Severe Asthma Research and Clinical Care
From Clinical Update, Winter 2006
Abstract: Physician-scientists at the Center for Human Genomics are studying severe asthma, a poorly understood and difficult to treat condition. The Center’s asthma group offers the most comprehensive asthma service in the Southeast, encompassing research and clinical care.
Of the 20 million Americans with asthma, less than 10 percent have severe asthma—but these patients are responsible for a disproportionate share of health care costs and morbidity associated with the disease.
The Center for Human Genomics at Wake Forest University Baptist Medical Center is part of two large multi-center asthma studies funded by the National Heart Lung and Blood Institute of the National Institute of Health: the Severe Asthma Research Program (SARP) and the Asthma Clinical Research Network (ACRN).
Wendy C. Moore, M.D., assistant professor of internal medicine, and Stephen P. Peters, M.D., Ph.D., professor of medicine, both of Wake Forest Baptist, recently reviewed severe asthma in the Journal of Allergy and Clinical Immunology (Vol. 117, No. 3).
“Severe asthma remains poorly understood physiologically and pathologically,” said Moore. “These patients are particularly difficult to treat, with current therapies incompletely controlling symptoms and even intensive treatment having little impact on health care utilization.”
The SARP has looked at more than 1,000 patients with asthma nationwide; over 300 of these patients have been studied at Wake Forest Baptist. A major goal of SARP is to characterize subjects with severe asthma to understand pathophysiologic mechanisms in severe asthma.
Researchers perform a comprehensive evaluation of asthma including questionnaires, allergy and pulmonary function testing and noninvasive measurements of airway inflammation. The SARP results should increase the understanding of severe asthma and, in the future, improve treatment of these difficult patients.
The Severe Asthma Research Program dovetails with the Asthma Clinical Research Network (ACRN), which performs clinical trials aimed at answering important questions in asthma treatment. The ACRN is currently investigating the effect of genes on response to beta-adrenergic drugs and the role of macrolides in asthma therapy.
The Center for Human Genomics was established in 2000 as part of a $67 million research initiative at Wake Forest University School of Medicine. The center is comprised of faculty with expertise in a variety of disciplines, whose primary purpose is to investigate genetic mechanisms in the development and progression of complex human diseases. Under the leadership of Eugene R. Bleecker, M.D., and Deborah A. Meyers, Ph.D., the center’s research priorities include cardiovascular disease, diabetes, prostate cancer and pulmonary disease.
The clinical center for respiratory studies is located at the Cloverdale Research Center, where studies are focused on asthma and chronic obstructive pulmonary disease (COPD). The research group often conducts clinical trials for pharmaceutical companies and industry in addition to NIH-funded studies.
“The asthma group at the Center for Human Genomics is a state-of-the-art, internationally known team which spans everything from looking at genes to looking at lung secretions to treating patients clinically,” said Moore. “We have the most comprehensive asthma program in the Southeast offering community physicians support and services to their patients not found outside of a tertiary care referral center.”
Patients may be referred to the Asthma Clinic, Department of Pulmonary, Critical Care, Allergy, Asthma and Immunologic Diseases. The clinic is held on Fridays, 1-5 p.m., 7th floor, the Richard Janeway Clinical Sciences Tower.