Category: Asthma Research and Studies

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Food Dye and Inflamation

Common food dye can trigger inflammatory processes, say university researchers

A recent university study funded by the Canadian Institutes of Health Research reflects that long-term consumption of Allura Red food dye can be a potential trigger of inflammatory bowel diseases (IBDs) and potentially other inflammatory diseases processes as well.

Researchers using experimental animal models of IBD found that continual exposure to Allura Red AC harms gut health and promotes inflammation. Researchers using experimental animal models of IBD found that continual exposure to Allura Red AC harms gut health and promotes inflammation.

‘This further understanding will benefit Asthmatics as well,’ said Alan Gray, Director at the World Asthma Foundation . The human gastrointestinal (GI) tract is home to a diverse ecosystem of microbes, known collectively as the microbiota. Among its many roles, the gut microbiota regulates the immune system and protects against harmful pathogens. In fact, the largest part of the immune system, the gut-associated lymphoid tissue, is found in the gut. This network of immune cells and tissues interacts closely with the gut microbiota, influencing inflammation throughout the body including the lungs.

The dye directly disrupts gut barrier function and increases the production of serotonin, a hormone/neurotransmitter found in the gut, which subsequently alters gut microbiota composition leading to increased susceptibility to colitis.

Khan said Allura Red (also called FD&C Red 40 and Food Red 17), is a common ingredient in candies, soft drinks, dairy products and some cereals. The dye is used to add colour and texture to foodstuffs, often to attract children.

The use of synthetic food dyes such as Allura Red has increased significantly over the last several decades, but there has been little earlier study of these dyes’ effects on gut health. Khan and his team published their findings in Nature Communications. Yun Han (Eric) Kwon, who recently completed PhD in Khan’s laboratory, is first author.

“This study demonstrates significant harmful effects of Allura Red on gut health and identifies gut serotonin as a critical factor mediating these effects. These findings have important implication in the prevention and management of gut inflammation,” said Khan, the study’s senior author, a professor of the Department of Pathology and Molecular Medicine and a principal investigator of Farncombe Family Digestive Health Research Institute.

“What we have found is striking and alarming, as this common synthetic food dye is a possible dietary trigger for IBDs. This research is a significant advance in alerting the public on the potential harms of food dyes that we consume daily,” he said.

“The literature suggests that the consumption of Allura Red also affects certain allergies, immune disorders and behavioural problems in children, such as attention deficit hyperactivity disorder.”

Khan said that IBDs are serious chronic inflammatory conditions of the human bowel that affect millions of people worldwide. While their exact causes are still not fully understood, studies have shown that dysregulated immune responses, genetic factors, gut microbiota imbalances, and environmental factors can trigger these conditions.

In recent years there has been significant progress in identifying susceptibility genes and understanding the role of the immune system and host microbiota in the pathogenesis of IBDs. However, similar advances in defining environmental risk factors have lagged, he said.

Khan said that environmental triggers for IBDs include the typical Western diet, which includes processed fats, red and processed meats, sugar and a lack of fibre. He added that the Western diet and processed food also includes large amounts of various additives and dyes.

He added that the study suggests a link between a commonly used food dye and IBDs and warrants further exploration between food dyes and IBDs at experimental, epidemiological and clinical levels.

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World Asthma Day Summary

On the day after World Asthma Day, May 3, 2022, we scanned the globe to find a statement that best sums up the current state of affairs regarding Asthma.

Kudos to tbe U.S National Institute of Environmental Health NIH Statement on World Asthma Day 2022: Toward Improved Asthma Care

Good enough of summary that we want to publish this in its entirety.

Asthma is a serious lung disease; causes chest tightness, wheezing, and coughing; can often be controlled with proper treatment.

Today (May 3, 2022) on World Asthma Day, the National Institutes of Health reaffirms its commitment to biomedical research aimed at preventing the onset of asthma, understanding its underlying causes, and improving the treatment of it. This chronic airway disease, which is characterized by periodic worsening of inflammation that can make it hard to breathe, affects more than 25 million people in the United States, including more than 5 million children. Left untreated, it can be life-threatening.

While scientists have made substantial progress in understanding asthma diagnosis, management, and treatment, therapies to permanently improve breathing for those who suffer from asthma remain elusive. Researchers around the globe are working steadily toward this goal while they seek to better understand and find new ways to manage the disease. They also are continuing research on the underlying causes of disparities in the incidence, care, and prevention of the disease. On the heels of recently updated management and treatment guidelines, researchers anticipate a brighter future for people living with asthma.

Three NIH institutes primarily support and conduct studies on asthma — the National Heart, Lung, and Blood Institute (NHLBI); the National Institute of Allergy and Infectious Diseases (NIAID); and the National Institute of Environmental Health Sciences (NIEHS). Other NIH Institutes and Centers also support and conduct asthma research. NIH scientists and grantees made important advances in understanding, treating, and managing asthma in 2021, which are briefly highlighted as follows:

Asthma and COVID-19

An NHLBI-funded study showed that during the pandemic, asthma attacks, also known as asthma exacerbations, significantly decreased in a large group of children and adolescents, compared to the year before the pandemic. The study also found that telehealth visits among these patients increased dramatically during this time. The study included nearly 4,000 participants aged 5-17 years with a prior diagnosis of asthma. Researchers believe a better understanding of the factors that contributed to these improved outcomes could lead to better asthma control in all children and adolescents, as researchers noted no racial or ethnic differences in health outcomes in this population.

