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Review
. 2021 Apr 28;22(9):4651.
doi: 10.3390/ijms22094651.

The Predictive Role of Biomarkers and Genetics in Childhood Asthma Exacerbations

Emanuela di Palmo  1 , Erika Cantarelli  2 , Arianna Catelli  2 , Giampaolo Ricci  3 , Marcella Gallucci  1 , Angela Miniaci  1 , Andrea Pession  1
Affiliations
Review

The Predictive Role of Biomarkers and Genetics in Childhood Asthma Exacerbations

Emanuela di Palmo et al. Int J Mol Sci. .

Abstract

Asthma exacerbations are associated with significant childhood morbidity and mortality. Recurrent asthma attacks contribute to progressive loss of lung function and can sometimes be fatal or near-fatal, even in mild asthma. Exacerbation prevention becomes a primary target in the management of all asthmatic patients. Our work reviews current advances on exacerbation predictive factors, focusing on the role of non-invasive biomarkers and genetics in order to identify subjects at higher risk of asthma attacks. Easy-to-perform tests are necessary in children; therefore, interest has increased on samples like exhaled breath condensate, urine and saliva. The variability of biomarker levels suggests the use of seriate measurements and composite markers. Genetic predisposition to childhood asthma onset has been largely investigated. Recent studies highlighted the influence of single nucleotide polymorphisms even on exacerbation susceptibility, through involvement of both intrinsic mechanisms and gene-environment interaction. The role of molecular and genetic aspects in exacerbation prediction supports an individual-shaped approach, in which follow-up planning and therapy optimization take into account not only the severity degree, but also the risk of recurrent exacerbations. Further efforts should be made to improve and validate the application of biomarkers and genomics in clinical settings.

Keywords: asthma; biomarkers; exacerbation; exacerbation prevention; exacerbation risk; genetic; non-invasive; prevention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Biomarkers and genetics as useful tools to identify asthma exacerbators at risk of lung function impairment.
Figure 2
Figure 2
Biomarkers as indicators of pathological modification in asthmatic airways. Abbreviations: B-Eos = blood eosinophils; NO = nitric oxide; VOCs = volatile organic compounds; EBC = exhaled breath condensate. Image in collaboration with: Freepik.com.
Figure 3
Figure 3
Genes implicated in asthma exacerbation pathogenesis, including gene-drug and gene-environment interactions.
See this image and copyright information in PMC

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