Can farmyard dust prevent childhood asthma?

Professor Sejal Saglani and her team at Imperial College London are exploring whether there’s something about farmyards that can prevent kids from developing asthma. In her blog, she tells us about what preschool wheeze is, and how her project is investigating farmyards for potential treatments for childhood asthma.

Preschool wheeze

Preschool wheeze is a lung condition that affects children under the age of five. Children affected develop noisy breathing (known as ‘wheeze’) and experience difficulty in breathing and breathlessness. The reason they develop these symptoms is because the breathing tubes, the tubes that we breathe in and out of normally, become narrow.

Children with preschool wheeze often experience a rapid worsening of their symptoms. The most typical scenario is when kids get a cold or a runny nose, which can result in their airways quickly becoming narrow, leading to wheeze and difficulty in breathing. This is known as a wheezing ‘attack’.

At least half of all children will have had at least one attack of wheezing by their sixth birthday. That’s not just a concept in the UK, that’s worldwide. However, not all children will then have repeated attacks of wheezing. So, up to half will have at least one attack before their sixth birthday but about a third of those then have recurrent, frequent attacks of wheezing. They’re the children that I'm really interested in, and they're the children that we really need to try and make better.

The reason is that the children who have frequent attacks of wheezing make up the majority of children who are admitted to hospital. And of all children who get admitted to hospital for asthma attacks or wheezing attacks, three quarters are in the preschool age group. What’s really disappointing is that rate has been unchanged for at least 15 or 20 years. So, we haven’t managed to impact the rate of hospitalisation for these children for a long time. There’s something fundamental that we need to change in the way we manage these children to make them better.

Of those children that experience preschool wheeze, about half will go on to develop asthma by school age. At least three children in every classroom will have asthma.

Preventing attacks of wheezing

In my research project, we’re trying to work out how we can prevent attacks of wheezing, either from ever occurring, or if we know the children that are likely to have an attack, that we can come in with a treatment to stop them from having the attacks again and again. Ultimately, we want to prevent a lifetime of lung problems for these people. In my study, we’re trying to work out what it is in the lungs that cause wheezing in these preschool children. We’re very specifically going to look at the children that experience wheezing with viral infections. We want to know what’s happening in their lungs and what’s changing to make the wheeze happen.

Farmyard environments, wheezing, and asthma

Then what we want to do is apply a scenario that’s quite interesting. There’s some really nice research that has shown that children who are brought up on farms or in a farming environment are very protected from wheezing and asthma.  This is especially true for the traditional farming environment where families are doing the work themselves without machinery and so on.

The research that we are doing is trying to mimic the protective effect of the farmyard environment. In strictly controlled and monitored research conditions, we’re seeing if we can create wheezing with viral infections and then see if we can mimic the farmyard environment to see if we can stop the wheezing.

We’ve generated a model in the lab that reproduces wheezing with viruses and what we’re actually using as the intervention are extracts from farm dust that we’ve brought into the lab. We’re putting those into our experimental model to see what is it that changes and what it is about those farm dust extracts that change the effects of the wheezing. We can then look at how we can translate that into medication for children.

The ultimate aim would be to come in early in the first few months of life to stop children from ever developing wheezing and preventing the development of asthma and long-term effects in adulthood. That would be our dream.

Asthma research is severely underfunded

DID YOU KNOW: Research into respiratory diseases like asthma accounts for just 2% of all the medical research funding in the UK.

This underfunding is exactly why we launched the 2021 Research Appeal...