Allergic Endotypes and Phenotypes of Asthma

Abstract

Allergic asthma is defined as asthma associated with sensitization to aeroallergens, which leads to asthma symptoms and airway inflammation. Allergic asthma is the most common asthma phenotype. The onset of allergic asthma is most often in childhood and is usually accompanied by other comorbidities including atopic dermatitis and allergic rhinitis. It is often persistent although there is a wide variation in disease severity. It is a T_H2-driven process. Biomarkers have been identified to distinguish patients with allergic asthma, particularly serum IgE levels, tests to indicate sensitization to aeroallergens such as specific IgE or skin prick test positivity, blood and sputum eosinophil levels, fraction of exhaled nitric oxide, and periostin. Treatments for allergic asthma include environmental control measures, allergen immunotherapy, and glucocorticoids. Biologics, targeting the T_H2 pathway, have been shown to be effective in the treatment of allergic asthma.

Keywords: Allergic asthma; Allergic endotypes; Allergic phenotype; Asthma; Biomarkers.

Figure 1.

Choosing a biologic. IV, Intravenous; LABA, long-acting β-agonist; OCS, oral corticosteroid; SC, subcutaneous. *Omalizumab is approved for patients ≥ 6 years of age. **Dupilumab is approved for patients ≥ 12 years of age with asthma and ≥ 6 years with atopic dermatitis.