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Toward clinically applicable biomarkers for asthma: An EAACI position paper
Zuzana Diamant1,2,3, Susanne Vijverberg4, Kjell Alving5
1Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund, Sweden.
Allergy
|April 7, 2019
Summary
Asthma involves airway inflammation, with Type 2 inflammation being well-defined. This review examines biomarkers and targeted therapies for severe asthma, aiding diagnosis and personalized treatment strategies.
Area of Science:
- Pulmonology and Immunology
- Biomarker Research
- Pharmacology
Background:
- Asthma is characterized by airway inflammation, structural, and functional abnormalities, with heterogeneous expression across patient subtypes.
- Type 2 inflammation, marked by eosinophils and specific cytokines, is the most understood asthma endotype, present in both allergic and some non-allergic severe asthma cases.
- The origins of non-Type 2 asthma remain less clear, highlighting a gap in understanding asthma heterogeneity.
Purpose of the Study:
- To review current and novel inflammatory biomarkers for asthma diagnosis, treatment selection, and monitoring.
- To investigate the clinical applicability of various biomarker sampling methods, including point-of-care approaches.
- To discuss existing and emerging targeted therapies for severe asthma and their associated biomarkers.
Main Methods:
- Literature review of inflammatory biomarkers in asthma.
- Analysis of biomarker sampling techniques and their clinical utility.
- Examination of targeted therapies (biologicals, small molecules) for severe asthma.
- Discussion of the European Academy of Allergy & Clinical Immunology Task Force's role.
Main Results:
- Type 2 asthma is the best-defined endotype, but its presence in non-allergic severe asthma indicates complexity.
- Targeted therapies are increasingly used for severe asthma, necessitating effective biomarkers for patient stratification.
- Few inflammatory biomarkers are currently validated for widespread clinical use, emphasizing the need for further research.
Conclusions:
- Biomarkers are crucial for identifying patients who will benefit from targeted asthma therapies.
- Further validation of inflammatory biomarkers is essential for clinical application in diagnosing, treating, and monitoring severe asthma.
- The development and application of point-of-care biomarkers could significantly advance personalized asthma management.
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