A NIAID-funded study found that asthma does not increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19. This finding came from a six-month household survey of more than 4,000 children and adults conducted between May 2020 and February 2021.

Asthma Disparities

Researchers have known for decades that social determinants of health – conditions like housing, neighborhood, education, income, and healthcare access – can affect the quality of life and asthma-related health outcomes of people living with the disease. NIH scientists are now reporting new advances in understanding the relationship between social determinants of health and asthma.

Black and Hispanic children who live in low-income urban environments in the United States are at particularly high risk for asthma attacks. These children tend to be underrepresented in large trials of new biologic therapies for asthma.

In a recent NIAID-supported clinical trial, the monoclonal antibody mepolizumab decreased asthma attacks by 27% in Black and Hispanic children and adolescents who have a form of severe asthma, are prone to asthma attacks, and live in low-income urban neighborhoods.

In one study, NHLBI-funded investigators demonstrated the importance of housing interventions in improving the health of children with asthma. Poor quality housing is associated with a high level of asthma triggers – including mold, cockroach, mouse, and dust mite allergens – that can pose a health threat to children with asthma. The study showed the feasibility of using targeted interventions – including better pest management, improved ventilation, and moisture reduction – to achieve healthy housing. It showed that such interventions can result in reduced symptoms and hospitalizations due to asthma.

Environmental Exposures and Asthma

Researchers have known for years that asthma can be triggered by substances in the indoor and outdoor environment. New research shows that exposure to some asthma triggers might even occur before birth.

In an NIH-supported study that included grant support from NIEHS and the NHLBI, researchers reported that prenatal exposure to tiny air pollution particles significantly increased the risk for developing asthma in children. The study, which analyzed data from two different study cohorts, focused on a group of mothers and their children, mostly Black or Hispanic, in the Boston area who lived near major roadways with heavy traffic. It found that more than 18% of the children who were exposed to high levels of these so-called ultrafine particles in the womb developed asthma in their preschool years, compared to 7% of children overall in the United States.

An NIEHS clinical study will assess how environmental factors affect disease progression in non-smoking adults who have moderate or severe asthma. The study will focus on the microbiological and genetic factors associated with atopic asthma, also known as allergic asthma, which is triggered by pollen, dust mites, and other allergens. A better understanding of this data might lead to improved treatments for people with this type of asthma, researchers say.

Climate Change and Asthma

Studies have shown that climate change can increase air pollutants such as ground-level ozone, fine particulates, wildfire smoke, and dust, and that these pollutants can exacerbate asthma. Climate change can also affect the production, distribution, and severity of airborne allergens.

NIEHS, NHLBI, and other NIH institutes and centers are leading the NIH Climate Change and Health Initiative. This is a cross-cutting NIH effort to reduce health threats such as asthma that can develop or worsen because of climate change. The initiative will look at these threats across the lifespan and find ways to build health resilience in individuals, communities, and nations around the world. A strategic framework for the Initiative will help guide NIH investments in this area.

An NIEHS-funded study provides examples of how extreme weather events can affect asthma outcomes. For example, as heat waves and droughts become more frequent and prolonged, the risk of large wildfires will likely increase, resulting in poor air quality that makes it more difficult to control asthma. Other climate-change events can lead to longer and more intense pollen seasons, while mold and dampness in homes may cause asthma to develop or worsen preexisting cases.

About the National Institute of Allergy and Infectious Diseases (NIAID): NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.

About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit www.nhlbi.nih.gov. For additional information about NHLBI’s asthma resources, visit https://www.nhlbi.nih.gov/BreatheBetter.

About the National Institute of Environmental Health Sciences (NIEHS): NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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The World Asthma Foundation Announces Speakers for Microbiome First Summit

On this World Asthma Day, May 3, 2002, The Microbiome First – Pathway to Sustainable Healthcare Summit organization committee invites healthcare professionals, non-communicable disease community leaders, and stakeholders to participate in the inaugural Microbiome First Summit, a virtual event taking place online at MicrobiomeFirst.org this May, 17-19, 2022. FREE to participants.

For detailed information and to register, visit: https://microbiomefirst.org/

The event, Microbiome First – Pathway to Sustainable Healthcare Summit, kicks off the inaugural event underwritten and moderated by the
World Asthma Foundation (WAF), which is pleased to announce the
following speakers:

Event Keynote
RODNEY DIETERT, PHD
Cornell University Professor Emeritus
Ithaca, NY, USA
Author of The Human Superorganism.
Keynote: “Big Picture View of Our Tiny Microbes”

Researcher Sessions
MARIE-CLAIRE ARRIETA, PHD
Associate Professor, departments of Physiology, Pharmacology, and Pediatrics, University of Calgary
Calgary AB, CANADA
Session: “The early-life mycobiome in immune and metabolic development”

JAEYUN SUNG, PHD
Assistant Professor, Microbiome Program, Center for Individualized Medicine, Mayo Clinic.
Rochester, MN, USA
Session: “A predictive index for health status using species-level gut microbiome profiling”

KATRINE L. WHITESON, PHD
Assistant Professor, Molecular Biology and Biochemistry School of Biological Sciences
Associate Director, UCI Microbiome Initiative
Irvine, CA, USA
Session: “High-Fiber, Whole-Food Dietary Intervention Alters the Human Gut Microbiome but Not Fecal Short-Chain Fatty Acids”

