Why is asthma worse in black patients?

January 10, 2017 by Jacqueline Carey, University of Illinois

African Americans may be less responsive to asthma treatment and more likely to die from the condition, in part, because they have a unique type of airway inflammation, according to a study led by researchers at the University of Illinois at Chicago College of Medicine.

Airway inflammation is a key component of asthma, and innovations in treatment are becoming more personalized based on the specific type of airway inflammation in a patient, says Dr. Sharmilee Nyenhuis, assistant professor of medicine at UIC and corresponding author on the study.

"Emerging evidence suggests that differences in airway inflammation can affect a patient's response to treatment, but whether the patterns of airway inflammation vary across race has, until now, been very unclear," said Nyenhuis, of UIC's division of pulmonary, critical care, sleep and allergy.

Black men and women are two to three times more likely than whites to be hospitalized or die from asthma. And while many factors contribute to the burden of asthma in African Americans—such as access to health care and environmental exposures—rates are disproportionate even when social and environmental elements are taken into account.

Nyenhuis and her colleagues performed a secondary analysis of more than 1,000 sputum samples obtained from AsthmaNet, a nationwide clinical research network created by the National Heart Lung and Blood Institute, and the Asthma Clinical Research Network. Samples of the coughed-up fluids were from past clinical trial participants over the age of 12 with mild or moderate persistent asthma and who had not smoked within the last year. The samples were tested for the presence of eosinophils—a type of white blood cell.

The study is one of the largest and most diverse trials conducted in the U.S. on race and asthma, with 26 percent of the patients self-identifying as African American.

Researchers found that were more likely to exhibit eosinophilic airway inflammation than whites, despite taking comparable doses of , such as inhaled corticosteroids.

The results are published in the Journal of Allergy and Clinical Immunology.

"Our findings of higher numbers of African Americans with this type of airway inflammatory pattern suggests a mechanism that may account for more severe and difficult to control asthma in African Americans," said Nyenhuis. "It follows that the persistence of eosinophilic airway inflammation in African Americans may be associated with and an impaired response to corticosteroids."

The findings suggest that black patients with eosinophilic may not benefit from increasingly strong corticosteroid treatment—instead, other targeted therapies may need to be considered and researched as a treatment option for those black patients with difficult to control eosinophilic .

Explore further: New model IDs inflammatory asthma without sputum

More information: Sharmilee M. Nyenhuis et al. Race is associated with differences in airway inflammation in patients with asthma, Journal of Allergy and Clinical Immunology (2017). DOI: 10.1016/j.jaci.2016.10.024

Related Stories

New model IDs inflammatory asthma without sputum

January 4, 2017
(HealthDay)—A new prediction model identifies eosinophilic asthma without the need for sputum induction, according to a study published online Dec. 28 in Allergy.

Asthma in many adolescents is not an allergic disease

January 13, 2016
New research indicates that asthma in many adolescents is not likely to involve inflammation of the airways and therefore should not be considered an allergic disease.

Test used to diagnose asthma may not be accurate

December 5, 2016
A new study urges caution in the use of the mannitol challenge test for asthma in non-clinical settings. The test is considered widely applicable to detect asthma, but its accuracy outside of patients referred for specialized ...

Enhanced arginine metabolism may counteract inflammation pathways in asthma

May 23, 2016
High arginine levels are often observed in asthmatic individuals and may support increased production of nitric oxide, which is known to worsen airway inflammation. Medications that reduce arginine availability do not effectively ...

A large subgroup of mild-to-moderate asthma is persistently non-eosinophilic

January 6, 2012
A large percentage of patients with mild-to-moderate asthma have persistently non-eosinophilic disease which may not respond to currently available anti-inflammatory treatments, according to a new study.

Which asthma drugs, dosages work best for African Americans?

February 19, 2014
The University of Illinois at Chicago has received funding from the National Institutes of Health to determine what combination and dosages of asthma medications works best to manage asthma in African Americans, who suffer ...

Recommended for you

Chronic inflammation causes loss of muscle mass during aging

January 12, 2018
People start losing muscle mass at the age of 40—about some 10 percent of the total muscle mass for each 10-year period, which may lead to fall-related injuries, slowing metabolism and reduced quality of life. Today, very ...

Breathing exercises help asthma patients with quality of life

December 13, 2017
A study led by the University of Southampton has found that people who continue to get problems from their asthma, despite receiving standard treatment, experience an improved quality of life when they are taught breathing ...

Study highlights the need for research into prevention of inflammatory bowel disease

December 7, 2017
Countries in Africa, Asia, the Middle East and South America have seen a rise in incidence of inflammatory bowel disease as they have become increasingly industrialised and westernised, a new study has found.

Air pollution can increase asthma risk in adults, even at low levels

November 24, 2017
Living close to a busy road can be bad for your respiratory health if you are middle aged, new Australian research has found.

Evidence found of oral bacteria contributing to bowel disorders

October 20, 2017
(Medical Xpress)—An international team of researchers has found evidence that suggests certain types of oral bacteria may cause or exacerbate bowel disorders. In their paper published in the journal Science, the group describes ...

New compound discovered in fight against inflammatory disease

September 22, 2017
A 10-year study by University of Manchester scientists for a new chemical compound that is able to block a key component in inflammatory illness has ended in success.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.