Asthma and wheezing: hope of earlier diagnosis and better treatment
Children's charity Action Medical Research is marking World Asthma Day (1 May) this year by celebrating the funding of an investigation into childhood wheezing and asthma, which hopes to pave the way to earlier diagnosis and better treatment.
Over one million children in the UK have asthma; that is one child in every 11 who can experience debilitating symptoms that affect the quality of their day-to-day life and can even prove life threatening.1 Wheezing is an early symptom of asthma that affects a large number of children under five, with around one third of these young children going on to develop asthma.2
The Action Medical Research funded study is investigating why some children grow out of wheezing, which affects at least one if four children before they start school, whilst in others this progresses to asthma.3 Professor Clare Lloyd and Dr Sejal Saglani, of the National Heart and Lung Institute, Imperial College London, and Professor Andrew Bush of London’s Royal Brompton Hospital were awarded £143,612 over two years.
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. Children with asthma experience difficulty breathing, with wheezing, coughing, breathlessness and tightness in the chest. If not diagnosed and treated early it can result in permanent lung damage.
The researchers want to identify potentially asthmatic children early, in the preschool years, to work towards a way to stop those with wheeze from developing asthma.
Professor Lloyd said: “Children with severe asthma often miss a lot of school. 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.”
“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.”
The researchers 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 using samples donated by around 40 children with and without wheeze.
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.”
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NOTES TO EDITORS:
1. 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....
2. 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.
3. Frank PI et al. Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004. BMJ 2008; 336 (7658):1423-6.
Case study: Sullivan Brown
Eight year old Sullivan Brown is a very sporty, fun loving and stoical little boy.
At only four months old, Sullivan had his first serious attack of wheezing and difficulty breathing. “He was fighting for breath and panicking. His dad and I were panicking too and rushed him to hospital, where he had to stay for a couple of days.”
At about only one year old Sullivan’s symptoms of asthma – wheezing, coughing, breathlessness and tightness in the chest – were detected by doctors. Unfortunately, it is not normally possible to diagnose asthma until a child reaches school age, even though evidence suggests the disease starts much earlier.
“From a very young age Sullivan started to have attacks where he could not breathe properly, which are frightening first and foremost for him but also for everybody else around him. He has had so many and they are always scary,” his mum says. Only recently he had an attack whilst playing in the garden of the family home.
“There have been many nights that my husband Russell – who also has asthma - and I have spent in hospital whilst Sullivan is treated. And also countless times at our local GP surgery having steroids administered.”
Sadly, these attacks often coincide with the festive season and Sullivan has had to spend a couple of Christmases in hospital. Neither of Sullivan’s two siblings have asthma.
Sullivan is allergic to some dogs, to cats and horses too, which can bring on his asthma. “We have two hypoallergenic dogs who he adores,” says his mum. “They don’t shed any hair so he is not allergic to them and his asthma is not affected.”
He also has a severe peanut allergy, “so not only do I have a handbag full of inhalers, I also carry an EpiPen (an autoinjector delivering a dose of adrenaline to avoid or treat the onset of anaphylactic shock) everywhere too. Fortunately we have never had to use it.”
Despite Sullivan’s asthma, “he takes everything in his stride and nothing really fazes him”, say his mum and dad. He would much rather play sport than sit in a classroom.
Now Sullivan’s asthma is treated with Ventolin, Becotide, Serevent inhalers and Singulair tablets daily. He is really good at using his inhalers and taking his tablets, but sometimes playing too much sport can bring on his attacks.
“He is a much loved boy with many friends who look out for him whilst he’s playing at school, and on the football and rugby pitch,” his mum proudly explains. Although Karen describes how scary it is when he is away from the family with friend’s who may not be aware of just how serious asthma can be.
Sullivan has had asthma attacks at school. “The school are fabulous and the inhalers are administered by staff when needed. When he was younger I wasn’t taught how to give him his inhalers correctly, so it’s important that everyone knows how to do this. It’s a huge responsibility,” his mum says.
Brave Sullivan has had a tremendous first football season playing in goal and is also a fantastic rugby player by all accounts. Unfortunately he broke his elbow earlier this year and had to rest for a few weeks, “which he found quite difficult,” his mum says.
“Action Medical Research is an amazing charity dedicated to helping babies and children. I got involved after I heard Davina McCall, one of the charity’s most steadfast supporters, give an inspiring speech at a Dine with Davina fundraising event in Southampton. I also own a children’s nursery in Farnham, Tootsies, so felt it was fitting to raise vital funds for the charity’s important work.”
“I’ve raised in excess of £5k for Action Medical Research with a charity ball in 2011 and other ‘tin rattling’ at events at the nursery. I hope that this goes some way to help the charity fund various research, like the project on asthma, which could help more children like my son Sullivan live a more healthy life,” Karen Brown, mother of asthma sufferer Sullivan, says.
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Action Medical Research - the leading UK-wide medical research charity dedicated to helping babies and children - is celebrating 60 years of vital research in 2012. We’ve been funding medical breakthroughs since we began in 1952 and have spent more than £100 million on research that has helped save thousands of children’s lives and changed many more. Today, we continue to find and fund the very best medical research to help stop the suffering of babies and children caused by disease and disability. We want to make a difference in:
• tackling premature birth and treating sick and vulnerable babies
• helping children affected by disability, disabling conditions and infections
• targeting rare diseases that together severely affect many forgotten children
But there is still so much more to do. Make 2012 a special year and help fund more life-changing research for some of the UK’s sickest babies and children.