Recent insights in the role of biomarkers in severe asthma management

Fouka, Evangelia; Domvri, Kalliopi; Gkakou, Foteini; Alevizaki, Maria; Steiropoulos, Paschalis; Papakosta, Despoina; Porpodis, Κonstantinos

doi:10.3389/fmed.2022.992565

Cited by 11 publications

(4 citation statements)

References 144 publications

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“…It is nowadays widely acknowledged that asthma, although presenting with a limited number of symptoms and signs, is heterogeneous from a pathogenetic standpoint so that different endotypes can be described according to the underlying molecular mechanisms. The most commonly used endotype classifications are based on the dominant cellular type (eosinophilic, neutrophilic, paucigranulocitic or mixed profile) or on the presence of Th2 cytokines (T2-high and T2-low endotype) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Metabolomics Applied to Pediatric Asthma: What Have We Learnt in the Past 10 Years?

Ferraro,

Zanconato,

Carraro

2023

Children

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Background: Asthma is the most common chronic condition in children. It is a complex non-communicable disease resulting from the interaction of genetic and environmental factors and characterized by heterogeneous underlying molecular mechanisms. Metabolomics, as with the other omic sciences, thanks to the joint use of high-throughput technologies and sophisticated multivariate statistical methods, provides an unbiased approach to study the biochemical–metabolic processes underlying asthma. The aim of this narrative review is the analysis of the metabolomic studies in pediatric asthma published in the past 10 years, focusing on the prediction of asthma development, endotype characterization and pharmaco-metabolomics. Methods: A total of 43 relevant published studies were identified searching the MEDLINE/Pubmed database, using the following terms: “asthma” AND “metabolomics”. The following filters were applied: language (English), age of study subjects (0–18 years), and publication date (last 10 years). Results and Conclusions: Several studies were identified within the three areas of interest described in the aim, and some of them likely have the potential to influence our clinical approach in the future. Nonetheless, further studies are needed to validate the findings and to assess the role of the proposed biomarkers as possible diagnostic or prognostic tools to be used in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Metabolomics Applied to Pediatric Asthma: What Have We Learnt in the Past 10 Years?

Ferraro,

Zanconato,

Carraro

2023

Children

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“…Several prior reviews outline the history of biomarkers in asthma precision care [22 ▪ ,25 ▪ ,26]. A recent survey of 412 multinational experts, researchers and clinicians in pediatric asthma, led by the Pediatric Asthma in Real Life (PeARL) think tank, found that precision medicine was a top important unaddressed need, specifically through the use of clinically relevant endotypes, phenotypes, and/or biomarkers (49% of participants) [27].…”

Section: Biomarkers In Asthma Precision Carementioning

confidence: 99%

Precision care in the treatment of pediatric asthma

Mahmood,

Keskin,

Jefferson

2024

Current Opinion in Pediatrics

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Purpose of review Precision medicine in pediatric asthma involves identification of asthma phenotypes, genetic markers, biomarkers, and biologics that target specific pathways. This review includes a discussion of the efficacy of currently approved biologics for pediatric asthma and most recent advances in biomarker/phenotype identification and genetic associations that affect asthma care. Recent findings Biologics targeting type-2 mediated pathways have shown success in the treatment of moderate to severe asthma in pediatric and adult patients. In comparative studies, dupilumab, an interleukin-4 (IL-4) alpha receptor inhibitor, and mepolizumab, an IL-5 inhibitor, have shown more improvement in asthma exacerbation rates and lung function compared to other biologics such as tezepelumab, omalizumab and benralizumab. Other methods used to categorize asthma treatment response have been investigated and include use of biomarkers such as fractional exhaled nitric oxide (FeNO). Genomic studies are also emerging in precision care for pediatric asthma. Summary An understanding of underlying immunologic and genetic mechanisms affecting the development of asthma in pediatric patients has resulted in the production of numerous targeted therapies that have led to improvement in lung function and reduced exacerbation burden.

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“…It is easily measured and reproducible. In addition, it has been shown to correlate with risk of exacerbations in patients with SA [ 68 ]. Moreover, eosinophils levels ranging from 150 to 400 cell/µL can also predict the response to treatment with mAbs, targeting the IL-5 pathway.…”

Section: Eosinophils and Bronchial Asthmamentioning

confidence: 99%

Eosinophilic Airway Diseases: From Pathophysiological Mechanisms to Clinical Practice

Mormile

Fuschillo

et al. 2023

IJMS

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Eosinophils play a key role in airway inflammation in many diseases, such as allergic and non-allergic asthma, chronic rhinosinusitis with nasal polyps, and chronic obstructive pulmonary disease. In these chronic disabling conditions, eosinophils contribute to tissue damage, repair, remodeling, and disease persistence through the production a variety of mediators. With the introduction of biological drugs for the treatment of these respiratory diseases, the classification of patients based on clinical characteristics (phenotype) and pathobiological mechanisms (endotype) has become mandatory. This need is particularly evident in severe asthma, where, despite the great scientific efforts to understand the immunological pathways underlying clinical phenotypes, the identification of specific biomarkers defining endotypes or predicting pharmacological response remains unsatisfied. In addition, a significant heterogeneity also exists among patients with other airway diseases. In this review, we describe some of the immunological differences in eosinophilic airway inflammation associated with severe asthma and other airway diseases and how these factors might influence the clinical presentation, with the aim of clarifying when eosinophils play a key pathogenic role and, therefore, represent the preferred therapeutic target.

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Recent insights in the role of biomarkers in severe asthma management

Cited by 11 publications

References 144 publications

Metabolomics Applied to Pediatric Asthma: What Have We Learnt in the Past 10 Years?

Metabolomics Applied to Pediatric Asthma: What Have We Learnt in the Past 10 Years?

Precision care in the treatment of pediatric asthma

Eosinophilic Airway Diseases: From Pathophysiological Mechanisms to Clinical Practice

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