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A novel nasal swab test developed by the University of Pittsburgh allows for the diagnosis of specific asthma endotypes in children, providing new avenues for precise treatment.
This innovation enables more accurate diagnosis and personalized treatments for pediatric asthma, particularly for minority groups disproportionately affected by the disease.
The University of Pittsburgh has developed a nasal swab test that identifies specific asthma endotypes in children, a breakthrough covered in a recent JAMA publication. This tool, based on the expression of eight signature genes, enables a more precise classification into T2-high, T17-high, and low-low endotypes. Across three studies, the test accurately depicted these profiles, promising a leap forward in tailored asthma management. The technology addresses the need for non-invasive procedures compared to traditional bronchoscopy, offering a safer, more ethical approach for young patients. This advancement paves the way for targeted treatment development, especially for severe cases lacking specific medications.
459: The number of youth participants from whom nasal samples were collected in the study.
23-29%: The percentage of participants identified with the T2-high asthma endotype.
35-47%: The percentage of participants identified with the T17-high asthma endotype.
30-38%: The percentage of participants identified with the low-low asthma endotype.
After reading this article, healthcare professionals should be able to:
Identification of asthma endotypes is crucial for effective treatment.
Asthma is categorized into several endotypes, each requiring different treatment approaches.
Different immune pathways drive various asthma endotypes, necessitating tailored interventions.
Starting with the premise that asthma is a variable disease and each subtype reacts differently to treatment, understanding specific endotypes logically leads to improved management.
Researchers have long recognized that asthma is not a uniform disease; it manifests in various subtypes, known as endotypes. These endotypes are defined by specific immunological profiles and responses to treatment.
"Asthma is the most common chronic disease of childhood, and it disproportionately affects Black and Puerto Rican children, so it's essential that we develop new therapies to better treat these young patients," said Dr. Juan Celedón, professor of pediatrics at Pitt.
Dr. Celedón emphasizes the importance of refining treatment strategies to address asthma's heterogeneity, especially in populations with a higher burden of the disease. This necessity forms the basis for ongoing research efforts, including the recent development of the nasal swab test.
Nasal swab testing offers a non-invasive method to accurately identify asthma endotypes.
Nasal swab tests provide a safer, more accessible alternative to traditional diagnostic methods like bronchoscopy.
Traditional methods are invasive and not feasible for all pediatric patients, particularly those with milder symptoms.
The inconvenience and risks associated with bronchoscopy naturally cause practitioners to seek alternative diagnostic methods, such as nasal swabbing, which offer a less risky and equally effective approach.
Traditionally, asthma diagnosis required invasive procedures like bronchoscopy to obtain lung tissue for genetic analysis. This approach is impractical for children, particularly those with milder forms of the disease.
"Precise diagnosis of endotype usually involves genetic analysis of a lung tissue sample taken by a procedure called a bronchoscopy, which is done under general anesthesia," noted Dr. Celedón, highlighting the limitations of existing methods.
The new nasal swab test circumvents these issues by using a simple, non-invasive method to gather the necessary biological data. This innovation holds promise for a broader application in clinical settings, easing the diagnostic process for both patients and healthcare providers.
Accurate endotype identification may lead to tailored treatment development, benefiting patient outcomes.
Identifying specific asthma endotypes can drive the development of targeted therapies, improving treatment efficacy.
With clearer insights into the underlying mechanisms of different endotypes, new therapies can be more precisely developed and applied.
Observing successful identification of endotypes in a controlled study encourages broader application and development of similar methods in various treatment protocols, suggesting potential improvements in clinical outcomes.
The ability to accurately determine asthma endotypes has significant implications for treatment. While T2-high endotypes can be effectively managed with biologics, T17-high and low-low endotypes currently lack targeted treatments.
"Now that we have a simple nasal swab test to detect other endotypes, we can start to move the needle on developing biologics for T17-high and low-low disease," Dr. Celedón stated, indicating the future direction of asthma treatment.
By facilitating the development of treatments directly aimed at specific endotypes, this approach can significantly enhance the effectiveness of asthma management, offering a pathway to personalized medicine in this field. This advancement in diagnostics is anticipated to stimulate further research and innovation in treatment development.
Molin Yue, Kristina Gaietto, Yueh Ying Han, Franziska J. Rosser, Zhongli Xu, Christopher Qoyawayma, Erick Forno, Wei Chen, Edna Acosta-Perez, Glorisa Canino, & Juan C. Celedón. (2025). Transcriptomic profiles in nasal epithelium and asthma endotypes in youth. JAMA. https://doi.org/10.1001/jama.2024.22684
University of Pittsburgh. (2025). The nose knows: Nasal swab detects asthma type in kids. Medical Xpress. Retrieved January 3, 2025, from https://medicalxpress.com/news/2025-01-nose-nasal-swab-asthma-kids.html