For parents, managing childhood asthma can feel like an endless guessing game. Despite countless doctor visits and treatments, relief often seems elusive. But what if a simple, non-invasive nasal swab test could change everything?
A nasal swab developed by researchers at the University of Pittsburgh is making waves in asthma care. Unlike traditional tests, which often fail to pinpoint the exact asthma subtype, this swab identifies specific “endotypes”, paving the way for personalised treatment plans.
Asthma affects millions across Southeast Asia, disrupting daily life for children and adolescents with prevalence rates as high as 15%.
“Asthma is the most common chronic disease of childhood, so it’s essential that we develop new therapies to better treat these young patients,” said Dr. Juan Celedón, professor of paediatrics at the University of Pittsburgh.
Now, researchers at Pitt have developed a nasal swab test that identifies specific asthma subtypes, or endotypes.
“Because asthma is a highly variable disease with different endotypes, which are driven by different immune cells and respond differently to treatments, the first step toward better therapies is accurate diagnosis of endotype,” Celedón explained.
This test offers a clearer picture of the disease, allowing for tailored treatments, particularly for children with moderate or severe asthma who do not respond to standard therapies.
Asthma’s in Southeast Asia
Asthma affects millions across Southeast Asia, disrupting daily life for children and adolescents with prevalence rates as high as 15%.
“Asthma is the most common chronic disease of childhood, so it’s essential that we develop new therapies to better treat these young patients,” said Dr. Juan Celedón, professor of paediatrics at the University of Pittsburgh.
Its prevalence in Southeast Asia varies widely, reflecting differences in environmental conditions, healthcare access, and public health priorities.
Thailand reports some of the highest rates, with 14.6% of children aged 6–7 years and 12.5% of adolescents aged 13–14 years affected by asthma. Severe symptoms, such as frequent wheezing, are observed in 6.8% of young children and 5.8% of teenagers.
In Malaysia, prevalence ranges from 8-13%, depending on the region.
The Philippines has one of the highest asthma diagnosis rates in the region, with up to 15% of the population identified as asthmatic, according to varying reports.
Indonesia, the largest country in the region, reports asthma symptoms at varying rates. As of 2020, approximately 4.5% of Indonesia’s population, equating to over 12 million individuals, were affected by asthma.
By contrast, Singapore’s asthma prevalence stands at 11.9%, though it boasts advanced healthcare systems for managing the condition.
Challenges in Diagnosing Asthma Subtypes
While asthma affects millions, accurately diagnosing its subtypes remains a persistent challenge.
Traditional diagnostic methods, such as measuring nitric oxide levels in breath or conducting blood tests, often fail to differentiate between two major forms: T2-high and T2-low asthma.
Discussing the potential impact of this innovation in an interview, Celedón shared with NBC News,
“Instead of treating most people the same, in a few years, we can treat you better according to the type of asthma you have.”
The Promise of Nasal Swab Testing for Asthma
Unlike traditional methods, the nasal swab test can detect both T2-high and T2-low asthma. Researchers achieved this by sequencing genetic material to identify specific markers of inflammation associated with these subtypes.
Asthma isn’t a one-size-fits-all condition. Subtypes matter because they respond differently to treatments. T2-high asthma, characterised by elevated levels of eosinophilic inflammation, responds well to steroid-based inhalers.
T2-low asthma, in contrast, involves different inflammatory pathways, often linked to air pollution or other environmental triggers, and may require alternative therapies.
Yet, distinguishing between these forms has long been a challenge, especially in children.
“Tests allow us to presume whether a child has T2-high disease or not,” said Celedón. “But they are not 100% accurate, and they cannot tell us whether a child has T17-high or low-low disease. This gap motivated us to develop better approaches to improve the accuracy of asthma endotype diagnosis.”
The nasal swab test is quick, painless, and easy to administer – especially helpful for children who might dread blood draws or complex equipment for existing options.
This makes it especially valuable in resource-limited settings, where advanced diagnostic tools may not be readily available.
Potential Impact of the Nasal Swab Test in Southeast Asia
The introduction of a nasal swab for asthma diagnosis could significantly improve healthcare access in Southeast Asia. In many regions, asthma subtypes are underdiagnosed due to limited testing methods, leading to generalised treatments.
The simplicity of nasal swabs could make this test accessible in low-resource settings. Mobile labs and collaborations with local healthcare facilities could help bring it to rural areas, where asthma prevalence and care vary widely.
Limitations and Next Steps for the Nasal Swab Test
While the test shows promise, it is not yet widely available.
Dr. Jessica Hui, a paediatric allergist at National Jewish Health, highlighted the practical challenges of the test.
“It’s a very specialised type of analysis,” she said in the interview. “It’s not like this is something we can implement immediately, but for sure it’s an exciting direction.”
Cost is another significant barrier. Genetic sequencing remains expensive, raising concerns about the affordability and accessibility of the test for large-scale use.
More studies are also needed to validate its effectiveness in diverse populations and age groups across Southeast Asia. While current studies suggest effectiveness in distinguishing asthma subtypes, findings may not necessarily apply universally.
The Future of Asthma Care
Questions remain about how asthma subtypes evolve over time.
Does a child diagnosed with T2-high asthma remain in that category throughout their youth, or do environmental factors push them into a different subtype? Answering these questions will be crucial for determining the long-term reliability of the nasal swab test.
Despite these challenges, researchers are optimistic. The test has the potential to revolutionise asthma care, particularly for children who suffer from severe or mismanaged cases.
With further research and investment, it could become an essential tool in addressing the asthma burden across Southeast Asia.
