1. Biomarkers and asthma management: analysis and potential applications.
- Author
-
Richards LB, Neerincx AH, van Bragt JJMH, Sterk PJ, Bel EHD, and Maitland-van der Zee AH
- Subjects
- Anti-Asthmatic Agents pharmacology, Asthma blood, Asthma diagnosis, Asthma genetics, Biomarkers analysis, Breath Tests methods, Bronchoalveolar Lavage Fluid chemistry, Bronchoalveolar Lavage Fluid cytology, Cell Adhesion Molecules blood, Drug Resistance genetics, Drug Resistance immunology, Eosinophils, Exhalation, Glucocorticoids pharmacology, Humans, Immunoglobulin E blood, Nitric Oxide analysis, Phenotype, Prognosis, Sputum cytology, Treatment Outcome, Volatile Organic Compounds analysis, Anti-Asthmatic Agents therapeutic use, Asthma drug therapy, Glucocorticoids therapeutic use, Precision Medicine methods
- 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.
- Published
- 2018
- Full Text
- View/download PDF