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Adult asthma biomarkers

Kim, Mi-Ae; Shin, Yoo Seob; Pham, Le Duy; Park, Hae-Sim

Current Opinion in Allergy and Clinical Immunology: February 2014 - Volume 14 - Issue 1 - p 49–54
doi: 10.1097/ACI.0000000000000028
MECHANISMS OF ALLERGY AND ADULT ASTHMA: Edited by Jean Bousquet and J. Andrew Grant

Purpose of review A variety of novel asthma treatments have been developed based on phenotypes, and the clinical trial results show promising responses. This review summarizes the current knowledge of biomarkers for the determination of asthma phenotypes.

Recent findings Eosinophilic inflammation is the most focused phenotype because most novel asthma treatments have targeted T-helper type 2 (Th2) pathway. Fractional-exhaled nitric oxide (FeNO) is a new method that represents an eosinophilic airway inflammation with a significant correlation with sputum eosinophilia and asthma severity instead of sputum eosinophil count that easily influenced by corticosteroid therapy. However, some reports indicated the discordance between treatment response or adjustment and FeNO levels. Serum periostin is a strong serum biomarker for eosinophilic airway inflammation and an indicator of Th2-targeted therapy (such as lebrikizumab or omalizumab) and airflow limitation. YKL-40 is associated with asthma severity and airway remodeling. In addition, genetic and metabolomic approaches have been made to determine asthma phenotypes and severity.

Summary Biomarkers such as FeNO and serum periostin represent eosinophilic airway inflammation, together with eosinophil-derived neurotoxin and osteopontin (OPN) needed more replication studies. Periostin, YKL-40, OPN and some metabolites (choline, arginine, acetone and protectin D1) are related to asthma severity and airflow limitation.

aDepartment of Allergy and Clinical Immunology, Ajou University School of Medicine

bDepartment of Biomedical Science, Ajou University Graduate School, Suwon, Gyeonggi-do, South Korea

Correspondence to Professor Hae-Sim Park, Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Wonchondong San 5, Youngtongku, Suwon 443-721, South Korea. Tel: +82 31 219 5196; fax: +82 31 219 5154; e-mail:

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