In addition, continually avoiding therapy until a child arrives at the ER can cause permanent changes to the airways. Some 20 years ago, University of Miami researchers were among the first to target the lining of the airways, the epithelium, for study instead. But it is the epithelium that brings on that response from stimuli, or 'triggers,' like respiratory infections, cold weather, cigarette smoke, auto exhaust, dust, and others. University of Miami researchers, in collaboration with William Abraham, Ph.D., professor of medicine, Tahir Ahmed, M.D., professor of medicine, and other faculty based at Mount Sinai Medical Center, are using different strategies to understand how the airway epithelium contributes to the clinical manifestations of asthma. Dr. Abraham has identified epithelium-damaging molecules, and Dr. Ahmed has discovered that heparin, a naturally occurring molecule in the body, has a protective effect in asthma.
Steroids work well in treating asthma, but they provide a sledgehammer approach to therapy.
If we can dissect this disease and target mechanisms that may not be working properly, we will one day have a better chance of having more directed treatment. In a properly working respiratory epithelium, hair-like filaments on the surface of epithelial cells, called cilia, beat in a synchronized fashion to carry 150 milliliters of mucous out of our lungs on a daily basis. The average person swallows it throughout each day without even knowing. But, for asthma sufferers, secretions are produced faster than cilia can move them out. This increased amount of mucus in the airways makes the breathing tubes even narrower and overwhelms the regular system for cleaning out the airways.