Allergic Asthma in the Era of Personalized Medicine

Abstract

Allergic asthma is the most common asthma phenotype and is characterized by IgE sensitization to airborne allergens and subsequent typical asthmatic symptoms after exposure. A form of type 2 (T2) airway inflammation underlies allergic asthma. It usually arises in childhood and is accompanied by multimorbidity presenting with the occurrence of other atopic diseases, such as atopic dermatitis and allergic rhinitis. Diagnosis of the allergic endotype is based on in vivo (skin prick tests) and/or in vitro (allergen-specific IgE levels, component-resolved diagnosis (CRD)) documentation of allergic sensitization. Biomarkers identifying patients with allergic asthma include total immunoglobulin E (IgE) levels, fractional exhaled nitric oxide (FeNO) and serum eosinophil counts. The treatment of allergic asthma is a complex procedure and requires a patient-tailored approach. Besides environmental control involving allergen avoidance measurements and cornerstone pharmacological interventions based on inhaled drugs, allergen-specific immunotherapy (AIT) and biologics are now at the forefront when it comes to personalized management of asthma. The current review aims to shed light on the distinct phenotype of allergic asthma, ranging over its current definition, clinical characteristics, pathophysiology and biomarkers, as well as its treatment options in the era of precision medicine.

The Impact of Forkhead Box Protein P3 (FOXP3) on Allergic Asthma: Review Article

“…Sputum generated by these people is often examined pre-treatment demonstrates eosinophilic airway irritation. Patients with this subtype of asthma typically benefit from inhaled corticosteroids (1,2) .…”

“…The most prevalent form of asthma is allergic asthma, which is defined by the development of characteristic asthmatic symptoms following exposure to airborne allergens due to the IgE's sensitivity to these allergens. Inflammation of the airways of type 2 (T2) is the etiology of allergic asthma (2) . It is estimated that 300 million individuals around the world suffer from asthma.…”

Mechanisms and biomarkers of successful allergen-specific immunotherapy

“…While allergic asthma is the dominant phenotype among asthma diagnosed in childhood, allergic sensitization among asthma patients is decreased with increasing age of asthma onset [ 79 80 ]. AIT effectively reduces symptoms and medication needs and improves the quality of life and bronchial hyperresponsiveness in allergic asthma patients [ 81 ]. Adolescents and adult asthmatics with AIT exposure are less likely to experience progression of asthma severity [ 82 ].…”

Asthma: The Use of Animal Models and Their Translational Utility

“…Discrete divisions between these endotypes do not exist in every patient, hence the heterogenous disease process. With the greater availability of optimized animal models, the T2-high endotype has been more extensively researched, is better characterized, and has more biological therapy options including those that target IgE, eosinophils, IL-4, IL-5, and TSLP [ 9 , 10 ].…”