Asthma Phenotypes and Biomarkers...61st Respiratory Care Journal Conference, June 19–21, 2024, Tampa, Florida.
Asthma experienced by both adults and children is a phenotypically heterogeneous condition. Severe asthma, characterized by ongoing symptoms and airway inflammation despite high doses of inhaled and/or systemic corticosteroids, is the focus of research efforts to understand this underlying heterogen...
| Publicado en: | Respiratory Care Vol. 70; no. 6; pp. 649 - 675 |
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| Autores principales: | , |
| Formato: | CEU pictorial proceedings review tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jun2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185630215&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185630215 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Jun2025 vid: 70 iid: 6 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 185630215 185630215 185630215 10.1089/respcare.12352 185630215 ppf: 649 ppct: 26 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Asthma Phenotypes and Biomarkers...61st Respiratory Care Journal Conference, June 19–21, 2024, Tampa, Florida. aug: au: Grunwell, Jocelyn R. Fitzpatrick, Anne M. affil: Dr. Grunwell is affiliated with Division of Critical Care Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia. sug: subj: Asthma Pathology Asthma Pathology Biological Markers Phenotype Asthma Therapy Congresses and Conferences Florida Education, Continuing (Credit) Child Adult Asthma Symptoms Adrenal Cortex Hormones Therapeutic Use Adrenal Cortex Hormones Administration and Dosage Severity of Illness Inflammation Disease Exacerbation Interleukins Blood Eosinophils Hypersensitivity Biological Products Therapeutic Use Immunoglobulins Blood Nitric Oxide Patient Admission Intensive Care Units Treatment Failure Child: 6-12 years Adult: 19-44 years ab: Asthma experienced by both adults and children is a phenotypically heterogeneous condition. Severe asthma, characterized by ongoing symptoms and airway inflammation despite high doses of inhaled and/or systemic corticosteroids, is the focus of research efforts to understand this underlying heterogeneity. Clinical phenotypes in both adult and pediatric asthma have been determined using supervised definition-driven classification and unsupervised data-driven clustering methods. Efforts to understand the underlying inflammatory patterns of severe asthma have led to the seminal discovery of type 2-high versus type 2-low phenotypes and to the development of biologics targeted at type 2-high inflammation to reduce the rates of severe asthma exacerbations. Type 2-high asthma is characterized by upregulation of T helper 2 immune pathways including interleukin (IL)-4, IL-5, and IL-13 along with eosinophilic airway inflammation, sometimes allergic sensitization, and responsiveness to treatment with corticosteroids. Type 2-low asthma is poorly responsive to corticosteroids and is not as well characterized as type 2-high asthma. Type 2-low asthma is limited by being defined as the absence of type 2-high inflammatory markers. Choosing a biologic for the treatment of severe asthma involves the evaluation of a panel of biomarkers such as blood eosinophils, total and specific immunoglobulin E/allergic sensitization, and fractional exhaled nitric oxide. In this review, we focus on the underlying pathobiology of adult and pediatric asthma, discuss the different phenotype-based treatment options for adult and pediatric type 2-high with or without allergic asthma and type 2-low asthma, and describe a clinical phenotyping approach to patients to guide out-patient therapy. Finally, we end with a discussion of whether pediatric asthma exacerbations necessitating admission to an ICU constitute their own high-risk phenotype and/or whether it is a part of other previously defined high-risk subgroups such as difficult-to-control asthma, exacerbation-prone asthma, and severe treatment-resistant asthma. pubtype: Academic Journal doctype: CEU pictorial proceedings review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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