LISA AZIZ-ZADEH, PHD
Cognitive neuroscientist; Expert in brain imaging, autism, body cognition
Associate Professor in the USC Chan Division of Occupational Science and Occupational Therapy
Los Angeles, CA, USA
Session: “Brain-Gut-Microbiome System: Pathways and Implications for Autism Spectrum Disorder”

MARTIN KRIEGEL, MD, PHD
Chief of Rheumatology and Clinical Immunology at University Hospital of Münster
GERMANY
Associate Professor Adjunct of Immunobiology at Yale School of Medicine.
Session: “Dietary Resistant Starch Effects on Gut Pathobiont Translocation and Systemic Autoimmunity”

ERICA & JUSTIN SONNENBURG, PHD
Senior research scientist and Associate Professor in the Department of Microbiology and Immunology at the Stanford University School of Medicine.
Palo Alto, CA, USA
Session: “Gut-microbiota-targeted diets modulate human immune status”

EMMA HAMILTON-WILLIAMS, PHD
Associate Professor
Principal Research Fellow
The University of Queensland Diamantina Institute
Faculty of Medicine
The University of Queensland
Translational Research Institute
Woolloongabba, QLD, AUSTRALIA
Session: “Metabolite-based Dietary Supplementation in Human Type 1 Diabetes is associated with Microbiota and Immune modulation”

ANDRES CUBILLOS-RUIZ, PHD
Scientist, Wyss Institute of Harvard University and Institute of Medical Engineering and Science at Massachusetts Institute of Technology
Cambridge, MA, USA
Session: “Protecting the Gut Microbiota from Antibiotics with Engineered Live Biotherapeutics”

EMERAN A MAYER, MD
Gastroenterologist, Neuroscientist, Distinguished Research Professor
Department of Medicine, UCLA David Geffen School of Medicine
Executive Director, G. Oppenheimer Center for Neurobiology of Stress and Resilience at UCLA
Founding Director, UCLA Brain Gut Microbiome Center.
Los Angeles, CA, USA
Session: “The Gut–Brain Axis and the Microbiome: Mechanisms and Clinical Implications”

BENOIT CHASSAING, PHD
Principal Investigator, Chassaing Lab
Associate professor, French National Institute of Health and Medical Research.
Paris, FRANCE
Session: “Ubiquitous food additive and microbiota and intestinal environment”

SEI WON LEE, MD, PHD
Associate Professor
College of Medicine, University of Ulsan
Department of Pulmonary and Critical Care, Asan Medical Center
Seoul, KOREA
Session: “The Therapeutic Application of Gut-Lung Axis in Chronic Respiratory Disease”

PATRICIA MACCHIAVERNI, PHD
Clinical and translational researcher
Research Fellow, The University of Western Australia
Perth, WA, AUSTRALIA
Honorary Research Associate, Telethon Kids Institute.
Session: “House Dust Mite Shedding in Human Milk: a Neglected Cause of Allergy Susceptibility?”

LIEKE VAN DEN ELSEN, PHD
Research Fellow, The University of Western Australia, Australia
Honorary Research Associate, Telethon Kids Institute.
Perth, WA, AUSTRALIA
Session: “Gut Microbiota by Breastfeeding: The Gateway to Allergy Prevention”

PAUL TURNER, PHD
Rachel Carson Professor of Ecology and Evolutionary Biology, Yale University
Microbiology faculty member, Yale School of Medicine.
New Haven, CT, USA
Session: “New Yale Center to Advance Phage Research, Understanding, Treatments, Training, Education”

ANDRES CUBILLOS- RUIZ, PHD
Scientist, Wyss Institute of Harvard University and Institute of Medical Engineering and Science of Massachusetts Institute of Technology MIT
Boston, MA, USA
Session: “Protecting the Gut Microbiota from Antibiotics with Engineered Live Biotherapeutics”

CLAUDIA S. MILLER, MD, MS
Emeritus Professor, Allergy/Immunology and Environmental Health University of Texas San Antonio, TX, USA
Session: “Toxicant-Induced Lost of Tolerance for Chemicals, Foods and Drugs: a Global Phenomenon”

Media Supporter Content
TONI HARTMAN
PRINCIPAL
Microbiome Courses
London, England UK
Session “Educating Parents About ‘Seeding And Feeding’ A Baby’s Microbiome”

Summit Details:

The goal of the Microbiome First – Sustainable Healthcare Summit is to
improve quality of life at reduced cost by addressing the microbiome
first, as recent research shows that all of these non-communicable diseases have a relationship to the microbiome.

For additional information visit https://microbiomefirst.org/ or on Twitter at @MicrobiomeFirst https://twitter.com/MicrobiomeFirst

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Bisphenol A or BPA in Pregnancy and Asthma Study

The Barcelona Institute for Global Health supported study concludes suggests that in utero BPA exposure may be associated with higher odds of asthma and wheeze among school-age girls.

Study Background

In utero, (before birth) exposure to bisphenols, widely used in consumer products, may alter lung development and increase the risk of respiratory morbidity in the offspring. However, evidence is scarce and mostly focused on bisphenol A (BPA) only.

