Asthma breakthrough could prevent disease development

New asthma treatments, such as a dietary supplement, could be on the way, after scientists revealed the disease’s link to a molecule produced by gut bacteria.
 
The new research from Monash University found early exposure to antibiotics can trigger long-term susceptibility to asthma.
 
But its breakthrough came after scientists found a molecule, indole-3-propionic acid (IPA), which is crucial to asthma’s prevention.
 
Lead researcher Professor Ben Marsland said this molecule, produced by bacteria in a healthy gut, provides an explanation as to why the recurrent use of antibiotics increases the risk of asthma.
 
‘We know that recurrent use of antibiotics early in life disrupts a person’s healthy gut microbiota and increases the risk of allergies and asthma,’ he said.
 
‘We have discovered that a consequence of antibiotic treatment is the depletion of bacteria that produce IPA, thus reducing a key molecule that has the potential to prevent asthma.’
 
For the study, researchers worked with mice predisposed to develop asthma.
 
Ultimately, they discovered that when given antibiotics in early life, the mice were more susceptible to house dust mite-induced allergic airway inflammation which lasted into adulthood.
 
This susceptibility was maintained even after the gut microbiome and IPA levels returned to normal.
 
However, when the mice had their diet supplemented with the IPA molecule early in life, they were ‘effectively cured’ of developing asthma in adulthood.
 
Asthma continues to be a common diagnosis in Australia, with 10.8% of people having the disease and one-third of those using medication daily to treat it.
 
Between 2021–22, asthma deaths jumped 32%, with 467 asthma-related deaths recorded in Australia in 2022, up from 355 in 2021.
 
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, told newsGP she hopes one day, there will be a cure for asthma, and the Monash research makes that goal more achievable.
 
‘It’s quite exciting to think that they potentially know the mechanism as to why there is this relationship between antibiotics in early life and development of asthma,’ she said.
 
‘All the researchers are looking for this cure for asthma, and they are hopeful they will eventually find it.
 
‘Some people think looking for a cure for asthma is still aspirational, but I think it’s within reach, and in the meantime, we need to emphasise that asthma can be managed.’
 
Professor Marsland said the research highlights the importance of developing a stable gut microbiota.
 
‘Infants at high risk of allergies and asthma have been shown to have a disrupted and delayed maturation of the gut microbiome,’ he said.
 
‘The use of antibiotics in the first year of life can have the unintentional effect of reducing bacteria which promote health.
 
‘We now know from this research that antibiotics lead to reduced IPA, which we have found is critical early in life as our lung cells mature, making it a candidate for early life prevention of allergic airway inflammation.’
 
Dr Hancock said the research also highlights the importance of antibiotic stewardship, and the role GPs can play in this.
 
‘Some of the early exposure to antibiotics is in children who end up in neonatal intensive care or neonatal units who do get given antibiotics out of necessity, and then you’ve got the infants and young children who may be given antibiotics,’ she said.
 
‘While sometimes you do need them, we need to have good stewardship around use of antibiotics.’
 
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allergy antibiotic stewardship asthma asthma management gut bacteria indole-3-propionic acid