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Clinical phenotypes of asthma.
1Department of Pulmonary Diseases, Leiden University Medical Center, The Netherlands. e.h.d.bel@lumc.nl
Current Opinion in Pulmonary Medicine
|January 30, 2004
Summary
Asthma presents diverse phenotypes, with distinct subtypes in children and adults. Precise phenotyping is crucial for understanding asthma
Area of Science:
- Pulmonology
- Genetics
- Immunology
Background:
- Asthma is a complex respiratory condition with varied clinical presentations.
- Phenotypic classification is essential for understanding asthma's underlying mechanisms and genetic associations.
- Existing classifications often rely on etiological factors or clinical severity.
Purpose of the Study:
- To review and define the current understanding of asthma phenotypes.
- To highlight the importance of precise phenotyping for genetic research and clinical management.
- To identify gaps in the classification of adult-onset asthma phenotypes.
Main Methods:
- Review of existing literature on asthma phenotypes.
- Analysis of current classification systems for childhood and adult asthma.
- Discussion of novel noninvasive techniques for assessing airway inflammation.
Main Results:
- Four well-defined asthma phenotypes exist in children: transient infant wheezing, toddler wheezing, IgE-mediated asthma, and late-onset childhood asthma.
- Adult asthma is broadly categorized into childhood-onset persistent asthma and adult-onset asthma.
- Adult-onset asthma phenotypes remain poorly defined, with significant overlap in classification criteria.
Conclusions:
- While IgE-mediated asthma is well-characterized, many other asthma phenotypes, particularly in adults, require further definition.
- Adult-onset asthma and noneosinophilic asthma represent significant, yet poorly understood, patient groups.
- Precise phenotyping is critical for identifying distinct genotypes, predicting treatment responses, and determining prognoses in asthma.