Doctors have got the wrong culprit for asthma attacks

Doctors have been getting it wrong about the causes of asthma for years—and the discovery could change the way the problem is treated.

Medicine has worked on the idea that leukotrienes—inflammatory molecules that tighten airways and trigger breathing problems—are responsible for distressing asthma attacks. The chemicals are released by white blood cells when they are exposed to an allergen or irritation.

Now, researchers at Case Western Reserve University say those molecules may not be the primary cause after all; instead, molecules that look like leukotrienes could be responsible.  Although they cause the same inflammatory cascade that happens during an asthma attack, they are responding to a different mechanism—and this changes the way that asthma could be treated.

These ‘pseudo leukotrienes’ are created when free radicals add oxygen to lipids. Free radicals are highly reactive molecules that can cause damage if they are not controlled, and they are like a fire or an explosion, the researchers say.

People with asthma may have lower levels of enzymes and antioxidant molecules that normally neutralize free radicals.

Leukotrienes and pseudo leukotrienes trigger inflammation by binding to the same receptor, much like a key turning an ignition to start an engine. Once activated, this process leads to airway constriction in people with asthma.

Asthma medications work by blocking that receptor, preventing the key from fitting and stopping the reaction from starting, but the solution could lie in preventing the free radical process from starting in the first place.

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