Asthma inhaler may not work for many children, study shows

Those with gene variant and using inhaler daily 30% more likely to have asthma attack than those who do not.

The most commonly-prescribed asthma inhaler may not work for a significant proportion of children who use it to relieve their symptoms every day, a new study shows.

Researchers from the Universities of Brighton and Dundee have found that children with a particular gene change do not get the benefit they should from Salbutamol – the "blue" inhaler most often prescribed by GPs – which goes under the brand name Ventolin.

One million children have asthma. The researchers say that 100,000 of them may have the particular form of gene that prevents the inhaler working when used daily.

The authors of the study say that no child should stop using the inhaler, which works for many. But they say more research needs to be done to find out whether there are alternative treatments that will work better for those with the gene change – in which case genetic testing might become routine.

The research, led by Prof Somnath Mukhopadhyay at Brighton and Prof Colin Palmer at Dundee, involved nearly 1,200 children and is published in the Journal of Allergy and Clinical Immunology. It found that a specific change, called the Arg16 variant, in the gene that makes the body molecule that binds Salbutamol, may cause the medicine to be less effective as a reliever when used at least once a day. Salbutamol is used to relieve the symptoms of an asthma attack. Children are often on long-term medication as well.

Those who had the gene variant and used an inhaler daily were 30% more likely to have an asthma attack than those who did not. Those with a double copy of Arg16 were twice as likely not to respond to the drug.

Researchers said it was possible that the presence of this gene change in young people with asthma and who were taking Salbutamol frequently could be worsening their health and driving up healthcare costs.

Mukhopadhyay said: "Salbutamol via the blue inhaler is effective 'reliever' treatment in most children but it is common experience among doctors that a proportion of children do not seem to respond to this medicine as well as others.

"Some of these children could progress to develop asthma attacks with wheeze and cough that leads to days off school, visits to GPs, courses of oral steroids and, often, hospital admissions, despite the use of concurrent controller medication.

"Our study shows that common gene changes may predict the children with asthma who will have a worsening of symptoms with this commonly used medicine. We need to find out if alternative reliever medication will provide better asthma control in these children."

But he stressed that children should continue using the inhaler as their doctor has directed until more research has come up with alternatives. "Our work does not alter current consensus guidelines for the treatment of asthma," he said.

Palmer said the research was "just scratching the surface" of the move towards using genetic information to give people personalised medicine – the drugs that will work best for them. It is known that not all drugs work on all people.

"This study gives us a better understanding as to who is at risk of poor asthma control using these drugs," said Palmer. "However, this information is not useful if we do not have a better treatment for these children.

"We now need to determine if other medications might be more effective in the children with the Arg16 variant."


P.S. protect yourself naturally against asthma by eating lots of Vitamin C and Vitamin D rich foods and fruits.



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