Personalised therapeutic approaches for asthma
File(s)
Author(s)
Type
Journal Article
Abstract
Differences in host susceptibility and environmental exposures result in significant heterogeneity in asthma clinical expression, natural evolution and response to treatment. These differences are influenced by many factors including genomics, epigenomics, transcriptomics, proteomics and metabolomics, many of which are modified by environmental and allergic exposures. The complex and multiple characteristics that interact in asthma development and progression pose significant challenges for personalized management. This review aims to guide the clinician in its management decisions by reviewing each of the components important in developing this therapeutic paradigm and by providing several integrated goals for precision or personalized medicine for asthma. Biologic characteristics of asthma in relation to the genomics, exposome and hypersensitivity reactions (allergic responsiveness) resulting in the asthma diathesis are discussed. Further insights including the use of targeted biologics and allergen immunotherapy are provided, while discussing the importance of targeting the epithelium, mucus production, airway smooth muscle and the small airways. We examine the value of multivariate cluster analyses as a new paradigm that can inform treatment decisions and the potential of adaptive trial design to evaluate known and novel predictive biomarkers and characterize disease heterogeneity.
Date Issued
2025-09-01
Date Acceptance
2025-03-27
Citation
Journal of Allergy and Clinical Immunology, 2025, 156 (3), pp.503-522
ISSN
0091-6749
Publisher
Elsevier
Start Page
503
End Page
522
Journal / Book Title
Journal of Allergy and Clinical Immunology
Volume
156
Issue
3
Copyright Statement
Copyright © 2025 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40203996
PII: S0091-6749(25)00375-6
Subjects
asthma
biomarkers
endotypes
precision medicine
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2025-04-07