Endotype Driven Treatment of Asthma

摘要: The heterogeneity of asthma in relation to clinically significant outcomes, including response treatment, has been established beyond any doubt. However, current treatment guidelines for ignore disease and causal pathways. Extended heterogeneous disease-related metabolic, inflammatory, immunological, remodeling pathways have described, a repetitive pattern is defined as endotype. targeted non-targeted interventions may vary among individuals or the same individual outcome measures (dissociated effect). Targeted should be both biomarker-driven outcome-driven. ideal biomarker pathway-specific, reproducible, easily measurable, affordable. Biomarker research increasingly shifting from assessment value single biomarkers multidimensional approaches, which clinical combination various markers studied. Translation into pathway-specific diagnostic tests essential guide design future large trials, incorporating longitudinal mechanism-tailored endpoints. selection measure difficult, it must reflect mechanistic intervention relevant asthmatic population general particular with asthma. While endotype-driven therapeutic strategies are successful, issues dissociated effect drug efficacy at target site remain unresolved. Efforts needed move field forward include profiling Th2-low inflammation, incorporation new targets, such airway smooth muscle epithelial components epigenetics modifications, well application systems pharmacology.