Chance to prevent asthma missed

Two Australian scientists are spearheading an international campaign that's challenging the way asthma drugs are developed and tested.

Professors Pat Holt and Peter Sly from The Kids for Child Health Research say current protocols that focus on the effectiveness of treatments in adults mean that the chance to actually prevent the development of the disease in children is being missed.

In an article published today in the prestigious international scientific journal Nature Immunology, the Perth researchers and a team of experts from USA and Europe outline a radical new approach to asthma prevention involving clinical trials of new anti-inflammatory drugs.

Lung specialist, Professor Peter Sly, said that recent discoveries, including groundbreaking research from the Perth group, indicate that the key factor driving asthma development is inflammation of the airways during early childhood.

"During early childhood the lung and airways are rapidly growing, and severe inflammation during this period can alter this growth process and lead to permanent structural changes that produce persistent wheezing symptoms," he said.

"If we can protect the growing lungs from inflammation during this critical period, the chances of asthma developing later are greatly reduced.

Professor Sly said the thrust of current research in asthma focused on developing new and better anti-inflammatory drugs to treat established asthmatics, principally adults.

"While these provide relief of symptoms, it is too late to reverse the damage which has already been caused.

"We know that if we are going to reduce the number of asthmatic patients, we need to tailor these drugs for use in young children, before the long term damage is done."

Immunologist Professor Pat Holt cited results from a Perth study which tracked asthma development in a group of 2,500 children over 10 years.

"Our research has shown that the most crucial factor in childhood is airway inflammation caused by virus infections, acting in combination with allergy," Professor Holt said.

"We have now proven that allergic sensitisation most commonly occurs in early childhood when the immune system us still maturing, and during this period it should be possible to therapeutically re educate the immune system to reverse this sensitisation process.

Professor Holt said that a range of new therapies to block allergy induced inflammation had been developed over the past decade but had only been tested on adults.

"Of course these drugs weren't very effective in adults where the chronic disease has already developed.  Our frustration is that, because of these results, they weren't tested on children where the evidence suggests they could be really effective in actually preventing asthma from developing."

"What we're advocating is that these new drugs that could prevent asthma are assessed in carefully controlled clinical trials in the right age groups."

Professor Sly said a major change in thinking is needed.

"The pharmaceutical industry which develops these drugs and the government regulators who administer pharmaceutical drug benefit schemes need to expand their thinking to look at prevention in children, not just treatment of symptoms.

"We and our colleagues in the US and Europe are appealing to both these groups to change their present policies, to take advantage of the recent advances in asthma research in children.

"Asthma prevention is not a pipe-dream, but a real possibility, and senior researchers throughout the world are united in their resolve to help achieve this goal."

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