title: Clinical utility of asthma biomarkers: from bench to bedside.
abstract: Asthma is a chronic disease characterized by airway inflammation, bronchial hyperresponsiveness, and recurrent episodes of reversible airway obstruction. The disease is very heterogeneous in onset, course, and response to treatment, and seems to encompass a broad collection of heterogeneous disease subtypes with different underlying pathophysiological mechanisms. There is a strong need for easily interpreted clinical biomarkers to assess the nature and severity of the disease. Currently available biomarkers for clinical practice - for example markers in bronchial lavage, bronchial biopsies, sputum, or fraction of exhaled nitric oxide (FeNO) - are limited due to invasiveness or lack of specificity. The assessment of markers in peripheral blood might be a good alternative to study airway inflammation more specifically, compared to FeNO, and in a less invasive manner, compared to bronchoalveolar lavage, biopsies, or sputum induction. In addition, promising novel biomarkers are discovered in the field of breath metabolomics (eg, volatile organic compounds) and (pharmaco)genomics. Biomarker research in asthma is increasingly shifting from the assessment of the value of single biomarkers to multidimensional approaches in which the clinical value of a combination of various markers is studied. This could eventually lead to the development of a clinically applicable algorithm composed of various markers and clinical features to phenotype asthma and improve diagnosis and asthma management.
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands ; Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Susanne Jh
authors.initials: SJ
authors.lastname: Vijverberg
authors.forename: Bart
authors.initials: B
authors.lastname: Hilvering
authors.forename: Jan Am
authors.initials: JA
authors.lastname: Raaijmakers
authors.forename: Jan-Willem J
authors.initials: JW
authors.lastname: Lammers
authors.forename: Anke-Hilse
authors.initials: AH
authors.lastname: Maitland-van der Zee
authors.forename: Leo
authors.initials: L
authors.lastname: Koenderman
keywords: airway inflammation; asthma; biological markers; metabolomics; pharmacogenomics