Asthma in the Precision Medicine Era: Biologics and Probiotics

Abstract

Asthma is a major global health issue. Over 300 million people worldwide suffer from this chronic inflammatory airway disease. Typical clinical symptoms of asthma are characterized by a recurrent wheezy cough, chest tightness, and shortness of breath. The main goals of asthma management are to alleviate asthma symptoms, reduce the risk of asthma exacerbations, and minimize long-term medicinal adverse effects. However, currently available type 2 T helper cells (Th2)-directed treatments are often ineffective due to the heterogeneity of the asthma subgroups, which manifests clinically with variable and poor treatment responses. Personalized precision therapy of asthma according to individualized clinical characteristics (phenotype) and laboratory biomarkers (endotype) is the future prospect. This mini review discusses the molecular mechanisms underlying asthma pathogenesis, including the hot sought-after topic of microbiota, add-on therapies and the potential application of probiotics in the management of asthma.

Real-Life Effectiveness of Mepolizumab on Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity in Patients with Severe Eosinophilic Asthma

“…However, SEA is characteristically GC-resistant, indicating the likely existence of multiple and heterogeneous mechanisms overriding molecular pathways conveying critical GC anti-inflammatory response [ 8 ]. Targeted therapy against IL-5 has fulfilled a crucial, previously unmet need for the treatment of GC-dependent SEA patients who are greatly affected by the side-effects of oral corticosteroid (OCS) therapy [ 9 ]; to this end, the OCS-sparing effect offered by anti-IL-5 biologics greatly contributes to patients’ overall improvement.…”

Microbiome Research and Multi-Omics Integration for Personalized Medicine in Asthma

“…The concept of precision medicine ensuring that each patient is provided, in a timely manner, with the appropriate prognosis, diagnosis and/or therapy, thus eliminating the negative consequences and resulting in the maximum clinical benefit, is clearly relevant to the heterogeneous nature of asthma [7][8][9][10]. Actually, research exploiting modern systems biology approaches that combine individuals' pathophysiological traits with highthroughput profiling of molecular biomarkers in large, well-characterized cohorts of asthmatics have significantly expanded our ability to better understand asthma complexity, as well as to develop more targeted strategies to disease diagnosis, therapy and monitoring [11,12].…”

Integrative Analysis Reveals a miRNA-mRNA Regulatory Network and Potential Causative Agents in the Asthmatic Airway Epithelium

“…4 In the era of precision medicine, elucidating the molecular mechanism of asthma pathogenesis and identifying suitable biomarkers for precisely categorizing asthma are urgently needed. 5 The airway epithelium is the first barrier to pathogens and allergic stimuli in the lungs. 6 Based on single-cell RNA sequencing, many newly recognized cell populations with unique molecular signatures have been discovered in the airway epithelium.…”