Researchers at Boston Children's Hospital are investigating whether early intervention with omalizumab (Xolair), an IgE-blocking medication, can prevent asthma in young children at high risk due to allergic conditions. The study, building on the Preventing Asthma in High Risk Kids (PARK) trial, aims to understand the long-term impact of early IgE blockade on asthma development.
The initial PARK study enrolled 200 wheezy 2- and 3-year-olds with heightened asthma risk, administering monthly injections of either omalizumab or a placebo for two years. Now, with a five-year grant from the NIH, the research team is following up with these children, now ages 6 and 7, to determine if the Xolair treatment effectively prevented the onset of asthma.
Molecular Analysis to Understand Treatment Response
In addition to clinical assessments, researchers are employing advanced molecular analyses to track antiviral and immunologic responses. "We want to understand how and why children respond to early interruption of the immune processes in the asthma march," says Wanda Phipatanakul, MD, lead researcher on the study. The study includes integrated systems biology, incorporating measures such as DNA methylation and RNA sequencing to identify changes in genetic and protein profiles within the children's airways.
The researchers hypothesize that children who respond to anti-IgE treatment may exhibit increased expression of genes related to the immune response to viruses, the structure of epithelial cells in the airways, and the integrity of the barrier between the airways and the external environment. "This has never been done," Phipatanakul notes, highlighting the novelty of the approach.
Identifying Biomarkers for Targeted Treatment
The study seeks to identify molecular differences between children who respond to Xolair and those who do not, potentially revealing biomarkers that could guide anti-IgE treatment in the future. "We expect to get insights on who will respond or not respond," Phipatanakul explains. Regardless of the trial's outcome, the research promises to enhance understanding of why some individuals develop asthma while others do not, potentially paving the way for more effective prevention strategies.
