Take my Breath Away: Diagnosing Asthma’s Severity When Every Minute Counts
When I first came to the Colorado, the mountains captivated me. They looked so imposing, yet enchantingly beautiful at the same time. A few months later, some of my mountaineering friends convinced me to climb one of these enchantresses (known locally as “14’ers”). They picked an “easy” one because I had spent all my life at a few hundred feet above sea level near the Mississippi River.
We started out on a beautiful crisp fall morning. The sun had yet to rise and illuminate the aspen trees that were already turning a golden yellow. As we climbed higher, the aspen grew smaller and it got colder. As the air grew colder and thinner, I found myself having a difficult time breathing. I kept soldiering on, but the fight for breath was getting harder. According to one friend’s watch, I had made it about 13,700 feet before the struggle for breath grew too much. I had to retreat back to a more oxygen-rich environment. The mountain won this round.
There are individuals who experience the fight for breath every day. The cause of this fight is a condition known as asthma, which can vary greatly in its severity. Diagnosing the severity and determining the correct course of treatment is not always straightforward, quick or cheap (Israel & Reddel, 2017). If new diagnostic tests became available, could they speed up the process of determining asthma severity and thus identifying the best treatment?
An international team of researchers united to answer that very question (Rossios et al., 2017). They queried sputum (another name for phlegm) samples from patients with different degrees of asthma to look for changes in the patients’ transcriptomic (looking at all RNA levels) and proteomic (looking at all protein levels) profiles. The researchers successfully found changes in those profiles that provide new insights about the underpinnings of asthma severity and may even help expedite the diagnosis (Rossios et al., 2017).
These researchers took not just one small step, but one giant leap towards summiting Mt. Improved Diagnostics. Instead of focusing on just one biomarker and looking for its presence in samples provided by patients with different degrees of asthma severity, the researchers utilized technologies that could cast a broad net (Rossios et al., 2017). Using the SOMAscan assay, they could scan various molecular pathways simultaneously, see the differences and achieve a better understanding (Rossios et al., 2017).
The asthma researchers certainly share a great vantage point with others who use proteomics. Proteins, which are the end product of our genes, are responsible for how our bodies respond to the environment, disease, etc. Aside from responding to cues, rogue proteins can also be the cause of disease. By looking at how proteins interact with one another and the downstream effects of those interactions, the scientific community can better discern the onset of disease (Fessenden, 2017). By thinking deeply about the data, it will feasible to scale the enchantress, Mt. Improved Diagnostics, with greater ease and surer breath.
Fessenden, M. (2017). Protein maps chart the causes of disease. Nature, 549(7671), 293-295. doi:10.1038/549293a
Israel, E. & Reddel, H. K. (2017). Severe and difficult-to-treat asthma in adults. N Engl J Med, 377(10), 965-976. doi:10.1056/NEJMra1608969
Rossios, C., Pavlidis, S., Hoda, U., Kuo, C. H., Wiegman, C., Russell, K., . . . Unbiased Biomarkers for the Prediction of Respiratory Diseases Outcomes Consortia Project Team. (2017). Sputum transcriptomics reveal upregulation of IL-1 receptor family members in patients with severe asthma. J Allergy Clin Immunol. doi:10.1016/j.jaci.2017.02.045