Link:
http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030616/hl_nm/asthma_genes_dc_1
As I am an asthmatic, and one whose lungs have been getting crummier with each passing year, naturally this story caught my eye. My dad and little brother have it worse than I do, although if I continue down this road I may well end up having to take daily steroids, either inhaled or oral, a thought which does not thrill me in the least.
So can someone explain to me the potential practical/treatment implications of the discovery that certain gene clusters and/or arginase are linked to asthma? What avenues of research might this open up? Might this mean that all asthma is linked to these gene clusters, or only certain types of asthma? Would this aid in diagnosis only, or treatment only? Both? Neither? Please educate me.
Well, I’m no expert, but I’ve taken my share of Bio courses. 
All of the implications that you listed are certainly possibilities, but unfortunately most will come later than sooner. First of all, simply knowing what is responsible for causing asthma in the first place is already a huge step forward. Knowing what genes are responsible for it means that scientists can probably isolate these genes fairly easily and determine whether an individual is particularly succeptible to asthma. This also means that, should you choose to have another child, they could likely determine before the child is born whether he/she will have asthma, too. At some point, if they could figure out how to deactivate these genes, they could in effect cure sufferers.
As for a timeline though…I’d guess (and these are totally WAGs, by the way) it will be several years before they can diagnose asthma through DNA, and at least 10-20 more before they can find a way to deactivate the problem genes.
Well, even 10-20 years before there are new treatment options could still mean several decades of a much happier existence for me, so this is a Very Good Thing.
Any medical/biotech/pharmaceuticals research geeks out there want to get technical on me? Can you help me out with a happy medium in terms of an explanation that falls somewhere higher than Yahoo News, but lower than a medical journal, in terms of complexity?
[hijack]Why the concern over inhaled steroids, eva luna? They preserve lung structure and function wonderfully, and are associated with extremely minimal side-effects. They are enabling asthmatics to live long lives with fewer asthma attacks and tremendously decreased lung destruction! [/hijack]
Otherwise, I’m clueless as to what the genetic findings mean for current asthmatics and their daily care.
Well, my dad has been taking oral steroids for years; he’s a pretty big geek, so he has researched the side effects,a nd he is currently convinced that they are possibly the cause of some orthopedic issues he’s been having. He’s told me there is a negative correlation between long-term steroid use and good bone density.
Considering my left fibula is held together by a plate and a bunch of screws, that’s not something I care to risk. Plus I’m generally a minimalist when it comes to long-term drug use of any sort; the less I have to monkey around with my body chemistry, the ahppier I am.
Oh, and **QtM, ** do you have any recommended reading on asthma and/or inhaled steroids that isn’t quite as dumbed-down as the usual patient literature, but would be comprehensible to someone without a medical or advanced science degree? My dad and I would appreciate it.
The bone density bad stuff is true for oral steroids, but hasn’t been seen in any significance with inhaled steroids. And I’ll look for some good resources on it.
Thanks, that would be great! I’m even willing to take a crack at a journal article or two, if it’s on-point. It just gives me a headache to plow through a bunch of tangentially related technical info, but if there’s something on-point, at least I can ask my doc to translate it into English.
After spending the past week hacking up my lungs with bronchitis, I’d really like to get a grip on my pulmonary situation.
Try http://asthma.about.com/mbody.htm as a resource. It’s written for the educated public, with many links to either simpler or more complex material. And it discusses at length the risks and benefits of all therapies.
Inhaled steroids are currently THE best thing out there to reduce and resolve inflamed asthmatic lungs. And asthma is fundamentally a disease of inflammation, with bronchospasm (wheezing) being a secondary effect.
It’s been demonstrated that inhaled steroids work better than the long-acting dilators like Serevent, the theophyllines, even the new leukotriene inhibitors. It preserves lung structure and function, and reduces and can even eliminate the progression of asthmatic lungs into emphysematous lungs. Its effects on growth and bones seems to be negligible, as are its effect on the lenses of the eyes, the endocrine system, and the adipose (fatty) tissue. The biggest downside is that one may develop an oral yeast infection if they neglect to rinse out their mouth after using it.
It is currently the standard of medical care that any asthmatic who needs a rescue inhaler (like albuterol) more than once a week should be on some sort of maintenance inflammation fighting medication, preferably an inhaled steroid.
BTW, I gain no financial benefit from prescribing or recommending inhaled steroids! 
These sites give the current guidelines about how asthma should be treated.
page 60-72 of the first link’s report address inhaled steroid issues.
http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
This one updates the initial report on asthma, and notes that inhaled steroid use in children is associated with much benefit and virtually no harm in the studies done. http://www.nhlbi.nih.gov/guidelines/asthma/index.htm
Hmmmm…thanks for the links. I’ll have to do some poking around, but it seems like the status quo may be the best for me…under normal circumstances, I can go weeks, or even months, without needing my rescue inhaler (as long as I stay away from cigarette smoke). The past couple of weeks have just sucked because of the bronchitis. As for Dad, I don’t know when the last time was that he tried to go without his oral steroids. He also has additional pulmonary issues; as a result of a long-ago horrible car accident that almost killed him, half of one of his lungs is scar tissue anyway.
I think my brother has been using Singulair, but I’m not positive. In any case, I’m really curious to see what comes out of the whole gene therapy concept, in terms of new drugs or any other treatments.
Still waiting for some bio researcher dude (or dudette) to pop in and explain the ins and outs of genetics…my geeky side has been piqued now, and it won’t go to sleep!