Asthma phenotyping: a necessity for improved therapeutic precision and new targeted therapies.

摘要: Asthma is a common heterogeneous disease with complex pathophysiology that carries significant mortality rate and high morbidity. Current therapies based on inhaled corticosteroids long-acting β-agonists remain effective in large proportion of patients asthma, but ~10% (considered to have 'severe asthma') do not respond these treatments even at doses or the use oral corticosteroids. Analytical clustering methods revealed phenotypes include dependence high-dose corticosteroid treatment, severe airflow obstruction recurrent exacerbations associated an allergic background late onset disease. One phenotype eosinophilic inflammation-predominant late-onset disease, rhinosinusitis, aspirin sensitivity exacerbations. Blood sputum eosinophilia been used distinguish Th2 inflammation predict therapeutic response targeted towards Th2-associated cytokines. New form humanized antibodies against targets, such as anti-IgE, anti-IL4Rα, anti-IL-5 anti-IL-13 antibodies, shown encouraging results terms reduction improvement 'Th2-high' expression profile blood eosinophilia. Research efforts are now focusing elucidating the phenotypes underlying non-Th2-high (or Th2-low) group, which constitutes ~50% asthma cases. There increasing need biomarkers indicate group who will specifically treatment. The improved tools measure activity better definition delineation inflammatory pathways omics analyses using computational tools, lead better-defined for specific therapies.