The Nose Knows: Nasal Swab Detects Asthma Type in Kids

Researchers at the University of Pittsburgh have developed a groundbreaking test that could revolutionize how asthma is diagnosed and treated in children. Using a simple pediatric nasal swab, it is now possible to identify various subtypes or endotypes of asthma quickly and non-invasively. This innovative approach could enable doctors to prescribe more targeted therapies and foster the development of specific, personalized treatments for lesser-known asthma subtypes, ultimately improving the quality of life for children worldwide.

A Method to Improve Diagnosis

The study, published in JAMA, analyzed data from three independent studies conducted in the United States. The participants were Puerto Rican and African American children, who have higher risk of developing asthma and complications compared to non-Hispanic white peers.

“Chronic respiratory diseases are among the most common in children, particularly affecting African American and Puerto Rican communities. Therefore, it is crucial to develop new therapies to treat these young patients,” commented Dr. Juan Celedón, senior author of the research, M.D., Dr.P.H., professor of pediatrics at Pitt and chief of pulmonary medicine at UPMC Children’s Hospital of Pittsburgh. “Since asthma is a highly variable disease, the first step toward better care is an accurate diagnosis of the endotype.”

Until now, identifying asthma endotypes required invasive procedures such as bronchoscopy, performed under general anesthesia. This method is not feasible for children with mild asthma, forcing doctors to rely on indirect and less precise diagnostic tools.

An Innovative Solution

Celedón and his team collected nasal swab samples from 459 children participating in the studies, analyzing the expression of eight specific genes for the T2 and T17 endotypes. The results demonstrated that the nasal swab could accurately identify the various endotypes. Among the participants, 23-29% had a T2-high endotype, 35-47% had a T17-high endotype, and 30-38% had a low-low endotype.

Toward Personalized Therapies

While specific biological drugs are already available for severe T2-high asthma, there are currently no targeted treatments for the T17-high and low-low subtypes. “Thanks to this new test, we can begin research to develop therapies dedicated to the less-studied subtypes,” added Celedón.

In addition to improving diagnosis, the nasal swab could also enhance understanding of how asthma evolves during growth, particularly during puberty, when symptoms can change significantly.

A Positive Impact

“Having tools to identify the main biological pathways of asthma, especially in children from vulnerable communities, can transform therapeutic approaches and reduce disparities in care,” emphasized Dr. Gustavo Matute-Bello, M.D., acting director of the Division of Lung Diseases at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health (NIH).

Read the press release: The Nose Knows: Nasal Swab Detects Asthma Type in Kids