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A University of Oxford team has been awarded a grant to study one of the major unsolved questions about asthma – why women are more likely to have it than men and why they are twice as likely to die from it.

Woman using asthma inhaler

Bioinformatician Dr Emanuele Marchi has received £98,000 from the national charity Asthma + Lung UK to analyse data that may shed light on why more women than men have asthma, why they experience significantly higher numbers of asthma attacks and why they are more likely to end up in hospital as a result.

Emanuele said: “This aspect of asthma – which disproportionately affects the life of women – has not been adequately studied, so we do not understand the biological factors that cause asthma to affect women differently. If we can understand this, we can look towards developing new treatments and a more personalised approach.”

The study team is supported by the NIHR Oxford Biomedical Research Centre (BRC).

Emanuele will examine data from 12 studies where samples were taken from the airways in the lungs, where the inflammation that causes asthma occurs. This data will be reanalysed with three questions in mind:

  • How does the inflammation of the airways in asthma differ between men and women, and how does this relate to hormone levels?
  • Which genes cause female forms of asthma?
  • Does the inflammation in women with asthma not respond as well to steroid treatment and why?

Dr Samantha Walker, Director of Research and Innovation at Asthma + Lung UK, said: “We don’t know why asthma is so much worse in women, so research like this is vital to work out how best to treat and prevent it. Currently, there isn’t enough research into why women are more likely to be hospitalised and die from asthma, as well as what treatments new and existing could help them.

“We’re delighted to be funding this work, which will help researchers understand the role of sex hormones in asthma and could help transform the lives of up to three million women with the condition in the UK, and the millions around the world. But much more investment is needed to prevent more lives being needlessly cut short.”

Victoria Sargent, aged 44 from North Oxfordshire, has taken part in asthma research, including a trial by the pharmaceuticals company Sanofi of its drug dupilumab, which is now used in the NHS to treat severe asthma.

Victoria has had asthma since she was 19, as a result of a chronic inflammatory disorder of the sinuses and lungs. Taking dupilumab, she says, has been a “life-changer”, and would not hesitate to take part in other clinical trials.

She welcomes the new study: “As a woman, I can only see this as a positive, thoughtful, future-facing move. Now that we know that asthma comes in many classifications and it’s either a symptom of another condition, as in my case, or the actual disease itself, maybe they’ll also find out that there are other factors, such as hormones, genetics or women’s physiology at play.

“The vast majority of medical studies don’t distinguish between men and women, and the male body is still thought of as the default. Men’s and women’s bodies are very different physiologically and if we’re not separating out our trials, then we are doing people a disservice by not recognising their different chemical balances and hormones. For me it’s the next logical step,” Victoria adds.

“Medicine should be preventative as much as possible. If we can treat asthma before it becomes too bad, and we know that women are more affected than men, that is going to help with managing medical resources down the line.”

The study’s Principal Investigator, Prof Timothy Hinks, Associate Professor of Respiratory Immunology at the University’s Nuffield Department of Medicine and a senior BRC respiratory researcher, said: “This work has the potential to define for the first time the changes underlying asthma specific to women. This will open new lines of enquiry for further scientific research. It may even allow us to identify new drug targets or new approaches to managing asthma.

“For our patients and their carers, increased understanding of the mechanisms of the disease will lead to an explanation for their lived experiences of asthma, and perhaps hope that in future specific and personalised treatments might be offered to them.”

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