Document Detail

Biomarkers of inflammation in asthma: a clinical perspective.
MedLine Citation:
PMID:  23047312     Owner:  NLM     Status:  In-Data-Review    
Asthma is a heterogeneous disease, with wide variability in pathology, natural history, and response to therapy. Historically, treatment of asthma relied almost exclusively on clinical judgment and pulmonary function tests (spirometry or peak flows), despite the limitations of both. Physiological tests are one step removed from what the clinician needs to know, namely, the underlying activity and whether it is amenable to additional or alternative treatment. Within the past decade, categorization of different pathological phenotypes and the treatment-response phenotypes have been used to guide therapy. Additionally, biomarkers (particular induced sputum analysis and exhaled nitric acid) have been tests to assess disease "activity" and predict potential response (or lack of response) to therapy. Currently, the value of biomarkers from exhaled air or airway fluids remains controversial. Clinical utility is dependent on the performance characteristics in relation to specific clinical questions. Financial constraints applied by health providers and funding agencies have limited the use of induced sputum analysis and exhaled nitric oxide to date. However, evaluation of candidate biomarkers has provided important insights in clinical practice and in research settings. At the very least, existing techniques should have a regular place in severe asthma clinics, if not more widely, where heterogeneity is the norm and not all asthma is what it seems.
D Robin Taylor
Publication Detail:
Type:  Journal Article     Date:  2012-10-09
Journal Detail:
Title:  Seminars in respiratory and critical care medicine     Volume:  33     ISSN:  1098-9048     ISO Abbreviation:  Semin Respir Crit Care Med     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431858     Medline TA:  Semin Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  620-9     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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