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Not All Asthma Created Equal

Distinct Differences Between Severe, Mild Asthma Could Lead to Targeted Treatments

Severe Asthma Unique continued...

There was no significant difference between patients with severe and milder asthma, however, in the length of time required to exhale a volume of air -- a measure known as air-flow limitation.

Airflow limitation was common among asthma sufferers, regardless of whether they had mild, moderate, or severe forms of the disease.

But there was little air trapping seen in patients with mild to moderate disease, even when air flow limitations occurred. Conversely, patients with severe disease had some air trapping even in the absence of airflow limitation.

"That tells us that something different is going on in people classified as having severe asthma, either physiologically or in the airways that are affected," Sorkness said. "It's likely that airflow limitation occurs in the larger airways of the lungs, while air trapping is occurring in the small airways that branch to the outer portions of the lung."

4,000 Asthma Deaths

About 4,000 people in the United States die each year from asthma, and half a million are hospitalized, according to the latest figures from the CDC.

The 5% to 10% of patients with the most severe disease account for a disproportionate number of deaths and the bulk of asthma-related costs to the health care system, Wake Forest University asthma researcher Wendy C. Moore, MD, tells WebMD.

Along with Wake Forest colleagues, Moore is studying the genetic differences between asthma patients through a SARP grant.

Other SARP researchers are examining the impact of latent viral infection and systemic inflammation on asthma.

"The overall goal is to understand the disease better so that we may be able to target treatments to individual patients," she says.

Asthma and allergy specialist John Sweet, MD, tells WebMD that there are promising new therapies for patients with severe, hard-to-treat asthma, including immunosuppression aimed at calming the immune system responses that lead to asthma, and anti-IgE, which targets allergic response.

Sweet agrees that a better understanding of the differences between asthma patients could lead to better treatments.

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