Phenotypes and Endotypes of Uncontrolled Severe Asthma: New Treatments

Journal of Investigational Allergology and Clinical Immunology

J Delgado⁶  JM Olaguibel²  R Cárdenas⁴  E Gómez-Torrijos⁴  C Pérez-Francés⁵  S Quirce⁸  P Barranco⁸  S Sánchez-García³  F Rodríguez⁷  P Campo¹ 

[1] UGC Allergy, Hospital General de Málaga, Málaga, Spain;Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Spain;Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain;Department of Allergy, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain;Department of Allergy, Hospital Universitario Dr. Peset, Valencia, Spain;UGC Allergy, Hospital Universitario Virgen Macarena, Sevilla, Spain;Department of Allergy, Hospital Universitario Marqués de Valdecilla, Santander, Spain;Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain

关键词: Treatment;    Phenotype;    Endotype;    Biomarkers;    Severe asthma;   

Others  :  1183820

【 摘 要 】

Severe asthma is a heterogeneous disease that affects only 5%-10% of asthmatic patients, although it accounts for a significant percentage of the consumption of health care resources. Severe asthma is characterized by the need for treatment with high doses of inhaled corticosteroids and includes several clinical and pathophysiological phenotypes. To a large extent, this heterogeneity restricts characterization of the disease and, in most cases, hinders the selection of appropriate treatment. In recent years, therefore, emphasis has been placed on improving our understanding of the various phenotypes of severe asthma and the identification of biomarkers for each of these phenotypes. Likewise, the concept of the endotype has been gaining acceptance with regard to the various subtypes of the disease, which are classified according to their unique functional or pathophysiological mechanism. This review discusses the most relevant aspects of the clinical and inflammatory phenotypes of severe asthma, including severe childhood asthma and the various endotypes of severe asthma. The main therapeutic options available for patients with uncontrolled severe asthma will also be reviewed.