Department of Medicine and Physiology, Copperbelt University, Kitwe, ZambiaSyabbalo N. Biomarkers for Diagnosis and Management of Eosinophilic Asthma. Ann Clin Med Res. 2020; 1(1): 1003Fulltext PDF
Abstract Asthma is a complex chronic airway disease with several distinct phenotypes characterized by different immunopathological pathways, clinical presentation, physiology, comorbidities, biomarker of allergic inflammation and response to treatment. Approximately 10% of patients with asthma have severe refractory disease, which is difficult to control on high doses of inhaled corticosteroids and long-acting beta2-agonists. About 50% of these individuals suffer from eosinophilic asthma. Eosinophilic asthma is a phenotype of asthma that is severe and persistent, with frequent exacerbations. It is associated with comorbidities such as chronic rhinosinusitis and nasal polyps. Laboratory findings include high sputum and blood eosinophil counts, high serum levels of perisotin and dipeptidyl petiptidase-4; and high levels of fractional exhaled nitric oxide. The T helper 2 cytokines, Interleukin-5 (IL-5), IL-4, IL-13, IL-25 and Thymic Stromal Lymphopoietin (TSLP), play a very important role in the pathogenesis of eosinophilic asthma. They are responsible for eosinophilic airway inflammation, hyper responsiveness and airway remodeling. Biomarkers such as sputum and blood eosinophil counts, fractional expired nitric oxide, serum periostin, dipeptidyl peptidae-4 and osteopontin are currently been used to diagnose eosinophilic asthma. This permits personalized therapies targeted at the inflammatory cytokines. Patients with steroidresistant eosinophilic asthma respond favorably to biologics targeted against IGE (omulizumab), IL-5 (mepolizumab, reslizumab and benralimab), IL-4/13 (dupilumab) and TSLP (tezepemumab). Biologics are effective in achieving disease control, reducing exacerbations, improve the quality of life and have the advantage of steroid-sparing.
Eosinophilic asthma; Biomarkers; Interleukins; Monoclonal antibodies
Syabbalo N. Biomarkers for Diagnosis and Management of Eosinophilic Asthma. Ann Clin Med Res. 2020; 1(1): 1003..