Treating Asthma: Personalized Medicine
Are you getting care that's right for your body, your age, and your background?
Asthma: A Changeable Disease
Asthma and asthma treatment can be affected by a number of things.
Age. "As children grow up, their asthma can change a great deal," says Bernstein. "For some, it goes away. For others, it gets worse." Children are also often exposed to more allergens while at camp or playing sports outdoors.
Environment. Your surroundings can have a huge effect on your asthma. Obviously, you'll be exposed to very different allergens if you move from the city to the country or vice versa. But much less dramatic changes can still have a tremendous impact. You may encounter all sorts of new triggers in a new house or at a new job. Even the most subtle change -- like a colleague using a new perfume -- can irritate your airways and make your asthma worsen dramatically.
Genes. We're still in the early stages of understanding the genetics of asthma, but researchers believe that genes play a big role. They may affect the course of your disease and how well a treatment will work.
"Some people have a vigorous response to bronchodilators and some don't," Windom tells WebMD. "We now think that part of the difference between these people may be in their genes." Windom says that many are wrongly blamed for treatment failure and accused of not taking their medicine, when it fact it just doesn't work for them.
Other Health Conditions. Conditions like a sinus infection, lung disease, and acid reflux can all make your asthma worse. Other diseases can have an indirect -- but significant -- effect. For instance, some people with painful arthritis may have trouble using inhalers properly, says Windom. This can prevent them from getting as much medicine as they need.
Race. While the research isn't conclusive yet, there's a growing belief that African-Americans may be more prone to asthma than other groups. For example, according to the American Lung Association the rate of asthma among African-Americans in 2002 is higher than among whites. African-Americans may also be three times more likely to die from asthma than whites.
"Socioeconomic factors, like limited access to good health care, probably also play a role," says Blaiss. "But I think that there is definitely a genetic component to why asthma is a more severe illness in the African-American community."
Genetic differences may also affect how well medications work in African-Americans. A 2006 article published in the journal Chest described one study of the long-acting bronchodilator Serevent. It turned out that African-Americans who took the drug were four times as likely to die or experience life-threatening events as those who did not. There were no significant differences between whites who did or didn't take the drug. The effects may be due to socioeconomic factors and not genetic ones, but more research needs to be done.