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Review
. 2020 Jun;145(6):1529-1534.
doi: 10.1016/j.jaci.2020.02.001. Epub 2020 Feb 18.

Toward personalization of asthma treatment according to trigger factors

Katarzyna Niespodziana  1 , Kristina Borochova  1 , Petra Pazderova  1 , Thomas Schlederer  1 , Natalia Astafyeva  2 , Tatiana Baranovskaya  3 , Mohamed-Ridha Barbouche  4 , Evgeny Beltyukov  5 , Angelika Berger  6 , Elena Borzova  7 , Jean Bousquet  8 , Roxana S Bumbacea  9 , Snezhana Bychkovskaya  10 , Luis Caraballo  11 , Kian Fan Chung  12 , Adnan Custovic  12 , Guillermo Docena  13 , Thomas Eiwegger  14 , Irina Evsegneeva  15 , Alexander Emelyanov  16 , Peter Errhalt  17 , Rustem Fassakhov  18 , Rezeda Fayzullina  19 , Elena Fedenko  20 , Daria Fomina  21 , Zhongshan Gao  22 , Pedro Giavina-Bianchi  23 , Maia Gotua  24 , Susanne Greber-Platzer  25 , Gunilla Hedlin  26 , Natalia Ilina  20 , Zhanat Ispayeva  27 , Marco Idzko  28 , Sebastian L Johnston  12 , Ömer Kalayci  29 , Alexander Karaulov  15 , Antonina Karsonova  15 , Musa Khaitov  20 , Elena Kovzel  30 , Marek L Kowalski  31 , Dmitry Kudlay  20 , Michael Levin  32 , Svetlana Makarova  33 , Paolo Maria Matricardi  34 , Kari C Nadeau  35 , Leyla Namazova-Baranova  36 , Olga Naumova  37 , Oleksandr Nazarenko  38 , Paul M O'Byrne  39 , Faith Osier  40 , Alexander N Pampura  41 , Carmen Panaitescu  42 , Nikolaos G Papadopoulos  43 , Hae-Sim Park  44 , Ruby Pawankar  45 , Wolfgang Pohl  46 , Harald Renz  47 , Ksenja Riabova  15 , Vanitha Sampath  35 , Bülent E Sekerel  29 , Elopy Sibanda  48 , Valérie Siroux  49 , Ludmila P Sizyakina  50 , Jin-Lyu Sun  51 , Zsolt Szepfalusi  25 , Tetiana Umanets  52 , Hugo P S Van Bever  53 , Marianne van Hage  54 , Margarita Vasileva  55 , Erika von Mutius  56 , Jiu-Yao Wang  57 , Gary W K Wong  58 , Sergii Zaikov  59 , Mihaela Zidarn  60 , Rudolf Valenta  61
Affiliations
Review

Toward personalization of asthma treatment according to trigger factors

Katarzyna Niespodziana et al. J Allergy Clin Immunol. 2020 Jun.

Abstract

Asthma is a severe and chronic disabling disease affecting more than 300 million people worldwide. Although in the past few drugs for the treatment of asthma were available, new treatment options are currently emerging, which appear to be highly effective in certain subgroups of patients. Accordingly, there is a need for biomarkers that allow selection of patients for refined and personalized treatment strategies. Recently, serological chip tests based on microarrayed allergen molecules and peptides derived from the most common rhinovirus strains have been developed, which may discriminate 2 of the most common forms of asthma, that is, allergen- and virus-triggered asthma. In this perspective, we argue that classification of patients with asthma according to these common trigger factors may open new possibilities for personalized management of asthma.

Keywords: Asthma; allergen; allergy; microarray; rhinovirus; wheeze.

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Conflict of interest statement

