Wheezing and asthma: hopes of earlier diagnosis and better treatment
This research was completed on 30 September 2013
Published on 22 November 2011
Wheezing is common in young children – affecting at least one in four children before they start school.1 Some children grow out of their wheezing, while others find it progresses to asthma. Professor Clare Lloyd and Dr Sejal Saglani, of Imperial College London, and Professor Andrew Bush of London’s Royal Brompton Hospital are investigating why. They hope to pave the way to earlier diagnosis and better treatment of both wheezing and asthma.
What is the problem and who does it affect?
Over one million children in the UK have asthma – that’s one child in every 11.2 They can experience difficulty breathing, with wheezing, coughing, breathlessness and chest tightness – debilitating symptoms that have broad-ranging effects on day-to-day life and can even prove life threatening.
“Children with severe asthma often miss a lot of school,” explains Professor Clare Lloyd. “When they do go to school, they may be unable to join in with sports. Children don’t like to feel different; having a long-term disease like asthma affects their independence.”
Unfortunately, it is not normally possible to diagnose asthma until a child reaches school age, even though evidence suggests the disease often begins much earlier. Wheezing is an early symptom that affects large numbers of children under five, with around one third of these young children going on to develop asthma.3
“Very few treatments are available for preschool children with severe wheezing. What is available is often ineffective,” says Professor Andrew Bush. “The biggest problem is that we do not have any treatments that can be used early to stop very young children with wheezing from getting asthma by school age.”
Many different factors are implicated in the development of asthma, including infections and allergies.
What is the project trying to achieve?
This group of scientists and doctors are investigating the link between early infections, allergy, wheezing and asthma.
They suspect that wheezy children who go on to develop asthma respond abnormally to infections and allergens – that cells lining the surface of their lungs produce excessive amounts of certain immune molecules, resulting in permanent lung damage. They are investigating their suspicions using samples donated by around 40 children with and without wheeze.
“We particularly want to understand why some children grow out of their wheezing, while others find their illness becomes more severe and they are eventually diagnosed with asthma,” says Dr Sejal Saglani. “A better understanding of the underlying disease mechanisms could eventually help us find ways to diagnose asthma earlier, before a child’s lungs have been damaged. It might also guide the development of better treatments.”
The ultimate goal is to work towards a way to stop children with wheeze from developing asthma.
What are the researchers’ credentials?
Professor Lloyd’s group is one of only a few in the world to be studying lung cells from children with severe wheeze and asthma (using samples taken when the children undergo routine investigations). The group, which includes clinicians and basic scientists, has a proven track record in investigating how the immune system behaves in the lungs.
|Project Leader||Professor C M Lloyd|
|Location||Faculty of Medicine, National Heart and Lung Institute, Imperial College, London|
|Grant awarded||22 August 2011|
|Start date||1 October 2011|
|End date||30 September 2013|
|Grant code||SP4657, GN1841|
|Acknowledgements||This project supported by a generous grant from The Henry Smith Charity.|
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- Frank PI et al. Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004. BMJ 2008; 336 (7658):1423-6.
- Asthma UK. For journalists: key facts and statistics. Website accessed 12 October 2011. http://www.asthma.org.uk/news_media/media_resources/for_journalists_key....
- Stern DA et al. Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study. Lancet. 2008; 372:1058-64.