Better ways to diagnose asthma
Dr Ramesh Kurukulaaratchy from the University of Southampton tells us about the research project he’s leading into better ways to diagnose asthma.
These days we have a much better understanding of the genetics involved in asthma. In our study, we’re looking at substances called microRNAs, which is a very new area of research. We’re finding microRNA ‘signatures’ which indicate that people might be more likely to develop particular diseases and even particular features of those diseases. So, we’re applying that model to asthma and looking at the microRNAs from blood samples.
Why it’s difficult to diagnose asthma
Asthma isn't one condition. It’s a collection of many different subspecies of the condition, what we now call phenotypes, to give it the technical name. This is an area I’ve been researching for over 2 decades now starting with my work as a junior researcher, which was initially funded by the forerunner of Asthma UK – the National Asthma Campaign – where we were looking at the diversity of wheezing and asthma in childhood, to begin with. And it became very apparent from that work that there are lots of different subtypes of this disease.
Being able to accurately diagnose is a real challenge because we don’t have any simple single soundbite diagnostic test that we can just apply for asthma. That really becomes difficult, because then your diagnosis is down to a clinical artform. And that then is in the hands of the person assessing and they need the appropriate experience, expertise and guidance to achieve a solid diagnosis.
Better ways to diagnose asthma
Our project is looking at trying to come up with some diagnostic markers for asthma and also for the risk of having more severe asthma. What we are looking at are particular biomarkers, which are biological substances that can be measured in individual patients, readily and easily. And where those measurements might then give us information to help make a clear diagnosis and also perhaps to give us an idea of whether they have a risk of more severe disease.
The focus of our research is to really look at one of the core principles around asthma which is that we know that asthma is a condition that in part is driven by the genes that we inherit. And we know that asthma is one of those conditions that tends to run in families, but also it's influenced by the environment we live in and the interaction of that environment with our genetic inheritance.
MicroRNA signatures
We are studying some of the genetic factors that might predispose people to having asthma, and perhaps more severe asthma.
Epigenetics is studying that interaction of genes and the environment and we now have a much better understanding of the genes and the epigenetics. That understanding also is evolving to look at other areas of genetics and in this study what we’re looking at particular substances called microRNAs which is a very new concept and novel area to start looking at.
These microRNAs are short sequences of genetic material or RNA that have regulatory influences on genes and their expression. We’re finding microRNA ‘signatures’ which indicate that people might be more likely to develop particular diseases and even particular features of those diseases. So, we’re applying that model to asthma and looking at the microRNAs from blood samples. What we are doing in this project is taking that concept to the next level and ultimately using that understanding of asthma to really try and come to some diagnostic tests.
5.4million people in the UK have asthma and every 10 seconds someone in the UK has a potentially fatal asthma attack. Yet research into asthma is severely underfunded. That’s why we’ve launched our 2021 research appeal.
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