Study Objectives

There is growing concern over the role of chemical pollutants on early life origins of respiratory diseases (Gascon et al., 2013, Vrijheid et al., 2016, Casas and Gascon, 2020, Abellan and Casas, 2021), specifically on bisphenols due to their large production worldwide (CHEMTrust, 2018) and its widespread exposure to human populations (Calafat et al., 2008, Haug et al., 2018). Bisphenol A (BPA) is the most commonly used bisphenol. It is present in polycarbonate plastics and epoxy resins, used in many consumer products, and diet is the main source of exposure (Liao and Kannan, 2013). In 2017, the European Chemical Agency considered BPA as a “substance of very high concern” (Calafat et al., 2008, Agency and Bisfenol, 2017). Consequently, BPA production is restricted in some countries, which has resulted in the emergence of substitutes such as bisphenol F (BPF) and bisphenol S (BPS), with suspected similar toxicity (Lehmler et al., 2018, Rochester and Bolden, 2015). Bisphenols can cross the placenta and are also found in breastmilk, which results in exposure to foetuses and newborns (Lee et al., 2018). To examine the associations of in utero exposure to BPA, bisphenol F (BPF), and bisphenol S (BPS) with asthma, wheeze, and lung function in school-age children, and whether these associations differ by sex.

Methods

We included 3,007 mother–child pairs from eight European birth cohorts. Bisphenol concentrations were determined in maternal urine samples collected during pregnancy (1999–2010). Between 7 and 11 years of age, current asthma and wheeze were assessed from questionnaires and lung function by spirometry. Wheezing patterns were constructed from questionnaires from early to mid-childhood. We performed adjusted random-effects meta-analysis on individual participant data.

In utero exposure to bisphenols, widely used in consumer products, may alter lung development and increase the risk of respiratory morbidity in the offspring. However, evidence is scarce and mostly focused on bisphenol A (BPA) only.

Study Objective

To examine the associations of in utero exposure to BPA, bisphenol F (BPF), and bisphenol S (BPS) with asthma, wheeze, and lung function in school-age children, and whether these associations differ by sex.

Results

Exposure to BPA was prevalent with 90% of maternal samples containing concentrations above detection limits. BPF and BPS were found in 27% and 49% of samples. In utero exposure to BPA was associated with higher odds of current asthma (OR = 1.13, 95% CI = 1.01, 1.27) and wheeze (OR = 1.14, 95% CI = 1.01, 1.30) (p-interaction sex = 0.01) among girls, but not with wheezing patterns nor lung function neither in overall nor among boys. We observed inconsistent associations of BPF and BPS with the respiratory outcomes assessed in overall and sex-stratified analyses.

Conclusion

This study suggests that in utero BPA exposure may be associated with higher odds of asthma and wheeze among school-age girl

According the U.S. National Institute of Health, Bisphenol A (BPA) is a chemical produced in large quantities for use primarily in the production of polycarbonate plastics. It is found in various products including shatterproof windows, eyewear, water bottles, and epoxy resins that coat some metal food cans, bottle tops, and water supply pipes.

How does BPA get into the body?

The primary source of exposure to BPA for most people is through the diet. While air, dust, and water are other possible sources of exposure, BPA in food and beverages accounts for the majority of daily human exposure.

Bisphenol A can leach into food from the protective internal epoxy resin coatings of canned foods and from consumer products such as polycarbonate tableware, food storage containers, water bottles, and baby bottles. The degree to which BPA leaches from polycarbonate bottles into liquid may depend more on the temperature of the liquid or bottle, than the age of the container. BPA can also be found in breast milk.

Why are people concerned about BPA?
One reason people may be concerned about BPA is because human exposure to BPA is widespread. The 2003-2004 National Health and Nutrition Examination Survey (NHANES III) conducted by the Centers for Disease Control and Prevention (CDC) found detectable levels of BPA in 93% of 2517 urine samples from people six years and older. The CDC NHANES data are considered representative of exposures in the United States. Another reason for concern, especially for parents, may be because some animal studies report effects in fetuses and newborns exposed to BPA.

If I am concerned, what can I do to prevent exposure to BPA?

Some animal studies suggest that infants and children may be the most vulnerable to the effects of BPA. Parents and caregivers can make the personal choice to reduce exposures of their infants and children to BPA:

  • Don’t microwave polycarbonate plastic food containers. Polycarbonate is strong and durable, but over time it may break down from over use at high temperatures.
    Plastic containers have recycle codes on the bottom. Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA.
  • Reduce your use of canned foods.
    When possible, opt for glass, porcelain or stainless steel containers, particularly for hot food or liquids.
  • Use baby bottles that are BPA free.

There is growing concern over the role of chemical pollutants on early life origins of respiratory diseases (Gascon et al., 2013, Vrijheid et al., 2016, Casas and Gascon, 2020, Abellan and Casas, 2021), specifically on bisphenols due to their large production worldwide (CHEMTrust, 2018) and its widespread exposure to human populations (Calafat et al., 2008, Haug et al., 2018). Bisphenol A (BPA) is the most commonly used bisphenol. It is present in polycarbonate plastics and epoxy resins, used in many consumer products, and diet is the main source of exposure (Liao and Kannan, 2013). In 2017, the European Chemical Agency considered BPA as a “substance of very high concern” (Calafat et al., 2008, Agency and Bisfenol, 2017). Consequently, BPA production is restricted in some countries, which has resulted in the emergence of substitutes such as bisphenol F (BPF) and bisphenol S (BPS), with suspected similar toxicity (Lehmler et al., 2018, Rochester and Bolden, 2015). Bisphenols can cross the placenta and are also found in breastmilk, which results in exposure to foetuses and newborns (Lee et al., 2018).

