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Severe asthma phenotypes and endotypes.

Ioana Agache1

  • 1Transylvania University, Faculty of Medicine, Brasov, Romania.

Seminars in Immunology
|August 31, 2019
PubMed
Summary
This summary is machine-generated.

Current severe asthma management fails to reduce disease burden. Understanding disease endotypes, not just phenotypes, is key to developing precision medicine approaches for better treatment outcomes.

Keywords:
BiologicalsBiomarkersEndotypesPhenotypesPrecision medicineSevere asthma

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Area of Science:

  • Pulmonology
  • Immunology
  • Genetics

Background:

  • Current severe asthma management, using guidelines or phenotypes, has not reduced disease burden.
  • Severe asthma presents with diverse phenotypes (clinical, inflammatory, molecular, etc.).
  • Phenotypes often lack direct correlation with underlying pathogenetic mechanisms.

Purpose of the Study:

  • To explore the concept of multidimensional endotyping for severe asthma.
  • To identify new tools and targets for precision medicine in severe asthma.
  • To shift from stratified to precision medicine approaches.

Main Methods:

  • Review of current severe asthma management strategies.
  • Analysis of disease phenotypes and their relation to endotypes.
  • Discussion of immune-inflammatory pathways defining endotypes (Type 2 high/low, mixed).

Main Results:

  • Endotypes, based on immune-inflammatory pathways, offer insights into pathogenetic mechanisms.
  • Severe asthma includes Type 2 high, Type 2 low, and mixed endotypes.
  • Shared pathogenetic pathways include genetic, epigenetic, metabolic, and neurogenic factors.

Conclusions:

  • Multidimensional endotyping provides an unbiased approach to severe asthma.
  • Precision medicine requires a shift from phenotype-based to endotype-based treatment strategies.
  • New tools and targets are emerging to facilitate personalized severe asthma care.