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Published in CenterView on January 14, 2013
Irene Williams, both a patient and manager in the UMMC division of Clinical Immunology and Allergy, receives an exam from Dr. Gailen Marshall, professor and director of the division.
Irene Williams, both a patient and manager in the UMMC division of Clinical Immunology and Allergy, receives an exam from Dr. Gailen Marshall, professor and director of the division.

Allergy research could help lead way to asthma cure

By By Jack Mazurak

Despite rising asthma rates nationally, Dr. Gailen Marshall believes a cure could be less than a lifetime away.

With that landmark in the distance, Marshall, R. Faser Triplett Sr., M.D. Chair in Allergy and Immunology, is spurring on research as he pulls together pieces to found a center at UMMC.

“I believe we will find the cure for asthma in this generation or the next,” Marshall said.

The number of people with asthma in the U.S. shot up 4.3 million to nearly 25 million between 2001 and 2009, the Centers for Disease Control and Prevention found. That’s one in 12 people, up from one in 14.

“We know that stress, seasons, genetics, sleep quality, mental outlook, nutrition, exercise and obesity all affect asthma,” Marshall said.

Recent identification of different types of asthma, along with new knowledge of a wider field of asthma triggers and contributors, gives Marshall the confidence to predict the puzzle’s eventual solution.

Scientists soon could discover how to remove the immune system’s firing pin that sets off an asthma attack, he said.

In that scenario, all the asthma-causing apparatus could be in place – environment, stress, genetics and so on – but a yet-to-be-developed drug would intervene and prevent the attack from blossoming.

Marshall’s lab investigates how psychologic stress can affect asthma. He’s collected information on Hurricane Katrina survivors and people affected by the Gulf Coast oil spill.

Current clinical trials include one that considers whether vitamin D deficiency plays a role in asthma.

“We’re particularly interested in looking at vitamin D deficiency among African-Americans, a group that experiences asthma at higher rates than others,” Marshall said.

Another trial collaborates with the National Center for Natural Products Research at the University of Mississippi in examining a nutritional supplement called immulina.

“It helps the body’s antiviral response mechanisms. So we want to know if immulina can improve the elderly’s response to flu vaccines,” Marshall said.

RehmFor a separate study by Dr. Krissy Rehm, assistant professor of medicine, two Mississippi Blues Marathon runners gave blood and saliva samples and filled out questionnaires a couple of days ahead of the Jan. 5 race.

“We’re studying the effects of the stress of marathon training on the immune system,” Rehm said. “We’ve got about 30 runners, including blues marathoners and others in the New Orleans marathon next month.”

Law student Amanda Sturinolo, one of the study participants, said she felt a bit nervous so close to the marathon. Her blood will likely reveal higher cortisol levels than in previous samples, Rehm said.

After Rehm and her group add post-race samples, they’ll graph changes in various hormone levels, attitudes, health, stress and other factors through a several-month window spanning each person’s entire experience. The journal Neuroimmunomodulation recently accepted a paper on Rehm’s work.

In much of the division’s research, Marshall said, investigators also seek genetic biomarkers to identify who is most susceptible to stress.

“And in every situation we are interested to see how the person’s mindset affects asthma. Their outlook, their social circle, their spirituality each contributes,” he said.

Marshall hopes to apply for designation as an integrative medicine center this year. Center designation would raise the division’s clinical stature regionally and help in attracting larger federal and private research grants.

Organizationally, a center would include research, clinical treatment and training programs. Functionally, it would embrace integrative medicine, an approach to care that considers the interplay of a patient’s body, mind and spirit.

“You do whatever’s best for the patient, whether it is prescribing medicine, psychological or spiritual support,” Marshall said, pointing to the major correlation between major depressive disorders, anxiety and asthma as evidence of the mind-body connection.

Some people see their doctor, follow his or her instructions, come back and are not getting better.

“What we are seeing now is that they may be taking their medications as prescribed, but they need treatment of the underlying causes,” Marshall said. “We need to ask about their stress levels and lifestyles.”

And until researchers discover the cure, targeting the underlying contributors – whether stress, obesity, lack of exercise, environment, mental state, genetics or some combination of them – will remain at the forefront of asthma treatment.