Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes

Melissa D Gans; Tatyana Gavrilova

doi:10.1016/j.prrv.2019.08.002

Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes

Paediatr Respir Rev. 2020 Nov:36:118-127. doi: 10.1016/j.prrv.2019.08.002. Epub 2019 Oct 9.

Authors

Melissa D Gans¹, Tatyana Gavrilova²

Affiliations

¹ Division of Allergy and Immunology, Montefiore Medical Center, 1525 Blondell Ave, Bronx, NY 10461, USA. Electronic address: mstone@montefiore.org.
² Division of Allergy and Immunology, Montefiore Medical Center, 1525 Blondell Ave, Bronx, NY 10461, USA. Electronic address: tgavrilo@montefiore.org.

PMID: 31678040
DOI: 10.1016/j.prrv.2019.08.002

Abstract

Asthma is a common disease in paediatrics and adults with a significant morbidity, mortality, and financial burden worldwide. Asthma is now recognized as a heterogeneous disease and emerging clinical and laboratory research has elucidated understanding of asthma's underlying immunology. The future of asthma is classifying asthma by endotype through connecting discernible characteristics with immunological mechanisms. This comprehensive review of the immunology of asthma details the currently known pathophysiology and clinical practice biomarkers in addition to forefront biologic and targeted therapies for all of the asthma endotypes. By understanding the immunology of asthma, practitioners will be able to diagnose patients by asthma endotype and provide personalized, biomarker-driven treatments to effectively control patients' asthma.

Keywords: Asthma; Biomarkers; Immunology; Pathophysiology; Phenotypes; Review.

Publication types

Review

MeSH terms

Asthma / classification
Asthma / immunology*
Asthma / physiopathology
Asthma / therapy
Asthma, Aspirin-Induced / immunology
Asthma, Aspirin-Induced / physiopathology
Asthma, Aspirin-Induced / therapy
Asthma, Exercise-Induced / immunology
Asthma, Exercise-Induced / physiopathology
Asthma, Exercise-Induced / therapy
Biological Products
Biomarkers
Cytokines / immunology*
Eosinophilia / immunology
Eosinophilia / physiopathology
Eosinophilia / therapy
Humans
Invasive Pulmonary Aspergillosis / immunology
Invasive Pulmonary Aspergillosis / physiopathology
Invasive Pulmonary Aspergillosis / therapy
Leukotrienes / immunology*
Molecular Targeted Therapy
Obesity / immunology
Obesity / physiopathology
Oxidative Stress / immunology
Phenotype
Respiratory Hypersensitivity / immunology
Respiratory Hypersensitivity / physiopathology
Respiratory Hypersensitivity / therapy
Respiratory Sounds
Th1 Cells / immunology*
Th2 Cells / immunology*

Substances

Biological Products
Biomarkers
Cytokines
Leukotrienes