Advertisement

Hot Topic: Precision Medicine for Asthma—Has the Time Come?

  • Xingnan LiEmail author
Asthma (V Ortega, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Asthma

Abstract

Purpose of Review

Asthma is a common inflammatory airway disease, which affects more than 300 million people worldwide. Although conventional drugs are effective for most of the patients with mild-to-moderate asthma, they are less effective for patients with difficult-to-treat or severe asthma. Identification of asthma endotypes and biomarkers will lead to more precise approaches to treat asthma.

Recent Findings

Asthma subphenotypes and endotypes have been described based on clinical variables and sputum granulocytes. A recent asthma endotype study has been summarized based on the combination of T2 (FeNO) and non-T2 (IL-6) biomarkers. Discovery of potential biomarkers for asthma has been discussed in the context of omics approaches. Current biologic drugs for asthma have been summarized, and the future direction of precise treatment of asthma has been suggested.

Summary

This review provides a concise overview of the current state of subphenotypes, endotypes, biomarkers, omics approaches, and biologic drugs in asthma.

Keywords

Asthma Biomarker Endotype Omics Precision medicine Subphenotype 

Notes

Compliance with Ethical Standards

Conflict of Interest

The author declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (GINA). [accessed July 1, 2019; updated 2019]. Available at https://ginasthma.org
  2. 2.
    • Moore WC, Meyers DA, Wenzel SE, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010;181:315–23 This is a study showing heterogeneous clinical asthma subphenotypes. CrossRefGoogle Scholar
  3. 3.
    Tliba O, Panettieri RA Jr. Paucigranulocytic asthma: uncoupling of airway obstruction from inflammation. J Allergy Clin Immunol. 2019;143:1287–94.CrossRefPubMedGoogle Scholar
  4. 4.
    Hastie AT, Moore WC, Meyers DA, Vestal PL, Li H, Peters SP, et al. Analyses of asthma severity phenotypes and inflammatory proteins in subjects stratified by sputum granulocytes. J Allergy Clin Immunol. 2010;125:1028–36.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Moore WC, Hastie AT, Li X, Li H, Busse WW, Jarjour NN, et al. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133:1557–63.CrossRefPubMedGoogle Scholar
  6. 6.
    •• Li X, Hastie AT, Peters MC, et al. Investigation of serum IL-6 and IL6R levels as biomarkers for asthma severity and asthma exacerbations. Am J Respir Crit Care Med. 2019;199:A2687 This is a study showing asthma endotypes based on T2 (FeNO or blood eosinophils) and non-T2 (IL-6) biomarkers. Google Scholar
  7. 7.
    Tiotiu A. Biomarkers in asthma: state of the art. Asthma Res Pract. 2018;4:10.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Li X, Ampleford EJ, Howard TD, Moore WC, Torgerson DG, Li H, et al. Genome-wide association studies of asthma indicate opposite immunopathogenesis direction from autoimmune diseases. J Allergy Clin Immunol. 2012;130:861–8.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Demenais F, Margaritte-Jeannin P, Barnes KC, et al. Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks. Nat Genet. 2018;50:42–53.CrossRefPubMedGoogle Scholar
  10. 10.
    Zhu Z, Lee PH, Chaffin MD, Chung W, Loh PR, Lu Q, et al. A genome-wide cross-trait analysis from UK Biobank highlights the shared genetic architecture of asthma and allergic diseases. Nat Genet. 2018;50:857–64.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Shrine N, Portelli MA, John C, Soler Artigas M, Bennett N, Hall R, et al. Moderate-to-severe asthma in individuals of European ancestry: a genome-wide association study. Lancet Respir Med. 2019;7:20–34.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pividori M, Schoettler N, Nicolae DL, Ober C, Im HK. Shared and distinct genetic risk factors for childhood-onset and adult-onset asthma: genome-wide and transcriptome-wide studies. Lancet Respir Med. 2019;7:509–22.CrossRefPubMedGoogle Scholar
  13. 13.
    Kan M, Shumyatcher M, Himes BE. Using omics approaches to understand pulmonary diseases. Respir Res. 2017;18:149.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Kersten ET, Koppelman GH. Pharmacogenetics of asthma: toward precision medicine. Curr Opin Pulm Med. 2017;23:12–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Agache I, Akdis CA. Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases. J Clin Invest. 2019;130:1493–503.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Genetics, Genomics and Precision Medicine, Department of MedicineUniversity of ArizonaTucsonUSA

Personalised recommendations