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Treating Asthma: Personalized Medicine

Are you getting care that's right for your body, your age, and your background?
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Asthma: A Changeable Disease continued...

"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.

Customizing Your Asthma Treatment

Because asthma is such a changeable disease, with so many different triggers and symptoms, finding the best treatment can be tricky. Even the most basic medical needs -- like the frequency of checkups -- can vary a great deal from person to person.

"It's really difficult to standardize how often a person with asthma should schedule appointments," says Bernstein. "A person with mild intermittent asthma may only need an appointment once a year. Someone with very severe asthma may need to go in once every two weeks." It all depends on your particular condition.

Asthma medicines are not interchangeable. "Some treatments work well for certain subgroups and some don't," says Windom. "But right now we don't have ways of testing beforehand what will work best." The foundation of asthma treatment is the use of prevention medications, which are used daily to keep symptoms from worsening. Inhaled corticosteroids -- such as Advair (a corticosteroid combined with a long-acting bronchodilator) and Flovent -- are examples of inhaled steroids. A newer class of long-acting drugs is leukotriene modifiers, such as Accolate, Singulair, and Zyflo.

As effective as these medicines are at controlling asthma, they essentially treat the symptoms of asthma or block the effects of specific allergens. One type of treatment stops the underlying cause of asthma symptoms. The only drug of this class available, Xolair, blocks the effects of IgE, a molecule that can trigger asthma symptoms. IgE is overproduced when the body is exposed to allergens.

As researchers learn more about the antibodies that trigger the symptoms of asthma, Windom predicts that drug companies will develop more medications to block their effects. So rather than having one "wonder drug" that controls everyone's asthma, we could have several different ones designed to help different groups of people.

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