Published: 04.03.08

Asthma is one of the most common diseases in western society, affecting one person in every five UK households. The million children in this country with asthma may suffer wheezing, coughing and breathlessness, causing many to miss out on school and play. The condition can be life threatening.

Now leading scientists from Brighton and Sussex Medical School and the University of Dundee have discovered a genetic change that doubles the risk of British children with asthma missing school from wheezy attacks or needing steroid tablets over a six-month period of study.

One in ten white British children have this gene change, putting them at greater risk of asthma attacks and increasing the pressure on the NHS.

The gene normally makes a protein called filaggrin which maintains an intact outer barrier against environmental allergens and toxins. However, the gene change cuts short the filaggrin protein at its root. This leads to a poorly functioning barrier in the skin, and possibly other parts of the body like the gut and the nose.

Children with this gene change may receive a greater 'dose' of allergens. Acute exposure to a higher 'dose' of allergens in the environment - whether peanuts or pollen - is already known to increase the risk of asthma attacks in vulnerable individuals.

A weak outer barrier resulting from the gene change may increase the likelihood of such attacks, particularly in those already sensitised to peanuts and other allergens. The weak barrier could let in greater 'doses' of allergen at times when allergen levels peak within the environment, provoking the attacks.

Research by Professor Somnath Mukhopadhyay (pictured right) could lead to help for these children. Further research is needed to test whether a simple gene check identifying those at risk focuses careful management on the vulnerable, reducing the likelihood of asthma attacks, thereby improving school attendance, preventing life-threatening situations and saving NHS resources by reducing emergency GP visits and hospital admissions.

It might be possible to improve skin barrier function with special creams and moisturisers, and such treatments targeted at those with the gene change at specific periods of allergen exposure could substantially reduce the 'dose' of allergens.

It is possible that gene therapy for such gene changes may eventually become available.

"Acute asthma attacks have a great impact both on a child's wellbeing and on NHS resources," says Professor Mukhopadhyay. "This exciting research could help focus treatment on the vulnerable, and even lead to novel treatments for this gene change becoming available. We'd like to make sure we can replicate these results in another area of the country, and I'm very keen to work with children and young people with asthma in Sussex - there is a high prevalence of asthma in children here."

The UK-wide research collaboration, e-published by Allergy, was led by Professor Somnath Mukhopadhyay of the Royal Alexandra Children's Hospital and the Brighton and Sussex Medical School, and Dr Colin Palmer and Professor Irwin McLean at the University of Dundee.