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July 2, 2009

New institute leads asthma research and treatment

Asthma is one of the most common chronic diseases, affecting 10 percent of both children and adults nationwide. It is on the increase with nearly one million emergency department visits and 500,000 hospitalizations recorded yearly. While progress has been made in treatment, up to 20 percent of patients respond poorly to current medications. In Pennsylvania, emergency visits and hospitalization of children for asthma are well above the national average.

To address this growing health problem, the University of Pittsburgh, in cooperation with UPMC, has established the University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine. The institute is a joint venture of the departments of Medicine and Pediatrics.

“The institute’s goals are to increase the scientific understanding of asthma and related allergic diseases and to translate these findings into innovative approaches to treatment,” says Sally Wenzel, MD, director. Leading-edge treatments and advanced diagnostic technologies will bring novel therapies within reach of those who need them most, through programs run by the UPMC Comprehensive Lung Center, the Asthma and Allergic Diseases Clinical Research Center, the Pediatric Environmental Medicine Center, and other pediatric outpatient clinics.

Asthma Institute researchers explore fundamental questions about asthma to gain insights that will translate into improved treatment options and patient outcomes. A component of the institute is the Difficult Asthma Clinic for patients with severe asthma who continue to have uncontrolled symptoms and exacerbations. The clinic provides state-of-the-art approaches to evaluation, consultation, and care for patients with severe asthma who experience uncontrolled symptoms despite taking multiple medications. 

The institute and clinic bring a global approach to research and treatment through the combined efforts of scientists, clinicians, and educators across the disciplines of pulmonology, allergic diseases, gastroenterology, and otolaryngology. Patients receive extensive evaluation and advanced lung-function testing to definitively diagnose and differentiate asthma and upper airway problems. The institute serves a tertiary role, seeing complicated patient cases referred by other pulmonologists, allergists, as well as primary care physicians.

Asthma Institute specialists treat the frequent comorbidities associated with severe asthma, including assessment and treatment of chronic sinusitis, allergies, vocal cord dysfunction, reflux, and sleep apnea through its specific subspecialty partners. Personalized management strategies are developed by detailed evaluation of symptoms and disease. Asthma is an inflammatory disease, but in most practices, assessment of this inflammation is unavailable.

Patients at the institute are evaluated for the type of lung inflammation present through measurement of exhaled nitric oxide and lung eoeinophils. In certain cases, lung tissue evaluation also is recommended. A strong educational component supports patients with coping strategies, inhaler techniques, and environmental control measures. Bimonthly support groups reinforce treatment and healthy lifestyles.

“Patients have access to advanced diagnostic technologies and treatments, and have the opportunity to participate in a large selection of research studies that may offer hope to improve their quality of life through access to new medications,” says Dr. Wenzel.

From a research perspective, the institute serves as a repository of clinical, epidemiologic, biologic, and genetic data both cross-sectionally and longitudinally. Its goals are to encourage translational research, local environmental impact studies, and epidemiologic studies of asthma in the local community. It provides a forum for exchange among clinicians, scientists, and educators, with enhanced opportunities for grant funding through scientific interactions and an asthma data bank. The Asthma Institute also affords opportunity for the education and training of medical students, residents, and allergy-pulmonary fellows, as well as training for physician practices.

Improved clinical care will help to reduce the escalating costs of asthma treatment by reducing the number of emergency department visits and hospitalizations, and by making more tolerable the long-term consequences of asthma and its treatment. The Asthma Institute is positioned to become a national and international leader in asthma care and research, effectively delivering quality care while improving the understanding and treatment of the disease. 

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