title: Novel biomarkers for asthma stratification and personalized therapy.
abstract: A stepwise pharmacological treatment is currently recommended for all asthma patients and is personalized mainly on disease severity, aiming for the lowest disease-controlling step. Nevertheless, asthma comprises several related pathologies with similar clinical manifestations resulting from distinct underlying mechanisms. Therefore novel biomarkers could lead to asthma stratification and thus improve upon the current stepwise approach. The aim of this review is to update the reader with regard to different assays proposed in the recent asthma literature for measuring potential biomarkers for patient stratification and treatment personalization. Promising biomarkers are sputum eosinophils, serum periostin and exhaled nitric oxide. Periostin could differentiate between Th2-high and Th2-low asthma (Th2-high patients are more responsive to glucocorticoids) and the less-defined asthma types which often present a therapeutic challenge. Several other biomarkers, mainly cytokines, leukotrienes and exhaled air components, can be quantified in body fluids and exhaled breath and could also be useful for asthma stratification.
authors.affiliation: Department of Asthma, Allergy and Lung Biology, King's College London 5th floor Tower Wing, Guy's Hospital, London Bridge, SE1 9RT, UK.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Bartminski
authors.forename: Matthew
authors.initials: M
authors.lastname: Crossley
authors.forename: Victor
authors.initials: V
authors.lastname: Turcanu
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D015415:Biomarkers; D001706:Biopsy; D001944:Breath Tests; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D015815:Cell Adhesion Molecules / Q000378:metabolism; D045853:Exhalation; D006801:Humans; D007962:Leukocytes; D009569:Nitric Oxide; D010641:Phenotype; D057285:Precision Medicine; D013183:Sputum / Q000166:cytology / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; C512835:POSTN protein, human; D009569:Nitric Oxide
keywords: asthma; biomarker; chitinases; eosinophils; exhaled nitric oxide; inflammatory; periostin; prostaglandins; volatile organic compounds