Asthma severity and asthma control: symptoms, pulmonary function, and inflammatory markers

Area of Science:

• Pulmonary Medicine
• Clinical Research
• Respiratory Health

Background:

• Asthma severity and control are distinct but overlapping concepts.
• Severity reflects underlying disease without treatment; control reflects status with treatment.
• Current assessment parameters for both concepts significantly overlap.

Purpose of the Study:

• To review and discuss the concepts of asthma severity and control.
• To identify key parameters used in assessing asthma clinical status.
• To explore the evolution of multidimensional measures for asthma control.

Main Methods:

• A MEDLINE search was conducted from July 1, 2002, to June 30, 2003.
• Keywords related to asthma severity and asthma control were used.
• Relevant articles were selected for discussion.

Main Results:

• Asthma is a complex syndrome; no single parameter accurately classifies all patients.
• Accurate classification requires assessing multiple parameters: physiologic measures, symptoms, and activity limitations.
• Validated multidimensional measures for asthma control exist, incorporating symptoms, activity limitation, and rescue medication use, with varying inclusion of physiologic measures and biomarkers.

Conclusions:

• Current instruments reflect an improved understanding of the multidimensional approach to asthma control assessment.
• Debate continues regarding optimal assessment parameters for asthma control.
• The role of biomarkers in clinical asthma assessment remains an area of active investigation.