Researchers Unveil Nasal Swab Test For Accurate Asthma Diagnosis In Children

Asthma remains the most common chronic condition among children, disproportionately affecting Black and Puerto Rican communities. Researchers at the University of Pittsburgh have introduced a revolutionary nasal swab test that simplifies diagnosing asthma endotypes, providing a safer alternative to invasive procedures like bronchoscopy.

Understanding Asthma Endotypes

Asthma is classified into “endotypes,” based on levels of inflammation in the body, to guide treatment options. The two primary categories are T2-high (high T2 inflammation) and T2-low (low T2 inflammation). T2-low asthma has been further subdivided into T17-high (high T17 inflammation, low T2 inflammation) and low-low (low levels of both T2 and T17 inflammation).

Accurate diagnosis of these endotypes is critical for tailoring effective treatments. However, traditional methods like bronchoscopy require general anesthesia, making them unsuitable for children, especially those with mild asthma. As a result, doctors often rely on less precise tools such as blood tests, lung function tests, and allergy checks.

Breakthrough in Asthma Testing

The newly developed nasal swab test addresses these limitations by providing a non-invasive, accurate way to identify asthma endotypes. This innovation holds particular promise for children from Puerto Rican and African American communities, who face the highest asthma rates and mortality risks.

The study, published in JAMA, analyzed nasal swabs from 459 children across three studies, focusing on eight genes associated with T2 and T17 inflammation. Results showed that:

• 23% to 29% of children had T2-high asthma,
• 35% to 47% had T17-high asthma,
• 30% to 38% had low-low asthma.

Implications for Treatment

While treatments for T2-high asthma already exist, therapies targeting T17-high and low-low asthma remain undeveloped. This nasal swab test could significantly accelerate research and therapeutic development for these underexplored asthma subtypes.

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