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Measuring inflammation in paediatric severe asthma: biomarkers in clinical practice

Amelia Licari1,2, Sara Manti3,2, Riccardo Castagnoli1

  • 1Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Breathe (Sheffield, England)
|June 5, 2020
PubMed

Insights

Identifying biomarkers for severe asthma in children is crucial for personalized treatment. Current non-invasive markers primarily detect type 2 inflammation, but non-type 2 asthma requires further research.

Area of Science:

  • Pediatric Pulmonology
  • Immunology
  • Biomarker Discovery

Background:

  • Severe asthma in children is heterogeneous, with diverse phenotypes and endotypes.
  • Personalized therapy requires identifying non-invasive biomarkers for treatment response prediction.
  • Current biomarkers mainly indicate type 2 inflammation, leaving non-type 2 asthma diagnosed by exclusion.

Purpose of the Study:

  • To review recent evidence on biomarkers for severe pediatric asthma.
  • To discuss the clinical implementation of these biomarkers for patient identification and treatment guidance.

Main Methods:

  • Literature review of current research on severe asthma biomarkers in children.
  • Analysis of non-invasive biomarkers reflecting airway inflammation (eosinophils, IgE, nitric oxide).
  • Discussion of clinical utility in guiding treatment decisions and patient stratification.

Main Results:

  • Established biomarkers like blood/sputum eosinophils, serum IgE, and exhaled nitric oxide are key indicators of type 2 inflammation.
  • The identification and understanding of biomarkers for non-type 2 asthma remain limited.
  • Clinical implementation strategies for existing biomarkers are discussed.

Conclusions:

  • Biomarkers are essential for managing heterogeneous severe asthma in children.
  • Further research is needed to identify reliable biomarkers for non-type 2 pediatric asthma.
  • Clinical practice can benefit from current biomarkers to guide personalized therapeutic approaches.

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