Asthma and Allergy: Unravelling a Tangled Relationship with a Focus on New Biomarkers and Treatment

Abstract

Asthma is a major driver of health care costs across ages. Despite widely disseminated asthma-treatment guidelines and a growing variety of effective therapeutic options, most patients still experience symptoms and/or refractoriness to standard of care treatments. As a result, most patients undergo a further intensification of therapy to optimize symptom control with a subsequent increased risk of side effects. Raising awareness about the relevance of evaluating aeroallergen sensitizations in asthmatic patients is a key step in better informing clinical practice while new molecular tools, such as the component resolved diagnosis, may be of help in refining the relationship between sensitization and therapeutic recommendations. In addition, patient care should benefit from reliable, easy-to-measure and clinically accessible biomarkers that are able to predict outcome and disease monitoring. To attain a personalized asthma management and to guide adequate treatment decisions, it is of paramount importance to expand clinicians’ knowledge about the tangled relationship between asthma and allergy from a molecular perspective. Our review explores the relevance of allergen testing along the asthma patient’s journey, with a special focus on recurrent wheezing children. Here, we also discuss the unresolved issues regarding currently available biomarkers and summarize the evidence supporting the eosinophil-derived neurotoxin as promising biomarker.

Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases

“…Asthma is a heterogeneous chronic inflammatory disease of the lungs’ airways provoked by exogenous (like air pollution, cigarette smoke) and endogenous factors (such as oxidative stress, chronic inflammation), and are mainly driven by a “type 2-high” immune signature [ 158 ]. Most current medications focus on regulating the inflammatory cascade, but cannot reverse tissue remodeling.…”

Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study

“…No reliable biomarker for paediatric allergic diseases has yet been identified, suggesting the need of a comprehensive approach using a combination of diagnostic markers together with clinical observations and medical history 39 . A limited number of biomarkers for a Th2‐driven inflammation are available, of which all face different challenges 40,41 . However, as an easily obtained and stable marker of eosinophil inflammation, EDN may by itself or in combination with other biomarkers be a useful complement in clinical practice.…”

“…39 A limited number of biomarkers for a Th2-driven inflammation are available, of which all face different challenges. 40,41 However, as an easily obtained and stable marker of eosinophil inflammation, EDN may by itself or in combination with other biomarkers be a useful complement in clinical practice.…”

Exploring the role of eosinophil cationic protein (ECP) in schizophrenia: Insights and implications

“…Variability in ECP measurements among studies, potential confounding factors, and the need for standardized assays and larger cohort studies represent critical aspects requiring attention. [25,26]…”