Asthma Heterogeneity: a heterogeneous disease with varying degrees of airway inflammation and variable response to treatment

Talk Overview

Asthma is a heterogeneous disease with varying degrees of airway inflammation and variable response to treatment with inhaled corticosteroids. Woodruff and Arron describe experiments to develop a biomarker to detect asthma subtypes and determine which patients are likely to benefit from anti-inflammatory treatments.

In the first of these lectures, Prescott Woodruff explains that while asthma may be episodic in nature, it is a chronic disorder characterized by airway hypersensitivity and bronchial inflammation. Although asthma is a heterogeneous disease, treatment is typically based upon clinical severity rather than the underlying molecular phenotype. Woodruff describes how he and Dr. Arron and their colleagues were able to distinguish two distinct groups of asthma patients, one of with higher levels of T helper 2 cytokines and one with lower levels, by measuring specific gene expression patterns. Patients with different levels of Th2 cytokines responded differently to inhaled steroid treatment. This finding suggests that developing biomarkers that could indicate whether patients were Th2-high or low would help guide anti-inflammatory treatment.

In the second lecture, Joe Arron reiterates the fact that asthma patients present with varying degrees of airway inflammation. Characterizing this heterogeneity objectively and consistently can be challenging. Arron describes how he and Woodruff, together with their collaborators, were able to determine that the serum level of a protein called periostin was a candidate predictive diagnostic biomarker for patients who might benefit from novel anti-inflammatory drugs including an IL13 inhibitor and an IgE inhibitor. Periostin is currently one of the biomarkers used to select patients for enrollment in clinical trials for two drugs candidates under development by Genentech.

Speaker Bio

Prescott Woodruff

Dr. Woodruff earned his MD from Columbia College of Physicians and Surgeons and completed his residency at Massachusetts General Hospital.  He did a research fellowship in respiratory epidemiology at Brigham and Women’s Hospital in Boston and also earned a Master’s of Public Health from Harvard University.  After completing a fellowship in pulmonary and critical care… Continue Reading

Joseph Arron

Dr. Arron was an undergraduate student at Princeton University. He earned his PhD from Rockefeller University and his MD from Weill Medical College of Cornell University. He was a post-doctoral fellow at Stanford University before joining Genentech in 2006.   At Genentech, Arron is a Senior Scientist and he directs a group investigating heterogeneity in… Continue Reading