Researchers at McMaster and Western universities are developing a new way for Canadians with severe asthma, in which an innovative lung imaging method provides a full picture of their disease, so their doctors can find the treatment that works best for them and helps them breathe easier.

Grace Parraga, PhD, and her research team have developed Magnetic Resonance Imaging (MRI) measurements of the asthmatic airways that show exactly where air moves into the lungs when a patient breathes, and more importantly, where the air cannot go when asthma is not optimally treated and symptoms are not controlled.

According to the Canadian Lung Association and Asthma Canada, asthma, a chronic airways disease, affects approximately three million Canadian adults and children and in 2016, 93% of Canadians with asthma reported they had poor control of their disease.

Two major lung airway abnormalities make it difficult for patients with asthma to breathe: airway inflammation and airway sensitivity to triggers related to airway smooth muscle dysfunction. These often occur together in patients, although sometimes patients have flares that are triggered or dominated by only one of these conditions.

"Canadians with asthma currently undergo tests that do not measure the independent and distinct contributions of airway inflammation and airway sensitivity to triggers that account for their symptoms and need for medication," said Parraga, Professor at Western's Schulich School of Medicine & Dentistry and Scientist at Robarts Research Institute.

Now, for the first time, imaging experts at Western – in collaboration with a team at McMaster University and St. Joseph's Healthcare Hamilton – are using two distinct measurements of mucus from the lungs in combination with MRI to quantify the different contributions of both airway inflammation and airway smooth muscle dysfunction in individual patients with severe asthma.

"It is quite important to identify these two separate components, particularly in patients with severe asthma, because the different abnormalities are treated with different therapies," said Dr. Parameswaran Nair, a Professor of Medicine at McMaster University.

"When MRI is used to directly measure and visualize the contributions of airway inflammation and smooth muscle abnormalities to asthma symptoms, as we did in this study, we can start to consider personalizing therapy for individual patients, which is very exciting because it holds the promise for much better quality of life for patients and lower health care costs," said Parraga.

The team is now embarking on studies to utilize this technology developed at Robarts to direct innovative therapies for patients with severe asthma. Lung MRI may help ensure that the right treatment can be delivered to the right asthma patient at the right time in order to abolish asthma symptoms and improve disease control.