title: Developing and emerging clinical asthma phenotypes.
abstract: For more than a century, clinicians have attempted to subdivide asthma into different phenotypes based on triggers that cause asthma attacks, the course of the disease, or the prognosis. The first phenotypes that were described included allergic asthma, intrinsic or nonallergic asthma, infectious asthma, and aspirin-exacerbated asthma. These phenotypes are being reviewed elsewhere in this issue of the journal. The present article focuses on developing and emerging clinical asthma phenotypes. First, asthma phenotypes that are associated with environmental exposures (occupational agents, cigarette smoke, air pollution, cold dry air); second, asthma phenotypes that are associated with specific symptoms or clinical characteristics (cough, obesity, adult onset of disease); and third, asthma phenotypes that are based on biomarkers. This latter approach is the most promising because it attempts to identify asthma phenotypes with different underlying mechanisms so that therapies can be better targeted toward disease-specific features and disease outcomes can be improved.
authors.affiliation: The Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands. Electronic address: p.w.hekking@amc.nl.
authors.forename: Pieter-Paul W
authors.initials: PP
authors.lastname: Hekking
authors.affiliation: The Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Bel
mesh_terms: D000818:Animals; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D001250:Asthma, Exercise-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D015415:Biomarkers / Q000032:analysis; D015897:Comorbidity; D018450:Disease Progression; D004781:Environmental Exposure / Q000009:adverse effects; D004785:Environmental Pollutants / Q000009:adverse effects; D006801:Humans; D008168:Lung / Q000276:immunology / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects; D010641:Phenotype; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D015415:Biomarkers; D004785:Environmental Pollutants; D014028:Tobacco Smoke Pollution
keywords: Adult-onset asthma; Air pollution-induced asthma; Asthma; Cigarette smoke-induced asthma; Cough-variant asthma; Eosinophilic asthma; Exacerbation-prone asthma; Exercise-induced asthma; Neutrophilic asthma; Obesity; Occupational asthma; Persistent airflow limitation; Phenotypes; Review