Collaboration with South Korea tackles severe asthma through precision medicine

A new project based across the UK and South Korea is set to establish the use of precision medicine in the treatment of severe asthma.

The project is led by Professor Fan Chung of the National Heart and Lung Institute, and Professor Tae-Bum Kim at the University of Ulsan College of Medicine, Seoul. The researchers aim to identify the molecular phenotypes in UK and Korean cohorts that relate to severe asthma and to define the biomarkers that predict these phenotypes. The project also hopes to discover targets for future therapies to treat the different molecular phenotypes of severe asthma. The MRC, Korean Ministry of Science and ICT (MSIT) and the National Research Foundation of Korea (NRF) have joined forces to fund this new precision medicine consortium.

"Asthma is very common and we hope that the approach we are taking may be applied to all patients with asthma in the future, making current treatments more effective, and also helping to discover new ones” Professor Fan Chung

Asthma is a common lung condition and can cause serious breathing difficulties. Every day 185 people in the UK are admitted to hospital with an asthma attack, and 5.4 million people are using treatments for asthma. Severe asthma is the most serious, debilitating and life-threatening form of asthma. These patients struggle to control their symptoms or exacerbations with currently-available treatments. Severe asthma affects up to 5% of asthmatics who in the UK are managed in specialist severe asthma centres.

Professor Chung comments “This is the first time we are going to apply precision medicine to severe asthma. Asthma is very common and we hope that the approach we are taking may be applied to all patients with asthma in the future, making current treatments more effective, and also helping to discover new ones”.

Precision medicine is an approach that allows doctors to select treatments that are most likely to help patients based on an understanding of the genes and the environment that may be driving the disease. Currently we ask asthma patients about their symptoms and then treat them, but asthma is heterogeneous, meaning it varies from patient to patient. The new approach being investigated will enable doctors to use a more precise categorisation of patients with severe asthma – by defining the molecular phenotype of each patient using an analysis of genes and proteins. We know that asthma varies from patient to patient because their disease is driven by different mechanisms, and this new research aims to build on that understanding.

The goal of precision medicine is to ensure that the right patient gets the right treatment at the right time. It represents a powerful tool that focuses on identifying patients with distinct mechanisms of disease, or particular responses to treatments. It aims to move away from a one-size-fits all approach, in order to identify and develop treatments that are targeted at the individual. This research will build on previous work from the European U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Diseases Outcomes) study that identified several molecular phenotypes of severe asthma.

Professor Chung highlights that “the challenge is to introduce new research into clinical practice. All the phenotypes that we have described in U-BIOPRED  now need to be translated to  the  clinic”. The study will observe patients with severe asthma who attend three severe asthma centres (Royal Brompton Hospital, Nottingham University Hospital and  Leicester Glenfield Hospital ) over one year, during which the  patients will be phenotyped and their phenotype will be related to the outcome of their treatment. The team will also determine whether biomarkers measured in the exhaled breath can be a more convenient predictor of the different molecular phenotypes in the clinic.

The Korea-UK Precision Intervention in Severe Asthma (PRISM) Consortium is multidisciplinary, bringing together the expertise of biologists, biostatisticians, bioinformaticians, clinicians, managers and patients from both the UK and Korea.