Nailing steroid resistant asthma was the focus of a recent Biomedical Forum for clinicians, researchers and allied health professionals from Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts and King’s College London.
As the management of steroid refractory asthma consumes up to 70% of total NHS asthma costs, there is an urgent need to increase understanding of the condition and to find ways to improve symptom control. The MRC/Asthma UK Centre at King’s College London and the Asthma and Allergy theme of the comprehensive Biomedical Research Centre are carrying out vital translational research to overcome these problems and to improve the health of people living with the condition.
Research is focusing upon three areas:
- Identifying new biomarkers to track the responsiveness of asthma to existing and new treatments
- Finding ways to increase steroid responsiveness in individual patients
- Increasing understanding of how steroids work so that these can be used more precisely.
One exciting line of research is focused on vitamin D. While many people are deficient in this vitamin, local research suggests that vitamin D may increase the effectiveness of the use of steroids in treating asthma and other diseases by increasing the production of an anti-inflammatory mediator called interleukin-10.
With modern technology now available, it should soon be possible to understand how steroids alter the function of cells and to use this knowledge to identify new approaches to improve response to treatment, which may well differ between individuals.
Professor Chris Corrigan said: "After many years of frustration, modern technology is now enabling us to identify the effects of steroids on cells, and how these may differ in patients who do not respond to steroids as we would expect. This opens up the exciting prospect of developing tailor-made new treatments for asthma, which we hope will make a real difference to the lives of patients, particularly those who suffer the daily misery of the most severe asthmatic symptoms".
(Source: King’s College London: January 2009)