title: Inflammatory biomarkers for asthma endotyping and consequent personalized therapy.
abstract: We argue that asthma be considered a syndrome caused by multiple inflammatory pathogenic processes. Bronchial hyperresponsiveness, reversible airflow limitation, and chronic airway inflammation characterize asthma pathophysiology. Personalized Medicine, i.e. a tailored management approach, is appropriate for asthma management and is based on the identification of discrete phenotypes and endotypes. Biomarkers can help define phenotypes and endotypes. Several biomarkers have been described in asthma, but most of them are not commonly available or still need external validation. Areas covered: This review presents useful pragmatic biomarkers available in daily clinical practice for assessing airway inflammation in asthmatic patients. Expert commentary: Eosinophil counts and serum allergen-specific IgE assessments are the most reliable biomarkers. Lung function, mainly concerning FEF25-75, and nasal cytology may be envisaged as ancillary biomarkers in asthma management. In conclusion, biomarkers have a clinical relevance in asthma in identifying asthma endotypes to direct personalized therapy.
authors.affiliation: a Respiratory Allergy, Department of Medicine , IRCCS - Azienda Ospedaliera Universitaria San Martino-IST , Genoa , Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: b Pediatric Pneumology and Allergy Unit and Cystic Fibrosis Center , IRCCS Istituto Giannina Gaslini , Genoa , Italy.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tosca
authors.affiliation: b Pediatric Pneumology and Allergy Unit and Cystic Fibrosis Center , IRCCS Istituto Giannina Gaslini , Genoa , Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Silvestri
authors.affiliation: c Department of Clinical and Biological Sciences , University of Torino , Turin , Italy.
authors.forename: Fabio Luigi Massimo
authors.initials: FLM
authors.lastname: Ricciardolo
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism*; D054316:Biomarkers, Pharmacological / Q000378:metabolism*; D019317:Evidence-Based Medicine; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D010641:Phenotype; D057285:Precision Medicine
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D054316:Biomarkers, Pharmacological; D018836:Inflammation Mediators
keywords: Asthma; biomarkers; endotype; personalized therapy; phenotype; precision medicine