Strange but true finding, animal airways have "taste buds" that allow them to react to exceedingly bitter substances -- causing the airways to relax, not unlike an asthma inhaler.  Dr. Susarla

Could a bitter compound give clues about asthma?

For a long time, scientists thought the taste receptors that signal sweet, bitter, or salty were found only in our taste buds. Then, things started to get weird.

Six years ago, researchers found taste receptors in the cells of the gut. Even more bizarre, scientists found them in cells that line the airway, and in the muscles that contract during an asthma attack. Basic scientific research began to suggest that bitter chemicals had potential as an asthma treatment. That is when Ronghua ZhuGe, a University of Massachusetts Medical School microbiologist, began to pay attention.

ZhuGe studies cell signaling involved in muscle function, a process that helps regulate blood pressure or airway constriction. He was intrigued when he read about experiments that showed that bitter compounds could cause those muscle cells to relax, pointing to a potential way to quell an asthma attack.

In that initial paper, the researchers called it a paradoxical result. They expected the bitter compounds would have the opposite effect, causing airway cells to contract. That would add to the problems patients experience in diseases caused by airway obstruction, such as asthma. But instead, bitter substances caused the cells to relax. ZhuGe decided to study how the compounds had that effect.

In a study published Tuesday in the journal PLOS Biology, ZhuGe and colleagues tease out the precise cellular mechanisms at work when bitter stuff, such as quinine and denatonium — ZhuGe says it is the most bitter compound that exists — are administered to those airway cells. The scientists took freshly procured muscle airway cells from mice and carefully figured out the complicated signaling that results in the relaxation of the cells. That is the goal with asthma medications, called bronchodilators.

“Definitely, we see a great potential to develop a new class of bronchodilators,” ZhuGe said. “When we compare how effective those compounds are to relax airways, we found we can relax them more completely compared” to existing treatments.

ZhuGe said the prospects are particularly exciting because there are so many bitter compounds that could be tried as potential new asthma treatments. The search will be guided, he hopes, by a more precise understanding of the mechanism at play when airway cells relax in response to a bitter stimulant.

But why did bitter taste receptors end up in our lungs in the first place? ZhuGe said his guess is it could be a protective mechanism; perhaps it is advantageous to have cells relax instead of contract when inhaling a bitter compound.

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Can Vitamin D Help Asthma?

This research study is one to follow, since it still is not clear if supplementing with vitamin D can help children with poorly controlled asthma if levels are low.  Dr Susarla

New Study Aims To Determine Relation Between Vitamins & Asthma

Previous studies show that lung function is worse in asthmatic children with a vitamin D deficiency, even when treated with inhaled steroids.

But the way these studies have been designed, only a link can be established — not cause and effect.

That’s why doctors at Allegheny General Hospital are taking part in a multi-center, randomized, placebo-controlled clinical trial in adults.

“This is actually your true best test to find a cause and effect relationship,” Dr, Deborah Gentile, an allergist at AGH, said.

Obesity, living in the city, and being African-American are common risk factors for both vitamin D deficiency and asthma.

So is it the vitamin D or some other factor that makes asthma harder to control? That’s what this clinical trial is designed to figure out.

Right now, they’re still screening for 12 participants to be randomly assigned to take 5,000 units of vitamin D daily or placebo.

To participate you must be 18 or older and have asthma and take controller medications, such as an inhaled steroid and still have symptoms several times a week.

You will not be eligible if you’ve smoked within the last year or if you already take high-dose vitamin D.

Aimee Fogarty is being screened today.

“My main things in the fall are ragweed, and dust mites are a killer for me. In the spring, it’s more grass,” she said.

Her inhaled steroids aren’t cutting it.

“They normally do, but right now, I’m having a little bit of a difficult time, and had to double the dose,” Fogarty said. “The taking of the steroids, I just don’t like it. It’s bothering me that I have to take a steroid to breathe better.”

People eligible for the study get a blood test for a vitamin D level, and breathing tests. Then, they are randomly assigned to a treatment group.

“Some will get placebo. Some will get vitamin D,” Dr. Gentile said.

For six months, lung function and symptoms will be closely watched.

“On the one hand, we may find it works, and it very inexpensively improves the outcomes in our patients. On the other hand, if it’s negative and we find out it doesn’t help, we know that it doesn’t help,” Dr. Gentile said.

“My whole family has it,” Fogarty said. “And if this can help people in any way, I’d like to be a part of it.”

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