Phenotypes/endotypes-driven treatment in asthma

Purpose of review Target therapy is the necessary step towards personalized medicine. The definition of asthma phenotypes and underlying mechanisms (endotypes) represent a key point in the development of new asthma treatments. Big data analysis, biomarker research and the availability of monoclonal antibodies, targeting specific cytokines is leading to the rapid evolution of knowledge. In this review, we sought to outline many of the recent advances in the field. Recent findings Several attempts have been made to identify asthma phenotypes, sometimes with contrasting results. More success has been obtained concerning the pathogenetic mechanism of specific asthma patterns with the consequent identification of biomarkers and development of effective ad hoc treatment. Summary We are in the middle of an extraordinary revolution of our mode of thinking about and approaching asthma. All the effort in the identification of clusters of patients with different disease clinical patterns, prognosis and response to treatment is closely linked to the identification of endotypes (Th2-low and Th2-high). This approach has allowed the development of the specific treatments (anti IgE, Anti IL5 and IL5R) that are now available and is leading to new ones. Correspondence to Angelica Tiotiu, MD, PhD, Pulmonology Department, CHRU Nancy, EA 3450 DevAH – Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, University of Lorraine, 9 Avenue de la Forêt de Haye, F- 54505 – Vandoeuvre-les-Nancy, France. Tel: +33 3 83 15 43 72; fax: +33 3 83 15 35 41; e-mail: a.tiotiu@chru-nancy.fr Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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