A study found that coronavirus disease 2019 (COVID-19) occurring in the context of severe asthma poses risks both to the underlying chronic airway inflammation of bronchial asthma and to COVID-19–related disease conditions.

The research team of Professors Yong-Cheol Lee and Jae-Seok Jeong in the Department of Respiratory Allergy at Jeonbuk National University (JBNU) announced on the 2nd that they have, for the first time, elucidated the clinical and immunological impacts of COVID-19 occurring in patients with severe asthma.

The study was published in the latest online edition of Allergy (European Journal of Allergy and Clinical Immunology, 2021 Journal Impact Factor 14.710, ranked No. 1 in the allergy field).

Using the advanced biosafety containment animal facilities of the JBNU Institute for Molecular Biology and Genetics, the research team, together with Professor Seong-Guk Eo's team from the College of Veterinary Medicine, established the world's first experimental animal model of severe bronchial asthma with concurrent COVID-19 infection. They demonstrated that COVID-19 occurring in the context of severe asthma can exacerbate not only the chronic airway inflammation underlying bronchial asthma but also the inflammatory pathways related to COVID-19 disease.

In particular, using the experimental model and various advanced methods such as transcriptome analysis, the team proved that activation of the NLRP3 inflammasome — a key component of the innate immune system known to be important in the establishment of severe asthma — is a major mediator of poor COVID-19 outcomes in patients with severe asthma. They revalidated this finding through collaborative analyses of COVID-19 patient specimens, including samples from multiple countries and ethnicities, with Professor Wan-Kyu Kim's team at Ewha Womans University and Professor Gyu-Young Ko's team at KAIST.

Furthermore, in collaboration with Professor Jong-Seung Kim's team in the Department of Medical Informatics at the JBNU School of Medicine, the researchers ultimately confirmed these findings through analysis of a large national cohort provided by the National Health Insurance Service that included more than 100,000 individuals. During the journal's review process, the study was evaluated as a high-level evidence medical study and was selected for rapid online publication.

The academic community has also regarded the results as meaningful, confirming the critical importance of therapeutic development strategies that target regulation of components of the innate immune system. The study was evaluated as an important contribution that could lead to development of effective COVID-19 therapies for many patients worldwide living with severe asthma.

The research team of Professors Yong-Cheol Lee and Jae-Seok Jeong stated, 'We hope this research will greatly assist in the treatment of COVID-19 in patients with severe asthma. Through follow-up studies in collaboration with Professor Seong-Guk Eo's team at the JBNU College of Veterinary Medicine and the JBNU Institute for Molecular Biology and Genetics, we plan to carry out various forms of in-depth integrated airway disease research addressing a range of novel and reemerging respiratory virus infections in patients with refractory pulmonary diseases.'