Patients and carers of someone with severe asthma have been involved across U-BIOPRED's activities via the project's Patient Input Platform (PIP). Members of the PIP have worked with the paper's author, Dominic Shaw, and project lead, Peter Sterk, to produce a lay abstract for the paper, to ensure that the findings of the study are also accessible to patients and the public.
Lay abstract - Characteristics of the European U-BIOPRED adult severe asthma cohort
Recent research has shown that severe asthma is more than simply a worsening of mild asthma, and needs a different approach to diagnosis and treatment. Over 30 million adults and children in Europe suffer from asthma; it is estimated that of these, four percent (roughly 1.2 million people) have severe asthma. These patients have daily symptoms despite maximal medical treatment and are more likely to be admitted to hospital and to require emergency healthcare. It is estimated that these patients contribute over half of the total health care burden for this disease, and that each patient with uncontrolled asthma costs healthcare systems approximately 2,280 Euros per year.
In order to better understand severe asthma and identify new treatment targets the U-BIOPRED (Unbiased BIOmarkers in PREDiction of respiratory disease outcomes) project was set up in 2008 with public-private funding obtained from the Innovative Medicines Initiative (IMI) via the European Commission and the European Federation of Pharmaceutical Industries and Associations. U-BIOPRED is a collaboration of 20 academic institutions across 11 European countries with involvement of 11 pharmaceutical companies, 3 small to medium enterprises and 1 multinational industry, and 6 patient and care organizations.
U-BIOPRED aims to discover new subtypes of severe asthma by measuring and characterising metabolites (substances produced by the cells in a human body) in biological samples using the latest research technologies. This will lead to the identification of new treatment targets (what drugs work on), so treatment can eventually be tailored for the patient.
The adult U-BIOPRED study recruited four groups of adult participants and followed them up for over a year; 311 non-smokers with severe asthma, 110 smokers and ex-smokers with severe asthma, 88 patients with milder asthma and 101 healthy volunteers. As part of the study, blood, urine and sputum (mucus) samples were collected and specialised assessments of lung function and anatomy were performed.
The U-BIOPRED project has already revealed that, when compared to milder asthma, patients with severe asthma have significantly worse symptoms, more attacks, and higher levels of anxiety and depression. Patients with severe asthma also have more nasal polyps (small growths in the nose), acid indigestion and poorer lung function. One key finding is that although patients with severe asthma take greater amounts of anti-inflammatory treatment, including inhaled and oral steroids, they still have higher levels of inflammation in their airways.
Research is ongoing to identify the mechanisms involved in severe asthma and to identify subtypes, or clusters, that respond differently to treatment. This work will lead to swifter and more accurate diagnosis and, by targeting the mechanisms that are driving severe asthma, personalised treatments to lessen the burden of this chronic and debilitating disease.