# Pathophysiology of Voice Disorders due to Combination Inhaled Corticosteroids in Asthma

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2022 · $450,474

## Abstract

PROJECT SUMMARY/ABSTRACT
Over 40 million children and adults in the US suffer from chronic pulmonary diseases including asthma, chronic
bronchitis and obstructive pulmonary disease. Asthma alone accounts for 25 million cases, with prevalence
increasing by 10% each decade. Combination inhaled corticosteroids (ICs) are the treatment of choice for the
long-term management of breathing symptoms. Regrettably, ICs are also associated with voice disorders in up
to 50% of cases. These disorders become chronic, impair communication, and have significant adverse
occupational, financial, and psychosocial consequences. Given the prevalence of voice disorders associated
with combination ICs since chlorofluorocarbon-propelled inhalers were banned in 2008, compelling clinical
evidence necessitates a new research initiative to address this critical threat to public health.
The long-term goal of this research program is to prevent and cure voice disorders associated with
combination ICs across the lifespan. Children placed on inhalers face lifelong, possibly permanent
communication impairment. Determining the pathophysiology of IC-related voice disorders is the critical
next step to developing new voice-sparing asthma drugs. It is essential to determine the pathophysiology
of voice disorders associated with combination ICs, to treat, reverse, and prevent these voice changes. This
project accomplishes these objectives in 3 hypothesis-driven aims. Aim 1 determines structural laryngeal
biomarkers of IC use associated with voice disorders in children and adults with the 2 most common
phenotypes of asthma (high TH2 allergic and low TH2 primarily eosinophilic). Aim 2 quantifies voice disorder
onset and reversibility for ICs versus sham using an in vivo animal model. Aim 3 examines the pathogenesis of
IC-related voice disorders via examination of cytokines associated with inflammation (IL-1β, IL-6, TNF-α) from
animal true vocal folds and human false vocal folds. Collectively, these aims define the pathophysiology
associated with IC-related voice disorders, laying the foundation for voice disorder cure and prevention in this
population. This translational project will have immediate and significant clinical implications, making a
powerful and sustained impact in the field of communication disorders.

## Key facts

- **NIH application ID:** 10909470
- **Project number:** 7R01DC016269-06
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Julie M Barkmeier-Kraemer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $450,474
- **Award type:** 7
- **Project period:** 2018-05-14 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909470

## Citation

> US National Institutes of Health, RePORTER application 10909470, Pathophysiology of Voice Disorders due to Combination Inhaled Corticosteroids in Asthma (7R01DC016269-06). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10909470. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*