March 18, 2019
According to the National Institutes for Health, asthma is a chronic lung disease affecting more than 300 million people worldwide—25 million in the U.S. alone, including 7 million children. Because it inflames and narrows the airways, the disease significantly affects quality of life, causing recurring periods of wheezing, chest tightness, shortness of breath and coughing.
The incidence of asthma is rising as more Americans subsist on high-fat, low-fiber diets, especially in low-income urban populations where air quality is also an issue, and as a result, health disparities are widening based on socioeconomic status. In fact, experts predict 100 million new asthma diagnoses worldwide by the year 2025.
With funding through a $100,000 grant award from the Flinn Foundation under its Translational Research in Precision Medicine Seed Grant Initiative, Emily Cope, NAU assistant professor of microbiology and assistant director of the Pathogen and Microbiome Institute, is working on a novel therapeutic for asthma. Although there is no cure for this complex disease, Cope recently launched a two-year clinical study to determine whether adding low-cost prebiotic soluble fiber supplements to a patient’s diet can help improve asthma symptoms. Her theory is that as a patient’s gut microbes metabolize the supplements, the resulting increase in short-chain fatty acids (SCFAs) will reduce airway inflammation, alleviating symptoms and improving quality of life.
Previous studies have shown a surprising connection between dysfunction of the gut, or gastrointestinal microbiome, the regulation of immune function and the development of pulmonary diseases such as asthma.
“Emerging evidence indicates that there is great potential in manipulating the gut microbiome-lung axis to treat airway diseases,” said Cope.
Because economically disadvantaged populations typically get less fiber in their diets for a variety of reasons, this health disparity is contributing to higher rates of asthma among these populations.
“Our study will lead to the development of safe, accessible therapeutics that will augment current treatment strategies to reduce asthma severity,” said Cope. “We think that this could be a low-cost dietary supplement that could improve the quality of life for these asthmatics and help achieve health equity.”
Clinical study to recruit patients from Phoenix Children’s Hospital
Collaborating with Mayo Clinic physicians Matthew Rank and Devyani Lal, Phoenix Children’s Hospital pediatric pulmonologist James Woodward, as well as with NAU associate professor Andy Koppisch, Cope’s clinical study will focus on a cohort of patients from the Severe Asthma Clinic at Phoenix Children’s Hospital. The team is recruiting 10-20 children, ages 6-17 years old, who are suffering from a specific type of airway inflammation from asthma. In this double-blind study, randomly assigned participants will ingest soluble corn fiber in a fruit-flavored beverage over a 4-week period, while others will ingest a placebo. The team will test blood, stool and nasal samples before and after the fiber intervention to measure the outcomes.
“The overall goal of our program is to improve asthma outcomes in children and adults suffering from this complex disease by manipulating the gut microbiome-lung axis,” said Cope. “Our study combines basic science with clinical asthma outcomes in a carefully selected cohort of asthmatic children. Our analysis of the changes in the gut microbiome during and after fiber supplementation will drive additional hypothesis-driven mechanistic studies to determine how SCFAs interact with mature and immature immune cells leading to reduced inflammation in the lung, and whether baseline gut microbial communities relate to differential clinical outcomes toward the goal of personalized medicine.”
“The collaboration Dr. Cope is leading with colleagues at Mayo Clinic and Phoenix Children’s Hospital provides a compelling illustration of what the Flinn Foundation aims to accomplish with this translational-research initiative,” said Mary O’Reilly, Flinn Foundation Vice President, Bioscience Research Programs. “Here you have academic researchers and clinicians coming together to target in a new way a chronic disease affecting hundreds of millions of people. The potential benefit to Arizonans and the world is profound.”
SHERC pilot study laid the groundwork for this project
An earlier pilot study Cope conducted as part of the Southwest Health Equity Research Collaborative (SHERC) laid the groundwork for this Flinn Foundation project. Working with NAU associate professors Greg Caporaso and Andy Koppisch, Cope conducted tests on mice to see how the fiber supplements affected their airway inflammatory response.
“We’re hoping that in addition to the SHERC study, this current project will lead to a five-year National Institutes of Health RO1 grant,” said Cope. “This funding opportunity will also significantly contribute to establishing a clinical-translational research program between NAU and Mayo Clinic Scottsdale to address novel therapeutic strategies in children with airway inflammation.”