Biomarkers in Severe Asthma: Identifying the Treatable Trait

Overview

Journal Lung India

Specialty Pulmonary Medicine

Date 2023 Jan 25

PMID 36695260

Authors

Aanchal Gvalani

Amita Athavale

Disha Gupta

Affiliations

Soon will be listed here.

Abstract

Asthma is a chronic condition of bronchial hyper-reactivity associated with inflammation ranges from mild to severe form. It affects 1 - 18% of the population globally and it is estimated that > 300million people in the world have asthma. Of this 5 - 10% have severe asthma. while the proportion of patients suffering from severe are smaller, the morbidity and mortality are higher in this group. With the advances in our understanding of the pathophysiology of asthma there is a need to understand the role of various biomarkers. We live in an era of precision medicine and today there is a clear unmet need to understand targeted therapies. This review aims to raise awareness to the available biomarkers used in clinical practice in India and their role in predicting response to targeted therapies.

Citing Articles

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References

Hanania N, Alpan O, Hamilos D, Condemi J, Reyes-Rivera I, Zhu J . Omalizumab in severe allergic asthma inadequately controlled with standard therapy: a randomized trial. Ann Intern Med. 2011; 154(9):573-82. DOI: 10.7326/0003-4819-154-9-201105030-00002. View

Gavala M, Bertics P, Gern J . Rhinoviruses, allergic inflammation, and asthma. Immunol Rev. 2011; 242(1):69-90. PMC: 3119863. DOI: 10.1111/j.1600-065X.2011.01031.x. View

Ishizaka K, Ishizaka T, HORNBROOK M . Physicochemical properties of reaginic antibody. V. Correlation of reaginic activity wth gamma-E-globulin antibody. J Immunol. 1966; 97(6):840-53. View

Dweik R, Boggs P, Erzurum S, Irvin C, Leigh M, Lundberg J . An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011; 184(5):602-15. PMC: 4408724. DOI: 10.1164/rccm.9120-11ST. View

Fowler S, Sterk P . Breath biomarkers in asthma: we're getting answers, but what are the important questions?. Eur Respir J. 2019; 54(3). DOI: 10.1183/13993003.01411-2019. View

Riccio A, Dal Negro R, Micheletto C, De Ferrari L, Folli C, Chiappori A . Omalizumab modulates bronchial reticular basement membrane thickness and eosinophil infiltration in severe persistent allergic asthma patients. Int J Immunopathol Pharmacol. 2012; 25(2):475-84. DOI: 10.1177/039463201202500217. View

Buchvald F, Baraldi E, Carraro S, Gaston B, de Jongste J, Pijnenburg M . Measurements of exhaled nitric oxide in healthy subjects age 4 to 17 years. J Allergy Clin Immunol. 2005; 115(6):1130-6. DOI: 10.1016/j.jaci.2005.03.020. View

Lotvall J, Akdis C, Bacharier L, Bjermer L, Casale T, Custovic A . Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol. 2011; 127(2):355-60. DOI: 10.1016/j.jaci.2010.11.037. View

Gauthier M, Ray A, Wenzel S . Evolving Concepts of Asthma. Am J Respir Crit Care Med. 2015; 192(6):660-8. PMC: 5447293. DOI: 10.1164/rccm.201504-0763PP. View

10.

Chiappori A, De Ferrari L, Folli C, Mauri P, Riccio A, Canonica G . Biomarkers and severe asthma: a critical appraisal. Clin Mol Allergy. 2015; 13:20. PMC: 4590266. DOI: 10.1186/s12948-015-0027-7. View

11.

Rochman Y, Leonard W . Thymic stromal lymphopoietin: a new cytokine in asthma. Curr Opin Pharmacol. 2008; 8(3):249-54. PMC: 2518061. DOI: 10.1016/j.coph.2008.03.002. View

12.

Moore W, Bleecker E, Curran-Everett D, Erzurum S, Ameredes B, Bacharier L . Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program. J Allergy Clin Immunol. 2007; 119(2):405-13. PMC: 2837934. DOI: 10.1016/j.jaci.2006.11.639. View

13.

Zietkowski Z, Bodzenta-Lukaszyk A, Tomasiak M, Skiepko R, Szmitkowski M . Comparison of exhaled nitric oxide measurement with conventional tests in steroid-naive asthma patients. J Investig Allergol Clin Immunol. 2006; 16(4):239-46. View

14.

Matucci A, Vultaggio A, Ridolo E, Maggi E, Canonica G, Rossi O . Asthma: developments in targeted therapy. Expert Rev Clin Immunol. 2011; 8(1):13-5. DOI: 10.1586/eci.11.71. View

15.

Kato A, Favoreto Jr S, Avila P, Schleimer R . TLR3- and Th2 cytokine-dependent production of thymic stromal lymphopoietin in human airway epithelial cells. J Immunol. 2007; 179(2):1080-7. PMC: 2220044. DOI: 10.4049/jimmunol.179.2.1080. View

16.

ONeill S, Sweeney J, Patterson C, Menzies-Gow A, Niven R, Mansur A . The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax. 2014; 70(4):376-8. DOI: 10.1136/thoraxjnl-2013-204114. View

17.

Schleich F, Manise M, Sele J, Henket M, Seidel L, Louis R . Distribution of sputum cellular phenotype in a large asthma cohort: predicting factors for eosinophilic vs neutrophilic inflammation. BMC Pulm Med. 2013; 13:11. PMC: 3657295. DOI: 10.1186/1471-2466-13-11. View

18.

Skiepko R, Zietkowski Z, Lukaszyk M, Budny W, Skiepko U, Milewski R . Changes in blood eosinophilia during omalizumab therapy as a predictor of asthma exacerbation. Postepy Dermatol Alergol. 2014; 31(5):305-9. PMC: 4221351. DOI: 10.5114/pdia.2014.40973. View

19.

Al-Ramli W, Prefontaine D, Chouiali F, Martin J, Olivenstein R, Lemiere C . T(H)17-associated cytokines (IL-17A and IL-17F) in severe asthma. J Allergy Clin Immunol. 2009; 123(5):1185-7. DOI: 10.1016/j.jaci.2009.02.024. View

20.

Gouder C, West L, Montefort S . The real-life clinical effects of 52 weeks of omalizumab therapy for severe persistent allergic asthma. Int J Clin Pharm. 2014; 37(1):36-43. DOI: 10.1007/s11096-014-0034-7. View