Severe Asthma: Updated Therapy Approach Based on Phenotype and Biomarker


Book Description

Asthma is responsible for considerable global morbidity and health-care costs affecting over 300 million people worldwide. This illness is a heterogeneous condition characterized by chronic airway inflammation and pulmonary tissue remodeling resulting in a variety of clinical manifestations and treatment responses. Recent studies have shown an increasing appreciation of heterogeneity in asthma based on molecular phenotyping, biomarkers, and differential responses to therapies. In terms of asthma classification, perhaps the most important distinction to make is whether the patient has evidence of an eosinophilic inflammatory process characterized by type 2 immune response (Th2) or not. Therefore, personalized therapies to asthmatic patients just will be a reality by identifying and characterizing biomarkers. This review approaches the advances in diagnoses and management of asthma and severe asthma and highlights those with difficult-to-treat asthma based on each phenotype and biomarkers, to assist in the optimization of conventional therapy and to guide the use of targeted therapies.




Severe Asthma


Book Description

This book presents state of the art knowledge on severe asthma with the aim of providing readers with a clear understanding of, first, the heterogeneity of the condition and of patients’ symptom profiles and responses to therapy and, second, the future implications of this heterogeneity for individualized patient care. After an opening section that offers an overview of severe asthma, including its clinical significance, the pathogenesis, available diagnostic approaches, and treatment options are described in detail. The sections on diagnosis and treatment cover the role of biomarkers, the use of radiologic diagnostic modalities, and both pharmacologic and non-pharmacologic therapies, including emerging options that will address hitherto unmet needs of patients. The outcomes of cutting-edge preclinical and clinical research are carefully documented and numerous useful tips provided on patient management. The inclusion of many informative schematic figures will assist readers in grasping the contents easily. The book will be of high value for medical students, researchers, general physicians, specialists, and paramedical staff.




Clinical Updates in the Management of Severe Asthma


Book Description

This eHealth SourceTM program examines best practices for assessing disease control in patients with severe asthma, the evidence for current and emerging biologic medications, and strategies to improve patient education and treatment adherence.




Asthma


Book Description

Asthma is a common complex and heterogeneous respiratory disease with an increasing prevalence in developed countries. Asthma is a disease consisting of different phenotypes that are driven by different mechanistic pathways (endotypes). The recognition of these phenotypes and endotypes is central to asthma management entailing prognostic and therapeutic implications. It is acknowledged that despite optimal treatment, many patients are poorly controlled, highlighting the need for phenotype-guided treatments. In this context, the emergence of novel therapies (monoclonal antibody therapy, bronchial thermoplasty) is paving the way for personalized asthma therapy. A better understanding of disease pathogenesis may enable the identification of biomarkers, mediators, novel therapeutic targets, and treatable traits. Further molecular phenotyping or endotyping of asthma will be necessary to tailor new therapeutic strategies. The present Special Issue on Asthma aims to provide the current knowledge on phenotypes and endotypes in appreciating and managing the heterogeneous condition that is asthma.




Heterogeneity in Asthma


Book Description

Asthma is a chronic relapsing airways disease that represents a major public health problem worldwide. Intermittent exacerbations are provoked by airway mucosal exposure to pro-inflammatory stimuli, with RNA viral infections or inhaled allergens representing the two most common precipitants. In this setting, inducible signaling pathways the airway mucosa play a central role in the initiation of airway inflammation through production of antimicrobial peptides (defensins), cytokines, chemokines and arachidonic acid metabolites that coordinate the complex processes of vascular permeability, cellular recruitment, mucous hyper-secretion, bronchial constriction and tissue remodeling. These signals also are responsible for leukocytic infiltration into the submucosa, T helper-lymphocyte skewing, and allergic sensitization. Currently, it is well appreciated that asthma is a heterogeneous in terms of onset, exacerbants, severity, and treatment response. Current asthma classification methods are largely descriptive and focus on a single aspect or dimension of the disease. An active area of investigation on how to collect, use and visualize multidimensional profiling in asthma. This book will overview multidimensional profiling strategies and visualization approaches for phenotyping asthma. As an outcome, this work will facilitate the understanding of disease etiology, prognosis and/or therapeutic intervention. ​




