Asthma is programmed early in life

An asthma sufferer is actually a patient before he or she even receives a diagnosis. This is the finding of a Danish research project which was recently published as an article in the influential scientific journal Science Translational Medicine.

The project is a collaboration between researchers at the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) at Herlev and Gentofte Hospitals and researchers from DTU Bioengineering, and they received funding from the Lundbeck Foundation, the Danish Ministry of Health and the Danish Council for Strategic Research, among others, for their work.

In a nutshell, the scientists designed a kind of risk model for asthma by studying blood samples taken from babies, explains Professor Hans Bisgaard, Head of COPSAC:

‘This model indicates that the disease is programmed early in life. Together with our colleagues from the Technical University of Denmark (DTU), we’ve demonstrated that particular changes in the immune systems of individuals who eventually develop asthma were already acquired during early childhood. Consequently, we can say that an asthmatic is already a patient at this early stage of life, even though the disease is not yet evident.’

Professor Bisgaard points out, however, that it is important to understand that this discovery is not a test that can be used on individuals:

‘We aren’t quite there yet. So, we can’t take a blood sample from a baby and, based on this, predict that this particular baby has an increased risk of developing asthma. The method isn’t that precise. But it can indicate asthma-related changes in the immune system when we study the blood samples taken from a large cohort of infants. This is what we’ve done – and we hope to be able to gain a better understanding of how asthma develops by looking more closely at these changes.’

Disruption of the immune system
The findings of the researchers from COPSAC and DTU are based on analyses of blood samples from 541 infants. All were around 18 months old when the sample was taken.

The samples – which, in the meantime, were stored in COPSAC’s freezer – were analysed when the children turned six. This meant that some of these children had developed either transient or persistent asthma during the intervening years.

When the researchers subjected the blood samples to a range of influences, e.g. from viruses and bacteria, in the laboratory, something very interesting happened. The researchers were able to identify certain signs of poor regulation of the immune system in the asthmatic children. This differed significantly from the reaction in the blood samples taken from children who had not developed asthma by the age of six.

Thus, the researchers were able to piece together a broad picture of how the immune system of a child predisposed to asthma reacts when threatened by bacteria or viruses.

This picture can also be described as an asthma risk profile, and it is so sensitive that it can differentiate between transient and persistent asthma.

Professor Bisgaard hopes, in time, to be able to develop similar risk profiles for a number of other diseases which, like asthma, are characterised by chronic inflammation:

‘For instance, diabetes, arthritis and inflammatory bowel syndrome. Our assumption is that, in some way or other, these disorders have a common origin. And we’d like to study this more closely.’

Facts
The blood samples included in the study were provided by the Copenhagen Prospective Studies of Asthma in Childhood (COPSAC). These are two major, long-term studies of asthma in Danish children. The first began in 2000 and the second in 2010.

The studies follow the children, their families and their daily lives and environment closely, from before birth until they reach the age of 18. COPSAC was founded by Professor Hans Bisgaard and receives funding from the Lundbeck Foundation.