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Biomarkers for selecting biologic therapies in asthma
Sergio E Chiarella1, Isabella Novoa-Caicedo2, Thanai Pongdee2
1Division of Allergic Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Therapeutic Advances in Respiratory Disease
|March 11, 2026
Summary
Biomarkers are crucial for selecting effective biologic therapies in asthma, moving beyond trial-and-error. Integrating established, emerging, and digital biomarkers, alongside socioeconomic factors, promises personalized asthma care and improved treatment outcomes.
Area of Science:
- Pulmonary Medicine
- Immunology
- Precision Medicine
Background:
- Asthma is a complex chronic respiratory disease with varied inflammatory pathways.
- Distinct molecular endotypes necessitate targeted biologic therapies for moderate-to-severe cases.
- Current biologic selection often involves inefficient trial-and-error methods.
Purpose of the Study:
- To review established and emerging biomarkers for guiding biologic therapy selection in asthma.
- To highlight the role of biomarkers in achieving precision asthma care.
- To discuss the integration of diverse biomarker types for optimized treatment.
Main Methods:
- Literature review of established biomarkers (e.g., blood eosinophils, FeNO, IgE).
- Exploration of emerging biomarkers (proteomic, transcriptomic, metabolomic, genomic).
- Consideration of digital biomarkers and non-medical health drivers (socioeconomic factors).
Main Results:
- Established biomarkers aid in identifying type 2-high asthma.
- Sputum biomarkers provide direct airway inflammation insights but face accessibility challenges.
- Emerging and digital biomarkers offer advanced potential for refining therapy selection.
Conclusions:
- Biomarker integration is essential for improving biologic selection and monitoring treatment response.
- Personalized approaches using multiple biomarkers can lead to better asthma control.
- The ultimate goal is to achieve asthma remission through precise, biomarker-guided therapies.
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