Integrated Phenotypic and Endotypic Assessment: A Need for Precision Medicine in Asthma Management

Asthma is a long-term, persistent disease characterized by inflammation in the lower airways. Patients with asthma can be of any age, from young children to elderly people, and present with various clinical manifestations such as chest tightness, wheezing, coughing, and difficulty in breathing. Distinguishing these variations is essential for the personalized and adequate management of the disease. Based on the factors that trigger asthma attacks, the duration of the illness, or the prognosis, clinicians have worked to categorize asthma into various phenotypes. Different pathobiological mechanisms can lead to similar symptoms but might be applicable to different phenotypes. These apparent pathways are referred to as endotypes, which are introduced to understand the complex pathophysiological mechanisms of asthma. Endotypes can be Th2 high or Th2 low, depending on the level of Th2 cells involved in the pathogenesis of the disease. There is a need to discuss various clinical presentations of asthma in the form of "phenotypes" and its complex pathomechanisms represented as "endotypes." Here, in this article, we have reviewed some research articles and literature based on various observable and intrinsic characteristics related to asthma. The present status of asthma classification has been outlined to better understand the disease and its precision treatment.