title: Asthma outcomes: biomarkers.
abstract: BACKGROUND
  Measurement of biomarkers has been incorporated within clinical research studies of asthma to characterize the population and associate the disease with environmental and therapeutic effects.
  
  
  OBJECTIVE
  National Institutes of Health institutes and federal agencies convened an expert group to propose which biomarkers should be assessed as standardized asthma outcomes in future clinical research studies.
  
  
  METHODS
  We conducted a comprehensive search of the literature to identify studies that developed and/or tested asthma biomarkers. We identified biomarkers relevant to the underlying disease process progression and response to treatment. We classified the biomarkers as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an National Institutes of Health-organized workshop convened in March 2010 and finalized in September 2011.
  
  
  RESULTS
  Ten measures were identified; only 1, multiallergen screening to define atopy, is recommended as a core asthma outcome. Complete blood counts to measure total eosinophils, fractional exhaled nitric oxide (Feno), sputum eosinophils, urinary leukotrienes, and total and allergen-specific IgE are recommended as supplemental measures. Measurement of sputum polymorphonuclear leukocytes and other analytes, cortisol measures, airway imaging, breath markers, and system-wide studies (eg, genomics, proteomics) are considered as emerging outcome measures.
  
  
  CONCLUSIONS
  The working group participants propose the use of multiallergen screening in all asthma clinical trials to characterize study populations with respect to atopic status. Blood, sputum, and urine specimens should be stored in biobanks, and standard procedures should be developed to harmonize sample collection for clinical trial biorepositories.
authors.affiliation: National Jewish Health, Denver, Colorado, USA.
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Szefler
authors.forename: Sally
authors.initials: S
authors.lastname: Wenzel
authors.forename: Robert
authors.initials: R
authors.lastname: Brown
authors.forename: Serpil C
authors.initials: SC
authors.lastname: Erzurum
authors.forename: John V
authors.initials: JV
authors.lastname: Fahy
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hamilton
authors.forename: John F
authors.initials: JF
authors.lastname: Hunt
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kita
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Liu
authors.forename: Reynold A
authors.initials: RA
authors.lastname: Panettieri
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schleimer
authors.forename: Michael
authors.initials: M
authors.lastname: Minnicozzi
mesh_terms: D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D015415:Biomarkers / Q000378:metabolism*; D035843:Biomedical Research / Q000592:standards*; D001944:Breath Tests / Q000379:methods; D004804:Eosinophils; D045853:Exhalation; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis; D007073:Immunoglobulin E / Q000097:blood; D017999:Leukotriene E4 / Q000652:urine; D009569:Nitric Oxide / Q000378:metabolism; D013183:Sputum / Q000166:cytology
chemical_list: D000485:Allergens; D015415:Biomarkers; D009569:Nitric Oxide; D007073:Immunoglobulin E; D017999:Leukotriene E4