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Asthma and Environmental Fungi – interview with Marie-Claire Arrieta Ph.D.

World Asthma Foundation “Defeating Asthma Series uncovers New Hope for Asthma Managementant

Our understanding of Asthma and the way we treat it may soon be radically different from what currently exists, due to new research on the human microbiome and how the microbiome affects asthma.

In this interview with Marie-Claire Arrieta Ph.D, Assistant Professor Depts. of Physiology and Pharmacology & Pediatrics Cumming School of Medicine University of Calgary Health Research Innovation Centre, Calgary, Alberta, Canada we learn that:

  • A significant proportion of asthmatics have severe asthma that also cannot be controlled easily with the current treatments
  • The microbiome is not only bacteria just like other ecosystems. Not only bacteria but they’re mix including environmental fungi
  • The microbiome is full of viruses as well

Interview

World Asthma Foundation: Dr. Arrieta, what prompted your research in this area?

Dr. Arrieta: As you know, asthma has no known cures. A significant proportion of asthmatics have severe asthma that also cannot be controlled easily with the current treatments, so we’re trying to figure out ways of improving both the prevention and the potential therapies for asthma. We also know that asthma has become an epidemic disease in Canada. At least it’s quadrupled in incidence over only 30 years, and we know that it’s mainly environmental factors that are explaining or possibly explaining this really great increase in incidence for asthma.

We’ve come to learn in the past 10 years that the microbiome is implicated. The gut microbiome is this very large community of microbes that we all harbor in our inner guts. However, The vast majority of these studies of the microbiome and asthma have only included bacteria, including studies that I have participated in before. This only provides a part of the view of this vast variety of microbes that we know inhabit this microbial ecosystem.

The microbiome is not only bacteria just like other ecosystems. Not only bacteria but they’re mixed, and they definitely include fungi. We thought that studying the role of fungi would be important because molds and environmental fungi are quite common triggers of asthma attacks in asthmatics, also for people with allergies. This, we thought, may suggest that the fungi in the microbiome, that no one has been studying much before, may be involved in some of the immune education that happens early in life that may later in childhood lead to this uncontrolled inflammation in the airways towards environmental fungi, along with other environmental triggers of asthma. That’s why we wanted to look at fungi.

World Asthma Foundation: Excellent. Great study. I’m most impressed. What are some of the key findings?

Dr. Arrieta: We found by giving specific species or types of fungi and/or bacteria to mice, and we used a specific type of mouse known as the germ-free mouse. These are mice that are kept completely devoid of microbes, so they’re like a blank state that you can associate with microbes in a way that would allow you to then make good conclusions from the experiment.

We found that fungi have a very important role in the way the microbiome establishes early in life. When I say microbiome, now I mean a combination of both bacteria and fungi. We also found that fungi are sensed by the immune system differently than bacteria in a way that they seem to amplify the immune response. For example, we found that mice that were colonized only with fungi were more susceptible to asthma.

World Asthma Foundation: Interesting. Along with that, what were some of the other key findings?

Dr. Arrieta: The story’s definitely developing. This study was certainly a proof of concept, but based on this work as well as others that are starting to look at fungi too, we think that when fungi in the intestine of babies bloom, for example, during an antibiotic treatment, this may change the way the immune system responds to this microbiome that is now higher in proportion with certain fungi. This may also increase the susceptibility to those immune alterations that can later lead to asthma in certain people.

World Asthma Foundation: Interesting. I noticed that you mentioned several references to Candida albicans. How does that fit into the mix?

Dr. Arrieta: We don’t know yet. We chose Candida because it’s a very common yeast in our guts. Virtually everyone would have some candida in their bodies, not just in their guts, but it’s a very common inhabitant. Because of that, we wanted to use a species that was common. We found that Candida certainly can outgrow during antibiotic treatments. It may be one of the species implicated, but we’re not there yet. We’re now trying more species of fungi. In fact, we started a new set of experiments based on an infant clinical study that we just completed that showed us exactly which are the yeast and fungal species that bloom when babies are given antibiotics.

This was an interesting clinical study. We ran it at the emergency department of one of our children’s hospitals where we enrolled babies under six months of age, that for one reason or another had to take an antibiotic. This is a very common occurrence for infants. Then what we did was that we followed the microbiome during this antibiotic treatment, and we were able to identify the most common yeasts that seem to outgrow during the antibiotic treatment. We’re focusing on those, and surprisingly, Candida is not one of those all the time. It seems that, of course, Candida is there, but there’s other fungi that are able to outcompete other ones including Candida. Those are the ones that we’re focusing on now.

World Asthma Foundation: Thank you for that. By outcompete, the suggestion or the inference would be that the imbalance of fungi and bacteria are what’s causing the inflammation process?

Dr. Arrieta: That could be that case. That will be the next step, but as I said, the story is very much developing. I think we’re one of the first ones, but we’re not the only ones interested in studying the fungal component of the microbiome and how it relates to allergies and asthma. I think that in the next couple of years we’re going to learn a lot more.

World Asthma Foundation: Fair enough. What implications are there for asthma? Asthma rates are on the rise. What would you like asthmatics to know about your study?

Dr. Arrieta: For now, because the study is developing, I think what we know for sure is that the gut microbiome during early life is extremely important when it comes to, in general, immune development. Because asthma, of course, is an immune disease, these changes in the gut microbiome can certainly determine a baby’s risk to develop this disease, especially as we now understand in families that have a familial history of asthma as well.