Approach Based on Phenotype and EndotypeAsthma Diagnosis and Management


Book Description

Asthma is a severe and growing threat affecting both children and adults in both developing and developed world, currently affecting approximately 8% of US population. It is becoming increasingly recognized as a syndrome constituted by airway obstruction, airway hyperresponsiveness, and airway inflammation with different causes, associated risk factors, and underlying pathophysiology. The advances in basic and clinical research of asthma have accelerated over the past 20 years with increasing diagnostic tools, especially biomarkers, that led to specific characterization of individual patient's asthma pathophysiology, or disease "phenotype" and "endotype," which allowed precision medicine therapies, including new asthma biologics. This book aims to update the paradigm shifts in precision medicine of asthma diagnosis and management, driven by underlying phenotypes or endotypes.




Asthma: A Multidisciplinary Approach, 2C (Clinics Collections)


Book Description

Clinics Collections: Asthma draws from Elsevier’s robust Clinics Review Articles database to provide multidisciplinary teams, including general practitioners, pulmonologists, otolaryngologists, allergists, pediatricians, and other healthcare professionals, with practical clinical advice and insights on this highly prevalent disease and its comorbidities. Clinics Collections: Asthma guides readers on how to apply current primary research findings on asthma to everyday practice to help overcome challenges and complications, keep up with new and improved treatment methods, and improve patient outcomes. Areas of focus include pathogenesis, treatment and management of adult asthma, management of pediatric asthma, and special considerations. Each article begins with keywords and key points for immediate access to the most critical information. Articles are presented in an easy-to-digest and concisely worded format. Elsevier Clinics Collections provide concise reviews of today’s most prevalent conditions and significant medical developments.




Asthma


Book Description

The clinical specificities developed in this book, particularly from those reported in the pediatric population to those reported in complex shapes at ACOS patients, emphasize the importance of identifying not only biomarkers but also critical aspects regarding the variability in pharmacogenomics responsible for the individual response to the different drugs on the therapeutic plan. The contribution of several well-known specialists with their profound knowledge inherent to this issue into different age groups and socio geographical contexts has resulted in this interesting book with relevant key contents in asthma.




Asthma: Targeted Biological Therapies


Book Description

This book focuses on the fundamentals of the use of biologics in asthma, describing the rationale, principles, mechanisms of action, and indications. It offers an excellent balance between basic science and the analysis of clinical trials, updating readers with new developments that are changing the global scenario for targeted biological anti-asthma therapies, especially with regard to more severe disease. A range of therapies are considered, from the humanized monoclonal anti-IgE antibody omalizumab, widely approved as add-on treatment for inadequately controlled disease, through to emerging biologics for which evidence supportive of efficacy is accumulating, including anti-IL-5, anti-IL-4, and anti-IL-13 therapies. One aspect to emerge is the variability in individual response, which suggests a need for characterization of different asthma subtypes to permit the effective implementation of phenotype-targeted treatments. This book will be of interest for pulmonologists, clinical immunologists, and physicians seeking sound information on these therapies, but also for scientists and pharmacologists wishing to enhance their knowledge of the therapeutic implications of the cellular and molecular mechanisms that underlie severe, uncontrolled asthma.




Precision Approaches to Heterogeneity in Asthma


Book Description

Asthma is a common chronic respiratory disease that causes substantial morbidity and has been challenging to treat due to its heterogeneous onset, environmental triggers, severity, and treatment response. To update the field on the rapid advances in this field, Precision Approaches to Heterogeneity in Asthma follows its highly successful predecessor, Heterogeneity in Asthma. In this new volume, noted authorities Allan R Brasier and Nizar N Jarjour and a cadre of leaders in the field incorporate new work advancing our understanding of phenotypes (endotypes) of disease, regional variations in ventilation, systems approach to analyzing the findings from studies of inducible phenotypes, and emerging results of biomarker-informed clinical trials. This work will facilitate our current understanding of the spectrum of disease etiology, prognosis, and the likelihood of responding to the range of available therapeutic interventions.