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Eosinophil-Driven vs. Eosinophil-Associated Severe Asthma: Practical Implications for Target Treatment.
Valentina D'Aiuto1, Ilaria Mormile1, Francescopaolo Granata1
1Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy.
International Journal of Molecular Sciences
|February 26, 2025
Summary
Identifying severe asthma (SA) patient subtypes using biomarkers like eosinophil counts and FeNO is key. This approach optimizes biologic therapy selection for better asthma management.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Severe asthma (SA) affects 10% of asthma patients, often involving eosinophilic inflammation.
- Biological therapies improve SA control by reducing exacerbations and oral corticosteroid use.
- Accurate patient phenotyping and endotyping are crucial for effective SA treatment selection.
Purpose of the Study:
- To review the role of phenotyping and endotyping in severe asthma.
- To highlight the impact of eosinophilic inflammation on treatment decisions.
- To evaluate the use of combined biomarkers for selecting biological therapies.
Main Methods:
- Review of current literature on severe asthma biomarkers.
- Analysis of IgE, absolute blood eosinophil count, and FeNO in asthma classification.
- Framework for T2-high, T2-mild, and T2-low asthma categorization.
Main Results:
- Biomarker integration aids in classifying asthma inflammatory profiles.
- Combinatory biomarker models improve patient stratification for biologic therapy.
- Personalized treatment strategies are enhanced by unified biomarker approaches.
Conclusions:
- Phenotyping and endotyping are essential for guiding SA management.
- Eosinophilic inflammation and combined biomarkers are critical for optimizing biologic selection.
- Integrated biomarker strategies promise improved outcomes in severe asthma.
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