Considering biomarkers in asthma disease severity

Area of Science:

• Pulmonology
• Immunology
• Biomarker Discovery

Background:

• Current asthma management relies on medication and symptom control, which inadequately identify patients at risk of adverse outcomes.
• Severe asthma often involves type-2 inflammation, suggesting the utility of specific biomarkers.
• Existing methods lack consistent accuracy, quantifiability, and reproducibility for risk stratification.

Purpose of the Study:

• To highlight the need for advanced biomarkers in asthma risk and treatment stratification.
• To explore the potential of type-2 inflammation markers for identifying severe asthma.
• To discuss the role of technological advancements and genetic factors in personalized asthma management.

Main Methods:

• Review of current literature on asthma biomarkers and endotyping.
• Identification of key type-2 inflammation markers (e.g., eosinophils, fractional exhaled nitric oxide, periostin).
• Exploration of advanced diagnostic technologies like component-resolved diagnostics and microarray technologies.
• Consideration of genetic predisposition and polygenic risk scores.

Main Results:

• Type-2 inflammation markers (airway/blood eosinophils, fractional exhaled nitric oxide) are crucial for severe asthma.
• A composite biomarker of blood eosinophils and fractional exhaled nitric oxide may improve severe attack prediction.
• Component-resolved diagnostics offer potential for severity assessment in sensitized patients.
• Genetic factors and environmental exposures may enhance prediction algorithms.

Conclusions:

• Asthma endotyping requires a dynamic understanding beyond static categories.
• Novel biomarkers and advanced diagnostics are essential for personalized asthma therapy and trajectory definition.
• Future research should focus on integrating molecular mechanisms, patient outcomes, and novel tools for precise asthma management.