Biologics in Asthma: Role of Biomarkers.

Our modern understanding of asthma mainly concerns identification of inflammatory endotype to guide management. The distinction mostly concerns identification of type-2 inflammation, for which different biomarkers have been well characterized. Blood eosinophils corroborate activity in the interleukin (IL)-5 axis while fraction of exhaled nitric oxide is indicative of the IL-4/IL-13 axis, giving us an indication of activity in these distinct but complementary pathways. These biomarkers predict disease activity, with increased risk of exacerbations when elevated, and a further, multiplicative increase when both are elevated. Serum immunoglobulin E is also implicated in this pathway, and can represent allergen-related stimulation.

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Déclaration de conflit d'intérêts

Disclosure In the last 5 years, I D. Pavord has received speaker’s honoraria for speaking at sponsored meetings from Astra Zeneca, Aerocrine, Almirall, Sanofi/Regeneron, Menarini, and GSK and payments for organizing educational events from AZ, GSK, and Sanofi/Regeneron. He has received honoraria for attending advisory panels with Sanofi/Regeneron, Astra Zeneca, GSK, Merck, Circassia, Chiesi, and Areteia. He has received sponsorship to attend international scientific meetings from GSK, Astra Zeneca, and Sanofi/Regeneron. G. Lavoie has no conflicts of interests to declare regarding this work.