Page 83 - Škrgat, Sabina, ed. 2022. Severe Asthma - Basic and Clinical Views. Koper: University of Primorska Press. Severe Asthma Forum, 1
P. 83
markers in Severe Asthma 4.2
Marina Lampalo
Abstract Clinic for Lung Diseases
Asthma is the most common chronic respiratory disease, affecting both children and adults. Jordanovac, Zagreb, Croatia
It is an umbrella term, encompassing multiple phenotypes. Asthma phenotypes may also be
identified as clusters of measurements from different dimensions of the disease, and are part-
ly genetically determined. The mechanisms leading to the disease are complex and it is still a
challenge to choose suitable biomarkers, which have become especially important with the in-
troduction of biological asthma treatment. Asthma can be broadly divided into T2-high and
T2-low molecular endotypes. Early-onset asthma is typical of allergic phenotype and has so
far been the most extensively investigated. The prevalence of adult-onset asthma i si increas-
ing because of the ageing population. This asthma phenotype can be divided into two types
considering the existence of eosinophilic inflammation. Various other asthma phenotypes, for
instance, exercise-induced, and obesity or smoking-associated asthma, should be taken into ac-
count when evaluating the patient. Severe asthma,with the prevalence of 5-10% of all asthma
patients, remains a clinical challenge. Various biomarkers are thus under investigation in the
hope of helping researchers and clinicians in better disease evaluation since the individual ap-
proach and personalized medicine are imperative.
Keywords: asthma phenotype, clusters, biomarkers, eosinophils
Introduction Phenotype is by definition an observ-
able disease characteristic which is the re-
Asthma is the most frequent chronic respira- sult of gene-environment interaction. These
tory disease1, with almost 1 in 8 children and characteristics can be disease symptoms, trig-
1 in 12 adults affected2. Since 2016, the Glob- gers, body shape and weight, age of asthma
al initiative for asthma (GINA) has stated that onset, etiology, atopic status, response to the
asthma is a heterogeneous disease3. Asthma smoking habit, laboratory findings, biomark-
phenotyping is needed for a more precise pa- ers, lung function parameters and presence of
tient approach and a better understanding chronic airflow obstruction, bronchodilator
of asthma diversity. Asthma heterogeneity is reversibility, reaction to drugs or substances,
seen in diverse clinical presentations, different response to treatment, level of asthma con-
responses to treatment, and different patho- trol, number of exacerbations, severity and
physiological features and findings due to var- speed of asthma deterioration, need for hos-
ious pathogenic mechanisms, which lead to pitalization or intensive care unit treatment,
multiple asthma phenotypes. including mechanical ventilation, duration
https://doi.org/10.26 493/978 -961-293 -157-5.83 -89
Marina Lampalo
Abstract Clinic for Lung Diseases
Asthma is the most common chronic respiratory disease, affecting both children and adults. Jordanovac, Zagreb, Croatia
It is an umbrella term, encompassing multiple phenotypes. Asthma phenotypes may also be
identified as clusters of measurements from different dimensions of the disease, and are part-
ly genetically determined. The mechanisms leading to the disease are complex and it is still a
challenge to choose suitable biomarkers, which have become especially important with the in-
troduction of biological asthma treatment. Asthma can be broadly divided into T2-high and
T2-low molecular endotypes. Early-onset asthma is typical of allergic phenotype and has so
far been the most extensively investigated. The prevalence of adult-onset asthma i si increas-
ing because of the ageing population. This asthma phenotype can be divided into two types
considering the existence of eosinophilic inflammation. Various other asthma phenotypes, for
instance, exercise-induced, and obesity or smoking-associated asthma, should be taken into ac-
count when evaluating the patient. Severe asthma,with the prevalence of 5-10% of all asthma
patients, remains a clinical challenge. Various biomarkers are thus under investigation in the
hope of helping researchers and clinicians in better disease evaluation since the individual ap-
proach and personalized medicine are imperative.
Keywords: asthma phenotype, clusters, biomarkers, eosinophils
Introduction Phenotype is by definition an observ-
able disease characteristic which is the re-
Asthma is the most frequent chronic respira- sult of gene-environment interaction. These
tory disease1, with almost 1 in 8 children and characteristics can be disease symptoms, trig-
1 in 12 adults affected2. Since 2016, the Glob- gers, body shape and weight, age of asthma
al initiative for asthma (GINA) has stated that onset, etiology, atopic status, response to the
asthma is a heterogeneous disease3. Asthma smoking habit, laboratory findings, biomark-
phenotyping is needed for a more precise pa- ers, lung function parameters and presence of
tient approach and a better understanding chronic airflow obstruction, bronchodilator
of asthma diversity. Asthma heterogeneity is reversibility, reaction to drugs or substances,
seen in diverse clinical presentations, different response to treatment, level of asthma con-
responses to treatment, and different patho- trol, number of exacerbations, severity and
physiological features and findings due to var- speed of asthma deterioration, need for hos-
ious pathogenic mechanisms, which lead to pitalization or intensive care unit treatment,
multiple asthma phenotypes. including mechanical ventilation, duration
https://doi.org/10.26 493/978 -961-293 -157-5.83 -89
