Licari Amelia, Manti Sara, Castagnoli Riccardo, Leonardi Salvatore, Marseglia Gian Luigi
Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
These authors contributed equally.
Breathe (Sheff). 2020 Mar;16(1):190301. doi: 10.1183/20734735.0301-2019.
Severe asthma in children is a highly heterogeneous disorder, encompassing different clinical characteristics (phenotypes) and immunopathological pathways (endotypes). Research is focusing on the identification of noninvasive biomarkers able to predict treatment response and assist in designing personalised therapies for severe asthma. Blood and sputum eosinophils, serum IgE and exhaled nitric oxide fraction mostly reflect type 2 airway inflammation in children. However, in the absence of available point-of-care biomarkers, the diagnosis of non-type 2 asthma is still reached by exclusion. In this review, we present the most recent evidence on biomarkers for severe asthma and discuss their implementation in clinical practice. We address the methods for guiding treatment decisions and patient identification, focusing on the paediatric age group.
Severe asthma in children is a highly heterogeneous disorder, encompassing different clinical characteristics (phenotypes) and immunopathological pathways (endotypes).Research is focusing on the identification of noninvasive biomarkers able to predict treatment response and assist in designing personalised therapies for severe asthma.Blood and sputum eosinophils, serum IgE and exhaled nitric oxide fraction mostly reflect type 2 airway inflammation in children. However, knowledge regarding non-type 2 inflammation and related biomarkers is still lacking.
To summarise the most recent evidence on biomarkers for severe asthma in children.To discuss their implementation in clinical practice through guiding patient identification and treatment decisions.
儿童重度哮喘是一种高度异质性疾病,涵盖不同的临床特征(表型)和免疫病理途径(内型)。研究重点在于识别能够预测治疗反应并协助设计重度哮喘个性化治疗方案的非侵入性生物标志物。血液和痰液嗜酸性粒细胞、血清IgE和呼出一氧化氮分数大多反映儿童的2型气道炎症。然而,在缺乏可用的即时检测生物标志物的情况下,非2型哮喘仍需通过排除法进行诊断。在本综述中,我们展示了关于重度哮喘生物标志物的最新证据,并讨论了它们在临床实践中的应用。我们探讨了指导治疗决策和患者识别的方法,重点关注儿童年龄组。
儿童重度哮喘是一种高度异质性疾病,涵盖不同的临床特征(表型)和免疫病理途径(内型)。研究重点在于识别能够预测治疗反应并协助设计重度哮喘个性化治疗方案的非侵入性生物标志物。血液和痰液嗜酸性粒细胞、血清IgE和呼出一氧化氮分数大多反映儿童的2型气道炎症。然而,关于非2型炎症及其相关生物标志物的知识仍然缺乏。
总结儿童重度哮喘生物标志物的最新证据。通过指导患者识别和治疗决策来讨论它们在临床实践中的应用。