Moderate asthma: burden, mechanisms and therapeutic perspectives.


Journal

Current opinion in allergy and clinical immunology
ISSN: 1473-6322
Titre abrégé: Curr Opin Allergy Clin Immunol
Pays: United States
ID NLM: 100936359

Informations de publication

Date de publication:
26 Oct 2023
Historique:
pubmed: 25 10 2023
medline: 25 10 2023
entrez: 25 10 2023
Statut: aheadofprint

Résumé

Global Initiative for Asthma (GINA) document provides a classification of asthma severity according with the current level of treatment required to achieve diseases control and underlines the limitations of this approach. In this review, we will provide an overview of recent investigations that have analyzed clinical and molecular features of moderate asthma. Moderate asthma is heterogeneous in terms of response to inhaled treatment and pathogenetic mechanisms underlying the clinical features. Analysis of inflammatory pathways in patients who do not achieve disease remission allows identification of patient subgroups that may benefit from specific biological treatments. Scientific progress makes increasingly clear that there are biological mechanisms capable of identifying and justifying the degree of severity of asthma. The identification of these, combined with the development of new pharmacological treatments, will be the cornerstones of improving the management of asthma in its degrees of severity.

Identifiants

pubmed: 37877372
doi: 10.1097/ACI.0000000000000953
pii: 00130832-990000000-00092
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Références

Global Initiative for Asthma. Global strategy for Asthma Managment and Prevention, 2023. Updated July 2023. Available from: www.ginasthma.org .
Schiffers C, Wouters EF, Breyer-Kohansal R, et al. Asthma prevalence and phenotyping in the general population: the LEAD (Lung, hEart, sociAl, boDy) Study. J Asthma Allergy 2023; 16:367–382.
Brusselle GG, Koppelman GH. Biologic therapies for severe asthma. N Engl J Med 2022; 386:157–171.
Tolomeo C. Biologic therapies for moderate to severe asthma in the pediatric population: a practice update. SAGE Open Nurs 2023; 9:23779608231154041.
Czira A, Turner M, Martin A, et al. A systematic literature review of burden of illness in adults with uncontrolled moderate/severe asthma. Respir Med 2022; 191:106670.
Braido F, Blasi F, Canonica GW, et al. Mild/Moderate Asthma Network in Italy (MANI): a long-term observational study. J Asthma 2022; 59:1908–1913.
Maspero J, Adir Y, Al-Ahmad M, et al. Type 2 inflammation in asthma and other airway diseases. ERJ Open Res 2022; 8:00576–2021.
Frøssing L, Klein DK, Hvidtfeldt M, et al. Distribution of type 2 biomarkers and association with severity, clinical characteristics and comorbidities in the BREATHE real-life asthma population. ERJ Open Res 2023; 9:00483–2022.
Tiotiu A, Badi Y, Kermani NZ, et al. Association of differential mast cell activation with granulocytic inflammation in severe asthma. Am J Respir Crit Care Med 2022; 205:397–411.
Hou R, Ye G, Cheng X, et al. The role of inflammation in anxiety and depression in the European U-BIOPRED asthma cohorts. Brain Behav Immun 2023; 111:249–258.
Reinke SN, Naz S, Chaleckis R, et al. Urinary metabotype of severe asthma evidences decreased carnitine metabolism independent of oral corticosteroid treatment in the U-BIOPRED study. Eur Respir J 2022; 59:2101733.
Chan R, Duraikannu C, Lipworth B. Clinical associations of mucus plugging in moderate to severe asthma. J Allergy Clin Immunol Pract 2023; 11:195–199. e2.
Chang D, Hunkapiller J, Bhangale T, et al. A whole genome sequencing study of moderate to severe asthma identifies a lung function locus associated with asthma risk. Sci Rep 2022; 12:5574.
Minagawa S, Araya J, Watanabe N, et al. Real-life effectiveness of dupilumab in patients with mild to moderate bronchial asthma comorbid with CRSwNP. BMC Pulm Med 2022; 22:258.
Wechsler ME, Ford LB, Maspero JF, et al. Long-term safety and efficacy of dupilumab in patients with moderate-to-severe asthma (TRAVERSE): an open-label extension study. Lancet Respir Med 2022; 10:11–25.
Pavord ID, Bourdin A, Papi A, et al. Dupilumab sustains efficacy in patients with moderate-to-severe type 2 asthma regardless of ICS dose. Allergy 2023; 00:1–12.
Chagas GCL, Xavier D, Gomes L, et al. Effects of tezepelumab on quality of life of patients with moderate-to-severe, uncontrolled asthma: systematic review and meta-analysis. Curr Allergy Asthma Rep 2023; 23:287–298.
Normansell R, Walker S, Milan SJ, et al. Omalizumab for asthma in adults and children. Cochrane Database Syst Rev 2014; CD003559.
Ferguson GT, FitzGerald JM, Bleecker ER, et al. Benralizumab for patients with mild to moderate, persistent asthma (BISE): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med 2017; 5:568–576.
Liu W, Ma X, Zhou W. Adverse events of benralizumab in moderate to severe eosinophilic asthma: a meta-analysis. Medicine (Baltimore) 2019; 98:e15868.
Flood-Page P, Swenson C, Faiferman I, et al. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. Am J Respir Crit Care Med 2007; 176:1062–1071.

Auteurs

Laura De Ferrari (L)

IRCCS Ospedale Policlinico San Martino.
Università di Genova, DiMI, Genoa, Italy.

Anna Maria Riccio (AM)

IRCCS Ospedale Policlinico San Martino.
Università di Genova, DiMI, Genoa, Italy.

Fulvio Braido (F)

IRCCS Ospedale Policlinico San Martino.
Università di Genova, DiMI, Genoa, Italy.

Classifications MeSH