Biomarker for bronchial asthma

Abstract

Asthma is a heterogenous chronic inflammatory disease of the airways. The main phenotypes that have been identified include (1) early-onset allergic asthma, (2) early-onset allergic moderate-to-severe remodeled asthma, (3) late-onset nonallergic eosinophilic asthma, and, (4) late-onset nonallergic noneosinophilic asthma. Further, asthma can be subdivided into Type 2 (high) and non-type 2 (or type 2 low) endotypes. For Type 2 high asthma, potential biomarkers could be serum-specific IgE (sIgE), fractional exhaled nitric oxide (FeNO), blood or sputum eosinophils, and, periostin. Moreover, Type 2 cytokines (IL-4, IL-5, and, IL-13) and innate (epithelial) cytokines (IL-25, IL-33, and, thymic stromal lymphopoietin (TSLP) ) can also be important biomarkers. In addition to the markers, clinical aspects such as onset of age, exacerbation factors, complication as well as physiological lung function are useful for selecting the appropriate therapy. Recent omics techniques including gene analysis may be useful at the stage of assessing the risk of asthma, may help define an endotype, and contribute to the prediction of responses to the given treatment.