Our modern understanding of asthma mainly concerns identification of inflammatory endotype to guide management. The distinction mostly concerns identification of type-2 inflammation, for which different biomarkers have been well characterized. Blood eosinophils corroborate activity in the interleukin (IL)-5 axis while fraction of exhaled nitric oxide is indicative of the IL-4/IL-13 axis, giving us an indication of activity in these distinct but complementary pathways. These biomarkers predict disease activity, with increased risk of exacerbations when elevated, and a further, multiplicative increase when both are elevated. Serum immunoglobulin E is also implicated in this pathway, and can represent allergen-related stimulation.
Journal article
Immunol Allergy Clin North Am
11/2024
44
709 - 723
Asthma, Biomarker, Inflammation, Management, Severe, Humans, Asthma, Biomarkers, Biological Products, Immunoglobulin E, Eosinophils, Anti-Asthmatic Agents, Cytokines