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ARRA Investments in Asthma: Clinical and Translational Research

Public Health Burden
Asthma is a chronic lung disease that affects more than 300 million people worldwide. Approximately 24.4 million Americans, including nearly 7 million children under 6 years of age, have asthma. Costs associated with asthma exceed $13 billion per year. Ethnic and racial disparities in asthma persist; minority communities have a higher prevalence of asthma and experience more severe disease. Currently, asthma cannot be prevented or cured, and existing therapies focus on controlling disease symptoms and preventing potentially life-threatening exacerbations. Through the ARRA, the NIH is supporting clinical and translational research to develop new and improved strategies to prevent and treat asthma.

Anti-inflammatory medications and bronchodilation agents are standard treatments for asthma. However, they are not effective for all patients, and more than 3,000 people die each year from asthma. ARRA funded grants are examining the efficacy of current therapies and supporting the development of alternative therapies. A few examples include grants to:
  • Examine the responsiveness of patients with persistent asthma to inhaled corticosteroids. 1
  • Study changes in gene expression and function following treatment with common medications used to treat acute asthma attacks. 2
  • Determine the mechanisms of beta-blocker induced improvements in asthma with the long-range goal of developing beta-blockers as an alternative therapy for asthma. 3
Translational Research
Asthma can be difficult to control because existing treatments provide symptom relief, but do not address its underlying causes. New approaches are needed to prevent, diagnose, and treat asthma. To that end, ARRA-funded grantees are investigating the underlying disease mechanisms and translating new knowledge into clinical research. Examples include studies to:
  • Improve understanding of mucosal immune responses to microorganisms present in the respiratory tract and determine how the responses lead to respiratory inflammation and the development of chronic lung diseases, such as asthma. 4
  • Determine whether activation of an enzyme, acidic mammalian chitinase, affects the immune responses responsible for the type of inflammation seen in asthma.5
  • Develop a noninvasive imaging method to evaluate regional inflammation in asthma to enable more advanced studies of cellular interactions and biological pathways involved in asthma.6
  • Develop a noninvasive method to assess lung function using exhaled nitric oxide. A new noninvasive method to guide clinical management of asthma would be a significant improvement over existing approaches. 7
  • Use web-based technology to improve adherence to treatment recommendations in urban school settings. 8
  • Compare the effectiveness of a patient-advocate intervention to improve the health literacy to standard asthma education approaches. If the study identifies new interventions that improve prevention of asthma exacerbations, the interventions easily could be incorporated into clinical practice. 9
Cooperative Research Centers
NIH ARRA funds have been awarded to two Asthma and Allergic Diseases Cooperative Research Centers (AADCRC) that are designed to conduct basic and clinical research on the mechanisms, diagnosis, treatment, and prevention of asthma and allergic disease. They are:
  • Asthma and Allergic Diseases Cooperative Research Center – University of Texas, MD Anderson Cancer Center10
  • Asthma and Allergic Disease Center – University of Virginia11

  1. 3R01AI079139-01A1S1 -- Pharmacogenomics of Inhaled Corticosteroid Responsiveness in Patients with Asthma -- Williams, Keoki
  2. 1R03AI078230-01A1 -- Methylation Analysis of the Gene ADRB2 -- Hawkins, Gregory
  3. 1R01AI079236-01A1 -- Mechanisms of Beta-blocker Induced Improvements in Asthma -- Bond, Richard
  4. 1RC1HL099839-01 -- Recognition of microbes by NKT cells at the lung mucosal surface -- Umetsu, Dale T
  5. 1RC1HL000738-01 -- Understanding the role of AMCase in asthma -- Flavell, Richard
  6. 1RC1HL099303-01 -- Imaging Inflammation in Asthma -- Erzurum, Serpil
  7. 2R01HL070645-05A2 -- Exhaled Nitric Oxide: Mechanisms and Limitations -- George, Steven Carl
  8. 1RC1HL099432-01 -- Using a Novel Technology to Improve Adherence: School-Based Asthma Treatment -- Halterman, Jill
  9. 1RC1HL099612-01 -- Patient Advocate and Literacy-based Treatment of Asthma -- Apter, Andrea
  10. 3U19AI071130-03S1 -- Asthma and Allergic Diseases Cooperative Research Center -- Liu, Yongjun
  11. 3U19AI070364-04S1 -- Asthma and Allergic Disease Center -- Platts-Mills, Thomas

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