Disclosure of potential conflict of interest K. Niespodziana receives grant support (grant no. P29398) from the Austrian Science Foundation (FWF). K. F. Chung has received honoraria for participating in advisory board meetings of GlaxoSmithKline (GSK), AstraZeneca, Novartis, Merck, Boehringer Ingelheim, and Teva regarding treatments for asthma and chronic obstructive pulmonary disease and has also been renumerated for speaking engagements. A. Custovic reports personal fees from Novartis, Regeneron, Thermo Fisher Scientific, Philips, and Sanofi, outside the submitted work. T. Eiwegger reports other fees from DBV, grants from Innovation fund Denmark, and other fees from Regeneron, outside the submitted work; is the Co-PI or scientific lead in 3 investigator-initiated oral immunotherapy trials supported by the Allergy and Anaphylaxis Program Sickkids; is on local advisory board for ALK; and serves as associate editor for Allergy. S. L. Johnston reports board memberships of Therapeutic Frontiers and Virtus Respiratory Research and personal fees from Myelo Therapeutics GmbH, Concert Pharmaceuticals, Bayer, Synairgen, Novartis, Boehringer Ingelheim, Chiesi, Gerson Lehrman Group, resTORbio, Bioforce, Materia Medical Holdings, Pre-pBio Pharma, Pulmotect, Virion Health, and Lallemand Pharma, outside the submitted work. K. C. Nadeau reports grants and other fees from the National Institute of Allergy and Infectious Diseases; other fees from Novartis; personal fees and other fees from Regeneron; grants and other fees from FARE; grants from EAT; other fees from Sanofi, Astellas, Nestle, BeforeBrands, Alladapt, ForTra, Genentech, AImmune Therapeutics, and DBV Technologies; personal fees from AstraZeneca, ImmuneWorks, and Cour; grants from Allergenis and Ukko; and other fees from AnaptysBio, Adare Pharmaceuticals, Stallergenes-Greer, the National Heart, Lung, and Blood Institute, NIEHS, EPA, and WAO Center of Excellence, outside the submitted work. P. M. O’Byrne reports grants and personal fees from AstrZeneca and Medimmune; grants from Novartis; and personal fees from GSK and Chiesi, outside the submitted work. N. G. Papadopoulos reports personal fees from Novartis, Nutricia, HAL, Menarini/FAES Farma, Sanofi, Mylan/Meda, Biomay, AstraZeneca, GSK, MSD, ASIT Biotech, and Boehringer Ingelheim and grants from Gerolymatos International SA and Capricare, outside the submitted work. W. Pohl reports personal fees from Astra Zeneca, Chiesi, GSK, Meda, Sanofi, Novartis, Teva, and Boehringer Ingelheim, outside the submitted work. V. Siroux reports grants from Aviesan Itmo santée publique, the Scientific committee “AGIR for chronic diseases,” and the French National Research Agency (ANR), during the conduct of the study. M. van Hage reports personal fees from Thermo Fisher Scientific, ALK, and Biomay AG, Vienna, Austria, outside the submitted work. E. von Mutius reports personal fees from OM Pharma S. A., Böhringer Ingelheim International GmbH, Peptinnovate Ltd, Pharmaventures Ltd, and Nestlé Deutschland AG, outside the submitted work. In addition, E. von Mutius has a patent application number LU101064, Barn dust extract for the prevention and treatment of diseases, pending; a patent publication number EP2361632: Specific environmental bacteria for the protection from and/or the treatment of allergic, chronic inflammatory and/or autoimmune disorders; with royalties paid to Protectimmun GmbH, a patent publication number EP 1411977: Composition containing bacterial antigens used for the prophylaxis and the treatment of allergic diseases; licensed to Protectimmun GmbH, a patent publication number EP1637147: Stable dust extract for allergy protection; and a patent publication number EP 1964570: Pharmaceutical compound to protect against allergies and inflammatory diseases licensed to Protectimmun GmbH. M. Zidarn reports personal fees from Takeda and Novartis, outside the submitted work. R. Valenta receives grant support from the Austrian Science Foundation (FWF) and Viravaxx, Vienna, Austria. Furthermore, R. Valenta is a recipient of a megagrant of the Government of the Russian Federation (grant no. 14.W03.31.0024) and serves as a consultant for Viravaxx, Vienna, Austria. In addition, S. L. Johnston, K. Niespodziana, and R. Valenta are authors of patent/patent applications related to the subject of the study. The rest of the authors declare that they have no relevant conflicts of interest.

Figures

Fig 1
Fig 1
Chips containing a panel of microarrayed allergen molecules covering the most common allergen sources allow to measure IgE sensitization against each of the individual allergen molecules and thus of the culprit sensitizing allergens (left). Chips containing microarrayed peptides derived from the VP1 coat proteins of representative panels of RV-A, RV-B, and RV-C strains are useful for measuring RV-strain–specific IgG levels, cumulative strain–specific IgG levels, and increases in strain-specific IgG levels that occur some weeks after acute exacerbations of virus-triggered wheeze (right).
Fig 2
Fig 2
How the identification of allergens and respiratory virus infections as triggers factors of asthma and wheeze could lead to personalization of asthma treatment by adding treatment options to guideline-based therapy. AIT, Allergen immunotherapy; ICS, inhaled corticosteroid.
See this image and copyright information in PMC

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