Updated: May 22, 2019
Despite being an ‘old’ disease recognized since ancient times, asthma remains a highly prevalent condition around the world and now recognized to be quite heterogeneous in clinical symptoms, severity and outcomes. While new therapies targeting specific inflammatory pathways have become available in the last few years, not all patients qualify or will benefit from them. At its root, the underlying drivers of asthma remain not well understood, are likely multifactorial and vary between patients.
Nearly three years ago the CAARS study (Characterization of Adults for Asthma Research Studies) was initiated at the University of Michigan with the vision of building a research cohort of adults with and without asthma, to enable use of novel scientific approaches to understand asthma and allergy. To date, 120 patients have volunteered and participated in CAARS, representing the breadth of asthma severity and its heterogeneous clinical features. This number also includes representation of individuals with respiratory allergies but not asthma, as well as individuals with neither allergies or asthma, both important groups for scientific comparisons. In 2018 we launched MICROMAAP (“Microbiome Markers of Adult Asthma Phenotype”), a companion study in which individuals who participated in CAARS volunteer for one year of follow up to study seasonal variation in symptoms and biological markers, and whenever they experience a respiratory illness, an asthma exacerbation or a change in prescribed treatments. The goal is to follow 90-100 individuals over the next few years.
We express enormous gratitude to all the individuals who have volunteered their time to participate in these translational studies of asthma at the University of Michigan. It also takes time to build patient cohorts for research and to collect and generate data for analysis, the latter considerable for the types of methods we apply. I would like to highlight the dedicated efforts of the following members of my lab who spearhead this work: Nicole Schafer, Molly Cook, Lesa Begley, Jane Zhao and Dr. Ariangela Kozik,. Our focus has been on determining how differences between individuals in their microbiomes (airway and gut) impact clinical and biological features of asthma or allergy and the potential mechanisms by which this occurs. To tackle this requires a multi-pronged approach, in both laboratory and computational methods, supported by an inter-disciplinary team. Early results from some of this work have been presented to the scientific community. We are still actively recruiting and growing the CAARS and MICROMAAP cohorts and look forward to sharing updates as we push onward.
Yvonne Huang, MD
Gut microbiome and asthma phenotype: pilot study
Recent perspective review of microbiome role in asthma