Biomarkers and asthma management: analysis and potential applications. Issue 2 (April 2018)

• Record Type: Journal Article
• Authors: Richards, Levi B.; Neerincx, Anne H.; van Bragt, Job J.M.H.; Sterk, Peter J.; Bel, Elisabeth H.D.; Maitland-van der Zee, Anke H.
• Is Part Of: Current opinion in allergy and clinical immunology. Volume 18:Issue 2(2018:Apr.)
• Publication Date: 2018-04
• Subjects: biologicals -- biomarkers -- precision medicine -- severe asthma -- therapy optimisation; Allergy -- Periodicals; Clinical immunology -- Periodicals; Hypersensitivity; Immunity; Immune System Diseases; Allergy and Immunology; 616.079
• DOI: 10.1097/ACI.0000000000000426
• Languages: English
• ISSNs: 1528-4050

Abstract

Abstract : Purpose of review: Asthma features a high degree of heterogeneity in both pathophysiology and therapeutic response, resulting in many asthma patients being treated inadequately. Biomarkers indicative of underlying pathological processes could be used to identify disease subtypes, determine prognosis and to predict or monitor treatment response. However, the newly identified as well as more established biomarkers have different applications and limitations. Recent findings: Conventional markers for type 2-high asthma, such as blood eosinophils, fraction of exhaled nitric oxide, serum IgE and periostin, feature limited sensitivity and specificity despite their significant correlations. More distinctive models have been developed by combining biomarkers and/or using omics techniques. Recently, a model with a positive predictive value of 100% for identification of type 2-high asthma based on a combination of minimally invasive biomarkers was developed. Summary: Individualisation of asthma treatment regimens on the basis of biomarkers is necessary to improve asthma control. However, the suboptimal properties of currently available conventional biomarkers limit its clinical utility. Newly identified biomarkers and models based on combinations and/or omics analysis must be validated and standardised before they can be routinely applied in clinical practice. The development of robust biomarkers will allow development of more efficacious precision medicine-based treatment approaches for asthma.