Sim Soyoon, Choi Youngwoo, Park Hae-Sim
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Department of Biomaterials Science (BK21 FOUR Program), College of Natural Resources and Life Science, Pusan National University, Miryang, Korea.
Allergy Asthma Immunol Res. 2024 Sep;16(5):462-472. doi: 10.4168/aair.2024.16.5.462.
Asthma is a chronic heterogeneous disease characterized by various symptoms and persistent airway inflammation, resulting in progressive lung function decline. Classifying asthma phenotypes/endotypes is crucial because the underlying mechanisms and long-term outcomes vary from patient to patient. Recent trials have identified several biomarkers for classifying asthma phenotypes/endotypes, and current treatments have been developed on the basis of these biomarkers. Conventional biomarkers, including immunoglobulin E, blood/sputum eosinophil counts, airway obstruction or reversibility, and fractional exhaled nitric oxide, are widely used to diagnose asthma. However, these markers have some limitations, necessitating the discovery of additional biomarkers. Therefore, this review summarizes recently suggested biomarkers for representing type 2-high (eosinophilic) vs. type 2-low (neutrophilic) asthma, non-steroidal anti-inflammatory drug-exacerbated respiratory disease, and severe asthma. Additionally, we discuss the potential benefits of these biomarkers in classifying specific phenotypes/endotypes and managing asthmatic patients.
哮喘是一种慢性异质性疾病，其特征为多种症状和持续性气道炎症，导致肺功能进行性下降。对哮喘表型/内型进行分类至关重要，因为其潜在机制和长期预后因患者而异。近期试验已确定了几种用于哮喘表型/内型分类的生物标志物，目前的治疗方法就是基于这些生物标志物开发的。传统生物标志物，包括免疫球蛋白E、血液/痰液嗜酸性粒细胞计数、气道阻塞或可逆性以及呼出一氧化氮分数，被广泛用于诊断哮喘。然而，这些标志物存在一些局限性，因此需要发现更多生物标志物。因此，本综述总结了最近提出的用于区分2型高（嗜酸性粒细胞性）与2型低（中性粒细胞性）哮喘、非甾体抗炎药加重的呼吸系统疾病和重度哮喘的生物标志物。此外，我们还讨论了这些生物标志物在特定表型/内型分类和哮喘患者管理中的潜在益处。
