Precision Medicine in Targeted Therapies for Severe Asthma: Is There Any Place for “Omics” Technology?

Abstract

According to the current guidelines, severe asthma still represents a controversial topic in terms of definition and management. The introduction of novel biological therapies as a treatment option for severe asthmatic patients paved the way to a personalized approach, which aims at matching the appropriate therapy with the different asthma phenotypes. Traditional asthma phenotypes have been decomposing by an increasing number of asthma subclasses based on functional and physiopathological mechanisms. This is possible thanks to the development and application of different omics technologies. The new asthma classification patterns, particularly concerning severe asthma, include an increasing number of endotypes that have been identified using new omics technologies. The identification of endotypes provides new opportunities for the management of asthma symptoms, but this implies that biological therapies which target inflammatory mediators in the frame of specific patterns of inflammation should be developed. However, the pathway leading to a precision approach in asthma treatment is still at its beginning. The aim of this review is providing a synthetic overview of the current asthma management, with a particular focus on severe asthma, in the light of phenotype and endotype approach, and summarizing the current knowledge about “omics” science and their therapeutic relevance in the field of bronchial asthma.

Novel Comprehensive Bioinformatics Approaches to Determine the Molecular Genetic Susceptibility Profile of Moderate and Severe Asthma

“…Asthma stratification at the molecular level, particularly with the use of accessible biospecimens, could greatly facilitate the selection of patients for targeted therapy. Additionally, an indicator of the genetic background of asthma could be given by the use of omics technology in patients with asthma in different ethnic groups [20][21][22]. In the present work, I used the GSE43696 and the GEO2R tool to individually analyze the top 250 DEGs (p-value < 0.001) for the moderate, severe, and moderate-to-severe asthma phenotypes (Figure 1 and Table S1).…”

Identifying Asthma genetic signature patterns by mining Gene Expression BIG Datasets using Image Filtering Algorithms

“…Gene set enrichment analysis was done as previously described [18] to identify top pathways in which the identified DEG are highly enriched to shed light on the molecular pathogenesis of asthma by deconvoluting the expression profiling signals generated from the same gene (datapoint) having different levels of expression based on the degree of Asthma severity. The flow chart of GSEA and details of enriched pathways are shown in figure (6). 3447 out of 6879 from C2, C5, and C7 gene set modules were upregulated in Severe asthma phenotype (22 samples) compared to healthy controls (57 samples).…”

“…The use of Omics technologies, including genomics, transcriptomics, proteomics, and metabolomics, provided extraordinarily details and enriched our knowledge about the asthma heterogeneity and molecular basis of asthma [5]. Moreover, these techniques helped in the discovery of new markers essential for precise classification of asthma as well as the development of new therapeutic targets [6]. However, the use of these techniques gives no conclusive and even contradictory results [7].…”

Advanced design and development of nanoparticle/microparticle dual-drug combination lactose carrier-free dry powder inhalation aerosols

“…Despite new endotypetargeted biologics, the mainstay of therapies spanning all endotypes remain the drugs that help to quickly expand the airway (bronchodilator) or control inammation (ICS-LABA). 6,7 Pulmonary drug delivery 8 has become a sophisticated eld presenting greater opportunities to achieve more efficient and targeted drug delivery. 9 Since the introduction of the Montreal Protocol and the banishment of the use of chlorouorocarbons (CFCs) as a propellant, dry powder inhalers (DPIs) have become an effective and the predominant inhalation class for many of the medications used to manage asthma and COPD.…”