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Hope for asthmatics in biochemical marker

What does wee reveal about the lungs? It’s not a question on everyone’s of mind but the answer could result in more effective treatment for the world’s 262 million asthma sufferers.

A study led by West Australians Stacey Reinke and Craig Wheelock of Sweden’s Karolinska Institute has found severe asthmatics have a distinct metabolite profile detectable in their urine.

It’s clear enough to distinguish them from mild-to-moderate asthma sufferers and those who do not have the respiratory condition.

The two researchers and their team analysed urine samples from more than 600 subjects in 11 countries as part of the U-BIOPRED study, a Europe-wide initiative to better understand sub-types of severe asthma.

They discovered that a specific type of metabolite called carnitine, which plays an important role in cellular energy generation and immune responses, decreases in severe asthmatics.

Further analyses confirmed carnitine metabolism is lower in the same group.

With 2.7 million Australians affected by asthma and 417 asthma-related deaths nationwide in 2020, Dr Reinke says the findings will help enable more effective therapies.

“Severe asthma occurs when someone’s asthma is uncontrolled, despite being treated with high levels of medication and/or multiple medications,” she said.

“To identify and develop new treatment options, we first need to better understand the underlying mechanisms.”

One method is to examine the body’s chemical profile, or metabolome, which provides a snapshot of a person’s current physiological state and gives useful insight into disease processes.

“In this case, we were able to use the urinary metabolome of asthmatics to identify fundamental differences in energy metabolism that may represent a target for new interventions,” Dr Reinke said.

She says while it can be difficult and invasive to investigate the lungs directly, they fortunately contain a lot of blood vessels.

“Therefore, any biochemical changes in the lungs can enter the bloodstream and then be excreted through the urine.”

“These are preliminary results but we will continue to investigate carnitine metabolism to evaluate its potential as a new asthma treatment target.”

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