Phenotypes and endotypes in asthma-practical approach

Abstract

Asthma is a complex heterogeneous inflammatory airway disorder. Inflammation is usually accompanied by an increase in airway smooth muscle mass, thickening of subepithelial lamina reticularis, matrix deposition in the airway walls, an increase in microvessels and neural networks, and mucus metaplasia. Clinical trials are going-on to evaluate the efficacy of biologicals or as an adjunct to allergen immunotherapy in high-T2 inflammation of allergic asthma. Management involves the titration of inhaled triple-drug therapy in a stepwise approach and to address the comorbidities. The targeted use of biological agents in severe diseases needs risk stratification of patients. We need further research on biomarkers and drivers of immune pathways in this era of changing global environment. This review will delve into personalized medicine strategies to treat asthma after phenotypic and endotypic characteristics.