Understanding asthma from the inside out

Head shot of Stavros Garantziotis, M.D.

Three NIH institutes fund asthma studies to improve treatment and learn more about what causes this widespread illness: the National Institute of Allergy and Infectious Diseases (NIAID); the National Heart, Lung, and Blood Institute (NHLBI); and the National Institute of Environmental Health Sciences (NIEHS).

NIH MedlinePlus magazine sat down with pulmonologist Stavros Garantziotis, M.D. to discuss one such study. He is a lead researcher on the Natural History of Asthma with Longitudinal Environmental Sampling (NHALES) trial. The trial is supported by NIEHS. Dr. Garantziotis and his team still need people to participate in this study, which is based in North Carolina.

What are the goals of the NHALES study?

There are two goals, both scientific and community-based. The scientific side is to try to understand the microbiome, or the microbial makeup of our environment and our bodies, and how that affects asthma activity. We gather samples from participants’ homes and their bodies, including phlegm, saliva, and stool samples. We are following asthma patients over a long period of time, five years at the minimum. These patients include those who have recurrent symptoms and have moderate to severe asthma. We offer free care and free medications for study participants. In that way, we can also give back to the community through the study.

How can patients tell if it’s just allergies or asthma?

There is certainly an overlap. The immune system response that causes you to have allergies plays a role in getting asthma. But while most patients with asthma have allergies, most patients with allergies don’t have asthma. The time to get worried is if you start feeling wheezy, have a cough, chest heaviness, or shortness of breath that prevents you from doing normal activities. These are signs that it is not just a simple allergy.

“The time to get worried is if you start feeling wheezy, have a cough, chest heaviness, or shortness of breath that prevents you from doing normal activities.”

– Stavros Garantziotis, M.D.

How do you suggest approaching potential triggers with children?

In terms of medication, you should use as much as necessary and as little as possible. When you can influence asthma symptoms by changing something in the environment that’s always the preferred way. Some scientists think that keeping our children’s environment too clean may prevent their immune system from learning to discriminate what is harmful and what is an innocent exposure. That may be a reason why allergies have become more common. I encourage my own children to play outdoors and that’s especially important when they’re young.

What should you do if you think you may have asthma?

Discuss your symptoms with a provider. Not every type of asthma needs intensive treatment.

We always try to improve asthma both by changing the immune response (through medications, diet, etc.) and by identifying and removing the environmental triggers that cause the immune response.

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