Contemporary Biomarkers in Severe Asthma Management

Abstract

Contemporary asthma management requires a proactive and personalized approach, integrating precise diagnosis with individualized treatment strategies. The incorporation of biological therapies for severe asthma into standard clinical practice underscores the importance of specific patient selection, outcome prediction, and continuous monitoring of these costly and prolonged treatments. Biomarkers, functioning as crucial indicators, have significantly impacted asthma by facilitating disease identification, predicting severity and prognosis, and assessing treatment effectiveness. This comprehensive review aims to thoroughly explore the diverse biomarkers associated with asthma, elucidating their roles in disease identification, severity prediction, and treatment response assessment. By delving into the intricate molecular and genetic aspects of asthma susceptibility, the review seeks to provide a nuanced understanding of the factors that influence the onset and severity of asthma. The review covers a spectrum of molecular factors that influence the susceptibility and severity of asthma. It explores the roles of specific biomarkers such as galectin-3, periostin, fractional exhaled nitric oxide, and eosinophils in airway remodeling and inflammation. Genetic factors like filaggrin mutations and chitinase-3-like protein 1 (CHI3L1 or YKL-40) variations are also examined. The review delves into proteomics, revealing unique plasma protein signatures linked to severe asthma and chronic obstructive pulmonary disease. It thoroughly examines the impact of the microbiome on asthma development, persistence, and severity, considering gut and lung microbial dysbiosis. Additionally, it highlights the potential of probiotics in managing allergic respiratory diseases and investigates the preventative effects of early exposure to pets in childhood. This review is a valuable resource for clinicians, researchers, and healthcare professionals in this field. It highlights the crucial role of biomarkers in asthma and offers a comprehensive understanding of genetics, proteomics, and the microbiome, enriching our comprehension of asthma management and preventive measures.