Researchers at Mass General Brigham and the Karolinska Institutet have developed a blood test that can predict severe asthma attacks up to five years before they occur. The study, published in Nature Communications on January 15, 2026, identifies high-risk patients who may appear clinically stable.
The test measures the ratio of sphingolipids—fats involved in cell signaling and inflammation—to steroids, hormones that regulate the immune system. An elevated sphingolipid-to-steroid ratio acts as a molecular “early warning sign” for future flare-ups.
Using metabolomic data from over 2,500 participants across three large asthma cohorts, the test achieved approximately 90% accuracy in identifying high-risk patients. It could differentiate high- and low-risk groups nearly a full year before the first major attack.
Currently, doctors rely on symptoms and lung function tests, which often fail to catch underlying metabolic changes. “By measuring the balance between specific sphingolipids and steroids, we can identify high-risk patients… allowing clinicians to intervene before an attack occurs,” said lead researcher Jessica Lasky-Su of Mass General Brigham.
The test uses standard mass spectrometry techniques, making it both analytically robust and cost-effective. Researchers say it could be integrated into clinical practice once further validation is complete.
Next steps include prospective clinical trials to determine if treatment adjustments based on the test can prevent predicted attacks, cost-effectiveness studies, and regulatory approval from agencies such as the FDA.
Experts say this breakthrough represents a major advance in precision medicine, offering the potential to save lives and reduce emergency hospitalizations for asthma patients worldwide.
