Author: Monica Kraft

There are an estimated 300,000 Americans who have ankylosing spondylitis (AS). This form of inflammatory arthritis commonly leads to a decline in the flexibility of the spine, as well as joint and back pain. Typically, it begins in early adulthood. 

It’s also a genetic condition that can be passed onto children.

Monica Kraft, formerly of Duke University and Arizona University, reports that many patients have chosen to participate in the National Institutes of Health’s All of Us Research Program. One day, the DNA from the blood that these patients submit may shed vital light on the way AS behaves — and could potentially lead to an effective treatment for future generations. 

The NIH is hoping to enroll 100,000 Wisconsin residents in the All of Us study. Announced in 2015, the All of Us initiative’s goal is to enroll 1 million people and collect as much health data as possible.

So far, roughly 500,000 have signed on to the program, the largest study of its type on precision medicine that also aims to diversify clinical trials to include a broader range of ages, sexes, and races.

While it may seem to be an ambitious plan, it already appears to be having notable results.

The History

Announced in 2015, the All of Us study began actively recruiting participants in 2018, and is expected to continue for at least a decade. All of Us will essentially be one of the largest and most diverse health databases ever created.

The data will be an essential resource to researchers who seek to uncover comprehensive knowledge about how the health of humans is impacted by everything from biology to the environment to lifestyle choices. 

This information could yield more effective treatment options for individuals who have a range of medical issues both small and large. Instead of a one-size-fits-all treatment plan, the goal is to establish precise medicine plans fueled by genetic data, tailored to every individual’s needs, even among those with the same type of condition.

Precision care takes into account not just personal habits and genes, but gender, age, and socioeconomic factors involved with medical conditions as well. 

The DNA data may also provide answers to longtime health disparities, such as why those of African descent are four times more likely to develop kidney failure than those of European descent.

How it Works 

The NIH has heavily promoted All of Us since its launch, having reached out to Americans directly via email or through its website. It also relies on industry partners throughout the country to recruit a range of people, including hospitals, researchers, and medical practitioners.

Anyone 18 or older is eligible to participate, and either blood or saliva samples are usually taken.

The whole genome sequences of volunteers are added to a database that is used by U.S. scientists who meet a rigid set of standards and requirements.

Many of those who have participated have already learned a lot about themselves, including genetic testing results, ancestral information, and their risk of inherited diseases caused by genetic variants.

Promising Early Results 

The All of Us study still has a long way to go to reach its goal, but what has been uncovered so far is fascinating.

These include important findings about the number of steps needed to help fight chronic diseases, as well as when COVID-19 infections may have first appeared in the United States. Higher education institutions involved in the study are receiving grants, such as the University of California-Davis’s $12.9 million grant focusing on precision nutrition to help prevent disease. 

Perhaps the most promising aspect of the All of Us Research Program is the fact that the participant’s future children and grandchildren may not ever have to experience certain genetic diseases, which is more than enough reason for AS sufferers to participate in the study.

Airway diseases, such as asthma and Chronic Obstructive Pulmonary Disease (COPD), are some of the most common conditions affecting millions of people worldwide. They can cause a range of symptoms, from shortness of breath, to wheezing and coughing, to difficulty breathing, or even pre-mature death. These diseases can significantly impact the quality of a person’s life, and can undermine their ability to enjoy everyday activities.

Unfortunately, airway diseases also put those afflicted at an increased risk of developing additional medical complications. In the following article, Monica Kraft, formerly of Duke University and the University of Arizona, current Chair and healthcare educator at the Department of Medicine and Icahn School of Medicine at Mount Sinai, discusses the role of the pulmonary system and how it is affected by airway diseases, as well as the most common pulmonary disorders, what happens when the pulmonary system is damaged, and how it can lead to serious medical complications.

The Role of the Pulmonary System

The pulmonary system is responsible for taking oxygen from the air we breathe and delivering it to our bloodstream. This oxygen is used by the body’s cells to perform necessary functions and keep us healthy. Within the pulmonary system, oxygen is dispersed throughout the body, allowing our organs to function properly.

What Happens When the System is Damaged

When the pulmonary system is damaged, it can no longer efficiently deliver oxygen to the body, which can lead to a large number of medical complications. These can include cardio-pulmonary problems, such as an increased risk of heart attack and stroke, or even issues with the immune system, limiting one’s ability to fight off infections. The decreased oxygen can also cause fatigue and shortness of breath.

Common Pulmonary Diseases

Asthma and COPD are two of the most common pulmonary diseases. Asthma is a chronic condition that causes inflammation, a narrowing of the airways, and is usually caused by environmental triggers such as dust, smoke, pet dander, or pollen.

