
Asthma Network (link is external) will be conducting clinical trials to
identify personalized medicine approaches that treat severe asthma more
effectively. It has established 10 centers
to test a series of treatments approved by the U.S. Food and Drug
Administration based on each patient’s specific biology or biomarkers.
Recruitment will begin this year.

NHLBI also
funds the Asthma Empowerment Collaborations to Reduce Childhood Asthma
Disparities. This program supports clinical trials to evaluate Asthma Care
Implementation Programs that provide comprehensive care for children at high
risk of poor asthma outcomes, such as low-income minority children. The program
aims to provide integrated care for children in all spheres of their lives and
to create programs that will be sustainable after the grant support ends.

Additionally,
NHLBI’s Center for Translation Research and Implementation Science (CTRIS)
serves as a focal point within the Institute to plan, foster and support
research to identify the best strategies for ensuring successful adoption of
evidence-based interventions.

NIAID’s Inner-City Asthma Consortium (ICAC) studies the causes of asthma in urban children as part of its effort to better understand the immune responses that lead to asthma. This work enables development of improved prevention strategies and treatments. ICAC oversees nine clinical research sites in the United States, and its observational studies, clinical trials and related research explore the convergent risks of allergen exposure, allergen sensitization and viral respiratory infections.

Programs
that aim to decrease exposure to household allergens, such as dust mites,
cockroaches and rodents, decrease asthma symptoms and health care visits in
children with allergic asthma. Paradoxically, early-life exposure to certain
allergens and bacteria may protect against asthma. The Urban Environment and
Childhood Asthma study showed that children exposed to high indoor levels of
pet and pest allergens during infancy have a lower risk of developing asthma by
7 years of age.

ICAC research
established that omalizumab can prevent most asthma exacerbations in the
autumn, many of which are caused by the common cold. More recently, ICAC
investigators have unveiled pathways in the development of asthma exacerbations
associated with the common cold, opening the possibility of identifying further
therapeutic agents to prevent exacerbations.

In addition, a comprehensive study by the consortium found that inflammation of the mucous membrane of the nose, known as rhinitis, is rampant in urban children with asthma. It is also very difficult to control and strongly linked to asthma symptoms and attacks.

At NIEHS,
scientists study asthma by looking at the interplay between the environment and
the immune system. The Natural History of Asthma with Longitudinal
Environmental Sampling (NHALES) study at the NIEHS Clinical Research Unit is
examining how the environment affects asthma symptoms.

During the
past 40 years, NIEHS has supported some of
the most important air pollution and asthma research studies. NIEHS research
has shown that air pollution makes people with asthma sicker and worsens their
breathing. In addition, some forms of air pollution, especially diesel and
traffic related pollution, may also cause children to develop asthma.

NIEHS-funded
research from the Cincinnati Childhood Allergy and Air Pollution Study (link is
external) has shown the important role of ambient air pollution, including
roadside pollution, as a cause of asthma and of its exacerbation in the United
States.

The NIEHS’s
Environmental Cardiopulmonary Disease Group focuses its research on the role of
the environment in the origin of asthma and allergic diseases. In addition to
large national studies, the group has led environmental interventions to reduce
indoor allergen levels in homes, which has improved scientists’ understanding
of indoor allergen and endotoxin exposures and their role in allergic
disorders.

The
NIEHS/EPA Children’s Environmental Health and Disease Prevention Research
Centers study factors that impact children’s health, with several centers
focusing on asthma. For example, the Children’s Center at Johns Hopkins
University found that vitamin D protects against pollution-induced asthma
.

NIH-supported
scientists continue to work to prevent and treat asthma every day of the year.
But this May, Asthma Awareness Month, and today especially, NIH honors the
children and adults who face the daily challenges of asthma, and we renew our
commitment to ensure that our research discoveries turn into improved health
outcomes for all of them.

Part of the National
Institutes of Health
, the National Heart, Lung, and Blood Institute (NHLBI)
plans, conducts, and supports research related to the causes, prevention,
diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and
sleep disorders. The Institute also administers national health education
campaigns on women and heart disease, healthy weight for children, and other
topics.

NIAID
conducts and supports research — at NIH, throughout the United States, and
worldwide — to study the causes of infectious and immune-mediated diseases, and
to develop better means of preventing, diagnosing and treating these illnesses.

NIEHS supports research to understand the effects of the environment on human health.

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