Eosinophilic Asthma, Phenotypes-Endotypes and Current Biomarkers of Choice

Porpodis, Κonstantinos; Tsiouprou, Ioanna; Apostolopoulos, Apostolos; Ntontsi, Polyxeni; Fouka, Evangelia; Papakosta, Despoina; Vliagoftis, Harissios; Domvri, Kalliopi

doi:10.3390/jpm12071093

Cited by 16 publications

(11 citation statements)

References 122 publications

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“…For example, in CPUO increased circulating blood eosinophils (> 4% or > 0.30 K/μL) was found to predict favorable response to immunomodulatory therapy 48 . Additionally, in asthma, treatment eligibility criteria for IL-5 targeting monoclonal antibodies or dupilumab includes the presence of elevated Th2 biomarkers that are predictive of a more likely patient response, such as blood eosinophils ≥ 0.30 K/μL or FeNO ≥ 25 ppb 50 .…”

Section: Discussionmentioning

confidence: 99%

Comprehensive plasma cytokine and chemokine profiling in prurigo nodularis reveals endotypes in Type 2 inflammation

Cornman,

Manjunath,

Reddy

et al. 2024

Sci Rep

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Prurigo nodularis (PN) is a chronic inflammatory skin disease that is associated with variability in peripheral blood eosinophil levels and response to T-helper 2 targeted therapies (Th2). Our objective was to determine whether circulating immune profiles with respect to type 2 inflammation differ by race and peripheral blood eosinophil count. Plasma from 56 PN patients and 13 matched healthy controls was assayed for 54 inflammatory biomarkers. We compared biomarker levels between PN and HCs, among PN patients based on absolute eosinophil count, and across racial groups in PN. Eleven biomarkers were elevated in PN versus HCs including interleukin (IL)-12/IL-23p40, tumor necrosis factor-alpha (TNF-α), Thymic stromal lymphopoietin (TSLP), and macrophage-derived chemokine (MDC/CCL22). Additionally, PN patients with AEC > 0.3 K cells/μL had higher Th2 markers (eotaxin, eotaxin-3, TSLP, MCP-4/CCL13), and African American PN patients had lower eosinophils, eotaxin, and eotaxin-3 versus Caucasian and Asian PN patients (p < 0.05 for all). Dupilumab responders had higher AEC (p < 0.01), were more likely to be Caucasian (p = 0.02) or Asian (p = 0.05) compared to African Americans, and more often had a history of atopy (p = 0.08). This study suggests that blood AEC > 0.3 K and Asian and Caucasian races are associated with Th2 skewed circulating immune profiles and response to Th2 targeted therapies.

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Section: Discussionmentioning

confidence: 99%

Comprehensive plasma cytokine and chemokine profiling in prurigo nodularis reveals endotypes in Type 2 inflammation

Cornman,

Manjunath,

Reddy

et al. 2024

Sci Rep

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“…Since the pathophysiology of EoE, BA, and AD is very similar, it is likely that unspecific biomarkers could be found when using samples such as blood the most common tissue used when looking for non-invasive biomarkers and therefore, will be the focus of this review. It should be noted that overall biomarkers for EoE [ 43 ], BA [ 44 ], and AD [ 45 ] have been reviewed recently. As counts of circulating eosinophil and serum IgE levels have been widely employed in EoE, BA, and AD, with inconclusive results, they will not be reviewed here.…”

Section: Current Knowledge Of Circulating Biomarkersmentioning

confidence: 99%

Blood-Based Biomarkers for Eosinophilic Esophagitis and Concomitant Atopic Diseases: A Look into the Potential of Extracellular Vesicles

Grueso-Navarro

Navarro

Laserna-Mendieta

et al. 2023

IJMS

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Eosinophilic esophagitis (EoE) is a chronic, Th2-inflammatory disease of the esophagus that can severely affect food intake. Currently, diagnosis and assessing response to treatment of EoE is highly invasive and requires endoscopy with esophageal biopsies. Finding non-invasive and accurate biomarkers is important for improving patient well-being. Unfortunately, EoE is usually accompanied by other atopies, which make it difficult to identify specific biomarkers. Providing an update of circulating EoE biomarkers and concomitant atopies is therefore timely. This review summarizes the current knowledge in EoE blood biomarkers and two of its most common comorbidities, bronchial asthma (BA) and atopic dermatitis (AD), focusing on dysregulated proteins, metabolites, and RNAs. It also revises the current knowledge on extracellular vesicles (EVs) as non-invasive biomarkers for BA and AD, and concludes with the potential use of EVs as biomarkers in EoE.

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“…Several biomarkers are available to phenotype asthma, some of which may predict clinical response to corticosteroids and T2 biologics; these include blood (or sputum) eosinophils, FeNO, serum total IgE (tIgE) levels, and periostin ( 15 , 16 ).…”

Section: Biomarkers Predicting the Response To Anti-t2 Therapiesmentioning

confidence: 99%

Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma

2023

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Asthma is a heterogeneous disease sharing airway instability but with different biology, risk factors, and response-to-therapy patterns. Biologics have revolutionized the one-size-fits-to-all approach to personalized medicine in severe asthma (SA), which relies on the identification of biomarkers that define distinct endotypes. Thus, blood eosinophils and, to some extent, exhaled nitric oxide (FeNO) can predict the response to approved anti-type 2 (T2) biologics (anti-IgE, anti–IL-5, and anti–IL-4R alpha), whereas age at onset and comorbidities such as anxiety/depression, obesity, reflux, and upper airway disease (UAD) also influence therapeutic responses in SA. In this article, focusing on the predictive value of biomarkers for the therapeutic response to biologics in SA, we first summarize the level of prediction achieved by T2 biomarkers (blood eosinophils, FeNO) and then review whether data support the predictive value of upper airway diagnosis on such outcomes. Post hoc analysis of most studies with T2 biologics suggests that chronic rhinosinusitis with nasal polyps (CRSwNP) and, to a lower extent, allergic rhinitis may help in predicting clinical response. Considering that T2 biologics are now also approved for the treatment of severe CRSwNP, diagnosis of upper airway disease is a key step in determining eligibility for such therapy.

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Eosinophilic Asthma, Phenotypes-Endotypes and Current Biomarkers of Choice

Cited by 16 publications

References 122 publications

Comprehensive plasma cytokine and chemokine profiling in prurigo nodularis reveals endotypes in Type 2 inflammation

Comprehensive plasma cytokine and chemokine profiling in prurigo nodularis reveals endotypes in Type 2 inflammation

Blood-Based Biomarkers for Eosinophilic Esophagitis and Concomitant Atopic Diseases: A Look into the Potential of Extracellular Vesicles

Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma

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