New research has made an important breakthrough that could lead to more effective treatments for the world’s 262 million asthma sufferers.
A study found severe asthmatics have a distinct metabolite profile detectable in their urine, compared to mild-to-moderate asthmatics and healthy individuals.
Researchers Dr. Stacey Reinke of Edith Cowan University, Australia, and Dr. Craig Wheelock of Karolinska Institute, Sweden, analyzed urine samples from more than 600 study participants across 11 countries as part of the U-BIOPRED study, a Europe-wide initiative to identify and better understand different sub-types of severe asthma.
“Asthma affects 2.7 million Australians and there were 417 asthma-related deaths in Australia in 2020,” said Dr. Reinke. “To identify and develop new treatment options, we first need to better understand the underlying mechanisms of the disease.”
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One way to do this is to examine the body’s chemical profile, or ‘metabolome’, which provides a snapshot of a person’s current physiological state and gives useful insight into disease processes.
“In this case, we were able to use the urinary metabolome of asthmatics to identify fundamental differences in energy metabolism that may represent a target for new interventions in asthma control,” Dr. Reinke said.
The research team discovered a specific type of metabolite, called carnitines, decreased in severe asthmatics. Carnitines play an important by the shuttling fatty acids into mitochondria for energy production. Deficiency is rare, and foods like beef, pork, cod, chicken, and milk easily provide the carnitine one needs.
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Further analyses found carnitine metabolism was lower in severe asthmatics. 20 different genetic defects involved in fatty-acid metabolism have been identified, some of which impact carnitine production.
These new findings will help enable researchers work towards new, more effective therapies for asthmatics, perhaps by investigating whether there is a link between severe-asthmatics and genetic defects related to carnitine. If so, special asthmatic carnitine supplementation could be an option.
Dr. Reinke said it can be difficult and invasive to investigate the lungs directly—but fortunately they contain a lot of blood vessels.
“Therefore, any biochemical changes in the lungs can enter the blood stream, and then be excreted through the urine,” she said. “These are preliminary results, but we will continue to investigate carnitine metabolism to evaluate its potential as a new asthma treatment target.”
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