Biomolecular markers in assessment and treatment of asthma

Abstract

Asthma is a chronic and heterogeneous inflammatory disorder with several different phenotypes. Whereas clinical features of asthma are non-specific and pulmonary function tests are often insensitive, further development is needed for efficient treatment or even early diagnosis. Recently, several airway inflammatory biomarkers have emerged as valuable tools in diagnosis and management of asthma. The analysis of molecular markers of airways inflammation has provided promising and non-invasive techniques that facilitate the detection of disease phenotypes as well as measurement of therapeutic efficacy. Although conventional treatments remain the preferred therapy, they do not adequately control some severe cases of asthma. Novel therapeutic agents have been developed to target various biomarkers involved in the inflammatory responses and have been investigated in patients with asthma. In this article, we summarized the most studied asthma biomarkers, derived from a variety of biological sources including exhaled gases, induced sputum, serum and urine. Likewise, the effects of current anti-inflammatory asthma treatments on inflammatory biomarkers and some promising biomarkers for developing new targeted therapies are also discussed.

Omalizumab for severe allergic asthma in clinical trials and real-life studies: What we know and what we should address

“…In fact it is characterized by strict inclusion and exclusion criteria in RCTs, which certainly do not reflect the real-life setting. Patient selection is one of the most important aspects in managing biological treatments as they usually target a very specific disease phenotype [56,57]. Though the drop-out rate for adverse events is not significantly different in RCTs and R-L studies, unexpectedly, local adverse events (LAEs) appear to be much more frequent in the first setting (79.5% vs 13.6% of patients).…”

“…In the light of asthma phenotypes the two prescription criteria listed above do not certainly allow a strict and proper patient selection as they only superficially explore the underlying asthma mechanisms. Patient selection is one of the most important aspects in managing biological treatments as they usually target a very specific disease mechanism [56,57]. This is much more important if we consider the high costs of omalizumab, and of all the other biological treatments that are going to get available [60].…”

Metabolic alterations in the sera of Chinese patients with mild persistent asthma: a GC-MS-based metabolomics analysis

“…Monitoring marker metabolite levels has become an important way to detect the pathogenesis of diseases. Biomarkers are typically measured in biofluids, such as urine, plasma, serum and exhaled breath condensate (EBC), which are commonly used to detect asthma due to the ease of collection and their minimally invasive nature [10][11][12] . However, many current biomarkers are not specific and lack adequate sensitivity in detection assays.…”

Airway inflammation in sickle cell disease—A translational perspective

“…Similar findings were observed in chimeric SCD mice which also showed an enhanced asthma phenotype, with a decreased IFN‐γ response in response to low‐dose OVA aerosol challenge . Thus, there is substantial overlap between SCD murine studies with immune responses found in allergic asthma, including higher levels of Th‐2 cytokines, IL‐4, IL‐5, and IL‐13, leading to increased IgE and influx of eosinophils in the airway matrix, thereby causing airway inflammation via leukotrienes and granule proteins . There are some key differences as well, which include increase in IL‐6 and MCP‐1, traditionally observed with monocyte activation and not with allergic asthma, in SCD mice.…”