Research underway at Riley Children’s Health aims to make personalized therapeutic approaches the norm when it comes to treating children with severe asthma.
Benjamin Gaston, MD, a pediatric pulmonologist and physician-scientist at Riley Children’s, is leading a five-year, $12 million program project grant (P01) from the National Heart, Lung and Blood Institute. The grant, Scientific Innovation for Personalized Severe Asthma Management, is one of the few pediatric pulmonology-based P01s in the nation.
Dr. Gaston is using the grant to fund three projects related to severe asthma: S-nitrosylation signaling, airway pH regulation and androgen signaling. The team, which includes investigators from Case Western Reserve University, has studied these mechanisms for more than a decade and has shown that they are not only indicators of the type of severe asthma a person has, but they are also potential targets for treatment.
“In personalized medicine lies the power to get it right the first time—to find the markers that will tell you which therapy will work so patients don’t waste time and money and risk all the side effects of using a medicine that’s not going to work well for them,” said Dr. Gaston. “The hope is that our current work will, in the not-too-distant future, enable us to use biomarkers and genetic information to determine if any of these three therapeutic arms is an ideal fit for the individual being tested.”
At Riley Children’s, the research builds upon a record of leadership in the management of severe asthma. The multidisciplinary High-Risk Asthma Program, the longest-running clinic of its kind in the nation, provides intensive outpatient management for children with severe and difficult-to-control asthma, including those with life-threatening asthma. In addition to improving asthma control for patients, the program has decreased hospitalizations and readmission rates. From 2015 to 2020, the High-Risk Asthma Program at Riley Children’s resulted in a 30% decrease in asthma readmissions and a 25% decrease in length of stay. In 2022, the readmission rate was just 0.92%, down from 1.09% a year earlier.
In addition, Riley Children’s participates in the NIH’s Precision Intervention for Severe Asthma (PrecISE) research network, the first-ever adaptive trial design in asthma. Riley Children’s is also a core member of the Severe Pediatric Asthma Consortium, established in the past five years to develop best practice guidelines and to cultivate asthma research initiatives.
Overall, the Riley Pulmonology program is involved in more than 145 IRB-approved/active clinical research projects and approximately 15 basic science asthma projects.
For more on this research, see the following publications
- JAMA Pediatrics: Asthma Risk Among Individuals with Androgen Receptor Deficiency
- European Respiratory Society: Effects of pH Alternation on Respiratory Syncytial Virus in Human Airway Epithelial Cells
- American Journal of Respiratory Cell and Molecular Biology: A Between-Sex Comparison of the Genomic Architecture of Asthma
- Molecular Cell: S-nitrosylation is Required for β2AR Desensitization and Experimental Asthma