COPD is a progressive lung disease that is caused by long-term exposure to irritants such as cigarette smoke, air pollution, and chemicals. Both can cause significant breathing difficulties and may become life-threatening if left untreated.

Those at High Risk

Those who are most at risk for developing airway diseases are people who are exposed to irritants in their environment, such as those who work in industrial or manufacturing settings, or those who live in areas with high levels of air pollution. Smokers (current and former), and those with a family history of pulmonary diseases are also more likely to develop airway diseases.

How to Prevent Pulmonary Disease from Progressing

The best way to prevent airway diseases from progressing is to avoid exposure to irritants, such as cigarette smoke and potential triggers, like dust, mold, or pet dander. It is also important to maintain a generally healthy lifestyle, as this can help to strengthen the immune system and reduce the risk of developing additional cardiac or pulmonary diseases.

For someone already suffering from an airway disease, it is important to follow a doctor’s instructions and use any medications prescribed to manage the symptoms. After all, airway diseases can have a major impact on a person’s quality of life, and can even lead to premature death.

The Bottom Line

Those struggling with pulmonary disease are at an increased risk of developing medical complications, such as cardio-pulmonary problems and a decreased ability to fight off infections. To reduce these risks, it is important to avoid exposure to irritants, maintain a healthy lifestyle, and get regular checkups to monitor medical conditions. By doing so, everyone can help to protect themselves and reduce the risk of developing additional, serious complications.

When it comes to allergies and asthma, there is often some confusion. Allergic rhinitis, more commonly known as hay fever, and asthma, a lung condition, are two of the most common allergic diseases. But given their common comorbidity, researchers have been exploring a link between the two. Monica Kraft, formerly of Duke University and the University of Arizona, and currently System Chair for the Department of Medicine at Mount Sinai Health System, physician scientists and healthcare educator at Icahn School of Medicine at Mount Sinai, states that the study’s findings suggest that one potentially leads to the other.

Asthma is a life-long condition that can impair daily functioning. If doctors can prevent its progression by identifying early risk factors, they could improve the lives of millions of people. The following article will explore the potential link between allergic rhinitis and asthma and explain how a better understanding of these two conditions could improve American healthcare.

Allergic Rhinitis

Allergic rhinitis is an allergic reaction to airborne particles such as pollen, dust, mold, and pet dander. It is more frequently referred to as hay fever, and is one of the most common forms of allergies. Symptoms include sneezing and nasal congestion. It can also cause itchy, watery eyes, fatigue, sinus pressure, and headaches. Allergic rhinitis is often a seasonal condition, but also has the potential to be a perennial illness, meaning it can occur during multiple seasons (commonly spring and fall) or even year-round.

Asthma

Asthma is a chronic condition that affects the airways, causing them to be inflamed and narrowed. Symptoms of asthma include coughing, wheezing, chest tightness, and shortness of breath. Asthma is usually an underlying condition, but it can be triggered by airborne allergens. Asthma can be a seasonal condition, be present year-round and also can develop suddenly. In some cases, asthma can be life-threatening, due to the severity of airway constriction.

The Connection

Studies have shown that allergic rhinitis can increase the risk of developing asthma.  Both conditions are caused by an reaction to environment to allergens, leading to airway inflammation of the upper and lower airways. If upper airway inflammation occurs early in life, it can lead to asthma over time and is known as the allergic march.

Who are Most at Risk

Individuals who have a family history of allergies or asthma are at greater risk for developing one or both conditions. Additionally, those who are often exposed to airborne allergens such as pollen or dust mites are also more likely to develop allergic rhinitis.

How to Prevent Allergic Rhinitis from Becoming Asthma

The best way to prevent allergic rhinitis from becoming asthma is to avoid exposure to allergens, particularly if there are risk factors for asthma including history of wheezing illnesses as a young child/infant, history of other allergic diseases such as eczema and family history of asthma. However, having certain pets in the home such as a dog can reduce the presentation of asthma. Additionally, medications such as antihistamines can be used to reduce the symptoms of allergic rhinitis, reducing the development of lower airway symptoms such as cough, wheeze or shortness of breath.

The Bottom Line

Allergic rhinitis and asthma are two of the most common allergic conditions in the United States. While they are not the same, both are caused by exuberant responses to allergens, and can be prevented by reducing exposure to allergens and taking appropriate preventative measures. By understanding the link between the two conditions, doctors can better identify high-risk individuals and provide them with the necessary treatments to prevent the progression to asthma.