Asthma is a long-term lung condition that makes it hard to breathe. It affects more than 500 million people around the world and is especially common in children and older adults.
People with asthma often live normal lives most of the time, but many suddenly experience asthma attacks. These attacks can cause coughing, wheezing, chest tightness, and shortness of breath.
In severe cases, attacks can lead to hospital visits and even death. Because asthma attacks are unpredictable, doctors have long searched for reliable ways to identify which patients are most at risk before an attack happens.
A new international study by scientists from Mass General Brigham in the United States and Karolinska Institutet in Sweden offers an important breakthrough.
Their research, published in Nature Communications, shows that a specific pattern found in blood may help predict who is likely to suffer serious asthma attacks years in advance. This discovery could help doctors treat high-risk patients earlier and prevent life-threatening episodes.
To understand the study, it helps to know that our blood contains thousands of tiny chemical substances produced by the body. These substances reflect how our cells function and how our organs respond to disease. Scientists can now measure many of these chemicals at once using advanced laboratory techniques.
This field is known as metabolomics. Instead of looking at just one marker, metabolomics allows researchers to study a broad chemical fingerprint that shows what is happening inside the body.
The research team analyzed blood samples and medical records from more than 2,500 people with asthma across three large long-term studies.
These participants had been followed for many years, giving scientists detailed information about their asthma control and whether they later experienced attacks. The researchers focused on two important groups of blood chemicals: sphingolipids and steroids.
Sphingolipids are fatty molecules that play a role in inflammation and cell signaling. They help control how cells communicate and how the immune system reacts. Previous research has suggested that abnormal sphingolipid levels may be linked to lung inflammation in asthma.
Steroids, on the other hand, are natural hormones that help reduce inflammation. Many asthma treatments are based on steroid medicines because they calm the airways and prevent swelling.
The scientists discovered that it was not just the amount of these molecules that mattered, but the balance between them. When the level of sphingolipids was high compared to steroids, patients were much more likely to experience asthma attacks in the future. This balance, called the sphingolipid-to-steroid ratio, turned out to be a powerful warning signal.
The ratio predicted asthma attacks over a five-year period with about 90 percent accuracy. In some patients, the difference between high-risk and low-risk groups was so clear that attacks occurred almost a year earlier in the high-risk group.
This finding is important because current asthma care relies mainly on symptoms and lung function tests. These methods often miss hidden biological problems. Some patients appear stable but still carry a high risk of sudden worsening. A simple blood test that measures this chemical balance could help doctors identify these patients early.
The researchers believe this approach could be turned into a practical clinical test because measuring ratios is often more stable and reliable than measuring single molecules.
However, they also stress that more research is needed. The test must be confirmed in new patient groups and studied in real clinical settings to make sure it truly improves care and is affordable.
Overall, this study suggests that asthma attacks may be linked to deep biological changes in the body that can be detected long before symptoms worsen. By focusing on the balance between inflammation-related fats and natural anti-inflammatory hormones, scientists have found a promising way to foresee future risk.
If further research confirms these results, doctors may one day use a simple blood test to protect asthma patients from unexpected and dangerous attacks.
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