Abstract
Asthma is a common chronic airway disease affecting about 334 million people worldwide, and an estimated 7 million children globally. Approximately 10% of patients with asthma have severe refractory disease, which is uncontrolled despite using high doses of inhaled corticosteroids and other modifiers. Among these patients are patients with eosinophilic asthma. Eosinophilic asthma is a phenotype of asthma that is usually very severe and persistent, with frequent exacerbations. It is characterized by the presence of high levels of eosinophils, and CD+4 Th2 cells in the lungs and airways. Eosinophils play a pivotal role in the pathogenesis and severity of asthma
Highlights
Asthma is a complex chronic airway disease with several distinct phenotypes with different immunopathological pathways, clinical presentation, physiology, cormobidities, biomarker of allergic inflammation, and response to treatment [1,2,3,4]
Baseline blood eosinophil count is useful as a biomarker to stratify patients for treatment with interleukin monoclonal antibodies, such as anti-IL-4 antibodies for mepolizumab [68,80], and reslizumab [81], anti-IL-5 receptor antibody for benralizumab [82], and
In the BOBCA study of several biomarker in eosinophilic asthma, Jia et al [27], reported that, periostin was the best predictor of airway eosinophilia in patients with severe asthma that was uncontrolled despite maximal inhaled corticosteroids (ICSs) treatment
Summary
Asthma is a complex chronic airway disease with several distinct phenotypes with different immunopathological pathways, clinical presentation, physiology, cormobidities, biomarker of allergic inflammation, and response to treatment [1,2,3,4]. Severe refractory asthma includes eosinophilic asthma, is characterized by frequent exacerbations, poor quality of life, and unresponsiveness to standard treatment with inhaled corticosteroids (ICSs), long-acting β2-agonists (LABAs), and leukotriene receptor antagonists (LTRAs) [4,12,13]. Baseline blood eosinophil count is useful as a biomarker to stratify patients for treatment with interleukin monoclonal antibodies, such as anti-IL-4 antibodies for mepolizumab [68,80], and reslizumab [81], anti-IL-5 receptor antibody for benralizumab [82], and
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