AVANCEES DANS LA COMPREHENSION DE L’ASTHME: DE LA CLINIQUE A LA PHYSIOPATHOLOGIE ET LA BIOLOGIE MOLECULAIRE

Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the adult population across the world. It is a heterogeneous disease characterized by chronic airway inflammation associated with bronchial hyperresponsiveness and symptoms such as wheezing, dyspnoea, cough, and chest tightness. Despite a controller treatment according to the current guidelines (e.g. inhaled/systemic corticosteroids, leukotriene receptor antagonists), 17% of adult asthmatics have difficult-to-treat asthma with a negative impact on their quality of life and high costs for the healthcare system. These patients should be addressed in expert centers in order to optimize their management. However, despite the optimization, 4% of asthmatic patients finally have the diagnosis of severe asthma. Most of the recent research was focused on the identification of different phenotypes of severe asthma and the mechanisms driving the inflammatory reaction for each phenotype in order to find biomarkers and to better adapt the therapeutic strategy to every patient. Several phenotypes were described but not all of the mechanisms involved are identified. The present work summarises my contribution to the understanding of mechanisms driving different phenotypes of severe asthma and my future projects in order to improve the management of asthmatic patients (particularly those with severe asthma) and the applying of personalized medicine in this domain.