What is important to asthmatics to know? There are certain lifestyle, changes, or behaviors that are now being recommended, including natural birth if, of course, is safe and possible, the use of breast milk over formula if it is possible. One of the things that we’re learning more about is that one of the ways to foster a healthy microbiome early in life is when babies start eating solid foods to make the diet as healthy as possible, the way nutritionists have been asking as to do so for decades now because this will foster a varied microbiome.

World Asthma Foundation: Good point. A fair amount of adult asthmatics suffer from fungal issues relative to lung inflammation and infection. Any thoughts on that?

Dr. Arrieta: There’s a couple of clinical studies, and I wish I remember from the top of my head the name of the drug exactly, that is being tested right now. I’m by no means, involved in this. I have just been reading it with great interest because it is an immune modulator. It’s a biological drug that targets some of the immune mechanisms that we now know recognize fungi. It’ll be really interesting to see now from the point of view of these patients, both children, and adults, that have fungal asthma, if this is really going to change their treatment options because as you know, those asthma tend to be more severe and harder to treat as well.

World Asthma Foundation: What would you like the scientific community to know about your research?

Dr. Arrieta: That within this revolution of studying that microbiome, I think we’re missing out by only focusing on bacteria. There’s a great deal that I have learned from my colleagues in microbial ecology. I am not an ecologist, but I started to partner up with them because of the methods and the concepts, and scientific frameworks that they used to study the microbiome. The microbiome is an ecosystem, and we have experts that have been studying ecosystems for decades before biomedical researchers started to study ecosystems. The inclusion of fungi, I think, will get us more answers. Also, the inclusion of other microorganisms that very few people, if any, are considering right now in the context of asthma research, which are viruses, very popular of course now because we’re under a pandemic. The microbiome is full of viruses and children experience many viral infections during the first year of life or the first two years of life. How does the immune system react to that? How does it get educated? I think that using a broader, more ecologically informed approach to study the microbiome is a lesson that I have learned over the years and I hope that others follow suit too.

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Gut and Lung Connection to Asthma – Rodney Dietert, PhD

In this fifth in a series of interviews with Rodney Dietert PhD, he talks about communication between the gut and lung. Dr. Dietert is Cornell University Professor Emeritus, Health Scientist Head of Translational Science + Education for SEED and the Author of the Human Super-Organism How the Microbiome is Revolutionizing the Pursuit of a Healthy Life we learn about:

* The Gut and lung communication and its relationship to Asthma

World Asthma Foundation “Defeating Asthma Series uncovers New Hope for Asthma Managementant

Asthmatics: Our understanding of Asthma and the way we treat it may soon be radically different from what currently exists, due to new research on the human microbiome and how the microbiome affects asthma.

Interview

World Asthma Foundation: Research into the Microbiome and its relationship to health has improved significantly in the last few years. For example, we now know about the relationship between the gut and health. We’ve also learned about communication between the gut and the lung and the impact on Asthma. Dr. Dietert, so there’s some crosstalk, right?

Video interview: Asthma Connection to Gut and Lung Cross Talk – Rodney Dietert, PhD

Dr. Dietert: Tremendous crosstalk, absolutely tremendous. You’re correct that if you’re looking at endpoints, something like risk of asthma or management of asthma, then you really, at a minimum, are going to focus both on the respiratory system microbiome and the gut microbiome. That’s not necessarily the exclusion of others but those two are really important. Just like the gut microbiome can affect the brain, it can affect behavior, mood. You don’t need lots of hardcore meds as an antidepressant when you’ve got the solution sitting right in your gut in terms of the microbiome.

With the respiratory system, you’ve got both the local microbes being extremely important but you have crosstalk, you have chemical interactions that are originating in the gut that are affecting the respiratory system as well.

World Asthma Foundation: Dr. Dietert, we certainly thank you for your time, all that you do for the microbiome and the community. Good afternoon, and thanks again.

Dr. Dietert: Well, and thank you for all you do with the World Asthma foundation, Bill. Pleasure.

To learn more about Dr. Dietert, go here.

Gut and Lung crosstalk interview with Rodney Dietert.
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Asthma and the Microbiome – Rodney Dietert PhD Interview

Defeating Asthma Series uncovers New Hope for Asthma Management

In this interview with Rodney Dietert, PhD Cornell University Professor Emeritus, Health Scientist Head of Translational Science + Education for SEED and the Author of the Human Super-Organism How the Microbiome is Revolutionizing the Pursuit of a Healthy Life we learn that we’re a superorganism and we are, by several measures, primarily microbial, living on a microbial planet.

Our understanding of Asthma and the way we treat it may soon be radically different from what currently exists, due to new research on the human microbiome and how the microbiome affects asthma.

Interview

World Asthma Foundation: What prompted your interest in this area?

Dr. Dietert: It was literally the result of a dream. Woke up in the middle of the night, I had been struggling to write a new paper. The paper was supposed to identify the single, most important thing that you could measure in a newborn baby that would be the best predictor of whether that baby’s life was filled with health or filled with disease. That’s a challenging but a worthwhile idea. What could you measure in a newborn baby? I was pretty sure I had the answer because I’d been working for decades on the developing immune system and it was something surrounding that.

