The restrictions on research imposed for the COVID-19 pandemic prevented us from continuing recruitment and visits. Funding was not sufficient to continue the study.

The purpose of this study is to identify the causes of asthma that were not previously suspected, to better understand the effects of inhaled steroids on asthma and to identify new way to treat asthma.

In this study, we will explore mechanisms of exacerbation in asthma by careful characterization studies in asthmatics presenting in acute severe exacerbation. Specifically, we will determine the frequency of secretor status in these subjects by blood and saliva testing, and we will also perform a detailed cellular and biochemical analysis of their airway secretions. We will collect airway secretions using two methods. One method will be to have subjects cough sputum into a clean plastic container. The other method only applies to asthmatics with near-fatal asthma requiring intubation and mechanical ventilation. In these asthmatics, we will collect airway secretions by tracheal aspirate using methods normally applied in their clinical care.

Inclusion Criteria:

1. Male and female subjects with a history of asthma between the ages of 18 to 75 years.
2. Physician diagnosis of asthma.
3. Currently experiencing an acute exacerbation of asthma. This exacerbation may be severe necessitating treatment in the emergency room, ICU, or hospital ward.
4. Ability to provide informed consent.

Exclusion Criteria:

1. Lung disease other than asthma.
2. Females who are lactating or who are pregnant.
3. Use of recreational drugs in the 1 month preceding the study.

emergency deparment, admitted patients in the ICU and inpatient wards