Different phenotypes of asthma existed, with considerable differences in the presentation of airway inflammation, symptoms, severity, and responsiveness to therapy, according to current asthma diagnostic and management recommendations. For a study, researchers critically evaluated the novel asthma classification methodologies as well as the developing endotype-driven therapy options. Precision and deep phenotyping, as well as the identification of novel causal pathways and the conversion of biomarkers into pathway-specific diagnostic tests, were all new techniques for the categorization of asthma. Epigenetic phenotypes, asthmatic granulomatosis, and neuron phenotypes were among the new phenotypes identified. Large clinical studies examining the endotype-driven strategy were becoming more effective, but the dissociated impact and therapeutic efficacy at the target location remained the unresolved problems.  Profiling the Th2 low and the resident cell compartment of asthma were important unmet requirements in asthma endotyping.

Each of the cardinal features of asthma (inflammation, remodeling, and airway hyperreactivity) were the expression of a complex network of molecules that were exceedingly varied, both within any particular patient over time as well as between any two individuals. Some of these networks were repeated among patients with asthma and particularly for clinical expression, gene-environment interaction, and inflammatory cell profiles provided potential endotype-specific diagnostic and treatment options.

Reference:journals.lww.com/co-allergy/Abstract/2013/06000/From_phenotypes_to_endotypes_to_asthma_treatment.6.aspx

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