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Dr. Dietert: I started to write the paper and it was a very frustrating, terrible effort. Got a couple of paragraphs down and very unconvincing and uninspired and so I went to bed and woke up in the middle of the night and had a magnificent dream, which I don’t really remember the details of but it’s like, “Wow, have I been dreaming? Wow, do I have this idea?” The idea was the best measurement you could have at that point in time with a newborn is the extent to which the baby has self-completed. By self-completed, I mean acquired a full microbiome from mom, dad, and the environment and that is critical. That’s what we’re supposed to be.

We’re a superorganism and we are, by several measures, primarily microbial, living on a microbial planet. The major life form on the planet are bacteria. Really anything that disrupts that completion, in my mind, is viewed as a type of birth defect. It’s a correctable birth defect but nevertheless, it’s like missing a limb or missing a different organ. To miss the seeding events, to miss the microbiome the baby is intended to have is an incredibly serious biological effect that has really serious health ramifications.

My wife helped me put together the scrambled ideas coming off a dream. We wrote the paper and that wound up really turning my career in a whole different direction because it was seen by some filmmakers who were making a wonderful documentary called Microbirth, and it won the Life Science Film Festival Award for 2014. In that documentary, I was able to explain this concept and why it was so critical for preventing essentially diseases like asthma or really reducing the risk dramatically.

That we had control of these risks, the risk for diabetes, for asthma, for psoriasis, for inflammatory bowel, for a whole host of diseases that were to some extent under more control to a greater degree than we had ever envisioned. The reason we had that opportunity was because there was a new biology that we as humans were not what we had been taught or at least what I was taught decades ago in school and what I taught at Cornell for a number of years. That we were quite different.

Once we’ve recognize that difference, then it changes everything. It changes how you approach diet, how you approach what a healthy life looks like, how you approach medicine, therapeutics, drug development, environmental chemicals. Everything changes. Really that’s been my path, to try and help chart and provide useful information on how we, as a superorganism, can lead a healthier life.

World Asthma Foundation: With that, Dr. Dietert, we certainly thank you for your time, all that you do for the microbiome, and the patient population in the community. With that, good afternoon, and thanks again.

Dr. Dietert: Well, and thank you for all you do with the World Asthma foundation, Bill. Pleasure.

World Asthma Foundation: Thank you so much.

 

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Asthma and the Microbiome – Justin L. Sonnenburg PhD Interview

Defeating Asthma Series uncovers New Hope for Asthma Management

In this interview with Justin L. Sonnenburg PhD, Associate Professor of Microbiology and Immunology at Stanford University, we learn diseases largely driven by inflammation and an altered immune system may benefit from taking our microbiome into account.

Our understanding of Asthma and the way we treat it may soon be radically different from what currently exists, due to new research on the human microbiome and how the microbiome affects asthma.

“Diseases largely driven by inflammation and an altered immune system. If we start to take our gut microbiota into account, as we live our life, as we make medical decisions, eat different foods and potentially even eventually reintroduce some of these lost microbes, how profound can the impact be on our health?” Justin L. Sonnenburg Ph.D

Interview

World Asthma Foundation: Dr. Justin L. Sonnenburg Associate Professor of Microbiology and Immunology at Stanford University, well known author, sought after speaker and an infectious disease investigator.

Dr. Sonnenburg’s interest includes the basic principles that govern interactions within the intestinal microbiota and between the microbiota and the host. To pursue these aims, they colonize germ-free (gnotobiotic) mice with simplified, model microbial communities, apply systems approaches (e.g. functional genomics), and use genetic tools for the host and microbes to gain mechanistic insight into emergent properties of the host-microbial super-organism.

World Asthma Foundation: Good afternoon, Dr. Sonnenburg, and thanks for agreeing to the interview.

Dr. Justin L. Sonnenburg: Great to be with you.

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World Asthma Foundation: Super. Asthmatics want to know some things you’ve written about the gut. We know for example that we need more fiber. We also know that we need to eat healthier, but for some of us, unfortunately, the gut for a variety of reasons is out of whack or disrupted. Some suggested the potential of Missing Microbes. The gut is a delicate ecosystem. The question that I have for you today is can we get some of those microbes back?

Dr. Justin L. Sonnenburg: I think that’s a key question. It’s very clear that we’ve done things during the process of industrialization and things that are associated with our modernized lifestyle now, antibiotics, highly processed food, C-sections, baby formula. There are a lot of things that have been associated with microbiome deterioration.

The question is when we lose microbes or change this malleable component of our biology, our gut microbiota, how meaningful is that for our biology? I think what’s really interesting and notable is that at the same time that our microbiome has been changing, we’ve seen this incredible rise in what we call Western diseases or non-communicable chronic diseases.

Diseases largely driven by inflammation and an altered immune system. I think that a big question is if we start to take our gut microbiota into account, as we live our life, as we make medical decisions, eat different foods and potentially even eventually reintroduce some of these lost microbes, how profound can the impact be on our health?

Can we greatly improve the status of our immune system? Potentially both preventing the onset of chronic diseases and maybe even helping to treat or reduce the severity of some of these diseases.

