Page 22 - MEMOCiberes014-ENG

ASTHMA
Coordinator
Dr. Ma Victoria Del Pozo
Mechanisms underlying genesis and evolution of asthma
Asthma represents a major health problem throughout the world . There has been an epidemic increase in global prevalence of asthma in the last decades with an estimated 300 million people affected worldwide . This is particularly relevant in the developed industrialized world, which has noted a tremendous increase in the prevalence of asthma over the last 50 years . Asthma currently affects 8-12% of the population in the developed world . Patients affected by this disease are recognized to have a poorer quality of life, reduced
work productivity and school attendance and comorbidities associated . And, apart from individual suffering, because of their life-threatening of chronic course, these diseases present a high socioeconomic cost .
Asthma behaves as a spectrum of disorders initiated at different stages throughout life by a range of environmental factors interacting with a susceptible genetic background . At its simplest, asthma is divided into allergic (extrinsic) and no allergic (intrinsic) subtypes, but even within each of these 2 broad categories, there exists considerable heterogeneity with respect to underlying mechanisms, clinical and physiological manifestations, response to treatment, and natural history . The majority of asthma is associated with TH2- type T-lymphocyte-driven cell recruitment and mediator release involving mast cells, eosinophils, basophils, and macrophages that contribute to the chronic, subacute, and acute inflammatory responses .
During the last three decades an improved understanding of the pathophysiology underlying asthma, have led clinicians to shift their focus from managing acute attacks to achieving asthma control .
Severe asthma accounts for only 10% of patients with asthma, but it accounts for a considerable portion of the health care costs associated with the disease . Severe asthma patients are characterized by a poor quality of life, frequent hospitalisations and high risk of severe systemic side effects resulting from oral glucocorticoid therapy and/or high doses of inhaled glucocorticoids . All in all, these characteristics confer a relevant role to this group of patients when it comes to design a research programme aimed at achieving a better control of a disease that afflicts a progressively increasing number of patients .
Unmet needs in asthma are: The causes of the epidemic increase in asthma; Genetic susceptibility; The marginally understood interaction between environmental factors and immune system; Better subclassification of asthma: phenotypes; New agents acting on specific pathways in pathogenesis for the use as new therapeutic approaches; Better preclinical models for translation research; Better approaches in diagnosis and prediction of treatment responses and the monitoring of therapeutic effectiveness; Better tools to analysed complex data obtained; New and better biomarkers .
In our CRP project we will approach asthma as a trans-disciplinary research with expertise from clinical, epidemiological and biologist researchers to generate new therapeutic options based in a better diagnosis. In our integrative we will tackle immunological, genetic and environmental factors leading to complex asthma phenotypes in order to identify, describe and validate immunological and molecular networks involved in the genesis and evolution of asthma. To achieve our aims we propose to study retrospectively and prospectively two well defined cohorts .
22 CIBERES » Annual report 2014