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Allergic Endotypes and Phenotypes of Asthma
Nicole Akar-Ghibril1, Thomas Casale2, Adnan Custovic3
1Division of Pediatric Allergy/Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
The Journal of Allergy and Clinical Immunology. in Practice
|February 11, 2020
Summary
Allergic asthma, the most common type, involves allergen sensitization causing airway inflammation. Treatments focus on environmental control, immunotherapy, and biologics targeting the TH2 pathway.
Area of Science:
- Immunology
- Pulmonology
- Allergy
Background:
- Allergic asthma is the most prevalent asthma phenotype, often starting in childhood.
- It is characterized by sensitization to aeroallergens, leading to airway inflammation and symptoms.
- This TH2-driven condition frequently co-occurs with atopic dermatitis and allergic rhinitis.
Purpose of the Study:
- To define allergic asthma and outline its key characteristics.
- To identify established and emerging biomarkers for allergic asthma diagnosis.
- To review current and novel therapeutic strategies for managing allergic asthma.
Main Methods:
- Literature review of allergic asthma pathophysiology, diagnosis, and treatment.
- Analysis of established biomarkers including IgE, skin prick tests, eosinophils, FeNO, and periostin.
- Evaluation of treatment modalities such as environmental control, immunotherapy, and biologics.
Main Results:
- Allergic asthma is a TH2-driven disease with diverse severity and persistence.
- Key biomarkers aid in distinguishing allergic asthma, reflecting sensitization and inflammation.
- Effective treatments include allergen avoidance, immunotherapy, corticosteroids, and targeted biologics.
Conclusions:
- Allergic asthma requires specific diagnostic approaches and management strategies.
- Biomarkers play a crucial role in patient stratification and treatment selection.
- Targeting the TH2 pathway with biologics offers a promising therapeutic avenue for severe allergic asthma.
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