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Asthma and Indoor Air Pollution:

Key insights for Asthmatics:

  • Makes Asthma Worse
  • Significant Association with Exacerbations
  • Among this panel of relatively moderate to severe asthmatics, the respiratory irritants produced by several domestic combustion sources were associated with increased morbidity.
  • Although there is abundant clinical evidence of asthmatic responses to indoor aeroallergens, the symptomatic impacts of other common indoor air pollutants from gas stoves, fireplaces, and environmental tobacco smoke have been less well characterized. These combustion sources produce a complex mixture of pollutants, many of which are respiratory irritants.
  • Results of an analysis of associations between indoor pollution and several outcomes of respiratory morbidity in a population of adult asthmatics residing in the U.S. Denver, Colorado, metropolitan area. A panel of 164 asthmatics recorded in a daily diary the occurrence of several respiratory symptoms, nocturnal asthma, medication use, and restrictions in activity, as well as the use of gas stoves, wood stoves, or fireplaces, and exposure to environmental tobacco smoke.
  • Multiple logistic regression analysis suggests that the indoor sources of combustion have a statistically significant association with exacerbations of asthma. For example, after correcting for repeated measures and autocorrelation, the reported use of a gas stove was associated with moderate or worse shortness of breath (OR, 1.60; 95% CI, 1.11-2.32), moderate or worse cough (OR, 1.71; 95% CI, 0.97-3.01), nocturnal asthma (OR, 1.01; 95% CI, 0.91-1.13), and restrictions in activity (OR, 1.47; 95% CI, 1.0-2.16
  • The WAF Editorial Board wishes to thank and acknowledge B D Ostro 1 , M J Lipsett, J K Mann, M B Wiener, J Selner
    California Environmental Protection Agency, Berkeley for their contribution to Asthma education and research.
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Asthma and COVID-19 Update Study on Risk

Asthma does not appear to increase the risk or influence its severity, according to University study

Whats new

Rutgers researchers say further study is needed but those with the chronic respiratory disease don’t appear to be at a higher risk of getting extremely ill or dying from coronavirus.“Older age and conditions such as heart disease, high blood pressure, chronic obstructive pulmonary disease, diabetes and obesity are reported risk factors for the development and progression of COVID-19,” said Reynold A. Panettieri Jr., a pulmonary critical care physician and director of the Rutgers Institute for Translational Medicine and Science and co-author of a paper published in the Journal of Allergy and Clinical Immunology.

“However, people with asthma — even those with diminished lung function who are being treated to manage asthmatic inflammation — seem to be no worse affected by SARS-CoV-2 than a non-asthmatic person. There is limited data as to why this is the case — if it is physiological or a result of the treatment to manage the inflammation.”

Children and young adults with asthma suffer mainly from allergic inflammation, while older adults who experience the same type of airway inflammation can also suffer from eosinophilic asthma — a more severe form. In these cases, people experience abnormally high levels of a type of white blood cell that helps the body fight infection, which can cause inflammation in the airways, sinuses, nasal passages and lower respiratory tract, potentially making them more at risk for a serious case of COVID-19.

Further Study Needed

Panettieri discusses what we know about asthma and inflammation and the important questions that still need to be answered.

How might awareness of SARS-CoV-2 affect the health of people with asthma?
Since the news has focused our attention on the effects of COVID-19 on people in vulnerable populations, those with asthma may become hyper-vigilant about personal hygiene and social distancing. Social distancing could improve asthma control since people who are self-quarantined are also not as exposed to seasonal triggers that include allergens or respiratory viruses. There is also evidence that people are being more attentive to taking their asthma medication during the pandemic, which can contribute to overall health.

What effect might inhaled steroids have on COVID-19 outcomes?
Inhaled corticosteroids, which are commonly used to protect against asthma attacks, also may reduce the virus’s ability to establish an infection. However, studies have shown that steroids may decrease the body’s immune response and worsen the inflammatory response. Steroids also have been shown to delay the clearing of the SARS and MERS virus — similar to SARS-CoV-2 — from the respiratory tract and thus may worsen COVID-19 outcomes. Future studies should address whether inhaled steroids in patients with asthma or allergies increase or decrease the risks of SARS-CoV-2 infection, and whether these effects are different depending on the steroid type.

In what way does age play a role in how asthma patients react to exposure to the virus?
A person’s susceptibility to and severity of COVID-19 infection increases with age. However, since asthma sufferers tend to be younger than those with reported high-risk conditions, age-adjusted studies could help us better understand if age is a factor in explaining why asthma patients may not be at greater risk for infection.

Children and young adults with asthma suffer mainly from allergic inflammation, while older adults who experience the same type of airway inflammation can also suffer from eosinophilic asthma — a more severe form. In these cases, people experience abnormally high levels of a type of white blood cell that helps the body fight infection, which can cause inflammation in the airways, sinuses, nasal passages and lower respiratory tract, potentially making them more at risk for a serious case of COVID-19.

In addition, an enzyme attached to the cell membranes in the lungs, arteries, heart, kidney and intestines that has been shown to be an entry point for SARS-CoV-2 into cells is increased in response to the virus. This enzyme is also thought to be beneficial in clearing other respiratory viruses, especially in children. How this enzyme affects the ability of SARS-CoV-2 to infect people with asthma is still unclear.

How might conditions in addition to asthma affect a person’s risk of infection?
Asthma tends to be associated with far fewer other conditions than chronic obstructive pulmonary disease or cardiovascular disease. If SARS-CoV-2 is a disease that causes dysfunction in the cells that line blood vessels throughout the body, then diabetes, heart disease, obesity and other diseases associated with this condition may make people more susceptible to the virus than those who are asthmatic.

Important to know

However, older people with asthma who also have high blood pressure, diabetes or heart disease may have similar instances of COVID-19 as non-asthmatics with those conditions.