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Severe Asthma Phenotypes - How Should They Guide Evaluation and Treatment?
Anne M Fitzpatrick1, Wendy C Moore2
1Department of Pediatrics, Emory University, Atlanta, Ga.
Summary
Severe asthma exhibits significant patient heterogeneity. Identifying distinct clinical phenotypes is crucial for advancing precision medicine and tailoring treatments for better outcomes in severe asthma management.
Area of Science:
- Pulmonology
- Immunology
- Genetics
Background:
- Severe asthma is characterized by persistent symptoms and inflammation despite high-dose corticosteroid therapy.
- Significant phenotypic heterogeneity exists among patients with severe asthma, complicating treatment.
- Precision medicine approaches are needed but face practical challenges in severe asthma care.
Purpose of the Study:
- To review identified clinical severe asthma phenotypes.
- To explore associations between phenotypes, underlying endotypes, and biomarkers.
- To highlight knowledge gaps for implementing precision medicine in severe asthma.
Main Methods:
- Review of findings from the National Heart, Lung, and Blood Institute's Severe Asthma Research Program (SARP).
- Analysis of international research on clinical severe asthma phenotypes in adults and children.
- Synthesis of data on phenotype-endotype-biomarker relationships.
Main Results:
- Several distinct clinical severe asthma phenotypes have been identified in both adult and pediatric populations.
- These phenotypes offer a starting point for understanding disease heterogeneity.
- Understanding the link between phenotypes, endotypes, and treatment response is still developing.
Conclusions:
- Clinical phenotypes are valuable for initial severe asthma stratification.
- Further research is essential to connect phenotypes with underlying mechanisms and predict treatment responses.
- Bridging the gap between current understanding and clinical application is necessary for true precision medicine in severe asthma.
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