Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma

Asthma is a heterogeneous disease sharing airway instability but with different biology, risk factors, and response-to-therapy patterns. Biologics have revolutionized the one-size-fits-to-all approach to personalized medicine in severe asthma (SA), which relies on the identification of biomarkers th...

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Autores principales: Cottin, Sophie, Doyen, Virginie, Pilette, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073432/
https://www.ncbi.nlm.nih.gov/pubmed/37035303
http://dx.doi.org/10.3389/fmed.2023.1129300
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author Cottin, Sophie
Doyen, Virginie
Pilette, Charles
author_facet Cottin, Sophie
Doyen, Virginie
Pilette, Charles
author_sort Cottin, Sophie
collection PubMed
description Asthma is a heterogeneous disease sharing airway instability but with different biology, risk factors, and response-to-therapy patterns. Biologics have revolutionized the one-size-fits-to-all approach to personalized medicine in severe asthma (SA), which relies on the identification of biomarkers that define distinct endotypes. Thus, blood eosinophils and, to some extent, exhaled nitric oxide (FeNO) can predict the response to approved anti-type 2 (T2) biologics (anti-IgE, anti–IL-5, and anti–IL-4R alpha), whereas age at onset and comorbidities such as anxiety/depression, obesity, reflux, and upper airway disease (UAD) also influence therapeutic responses in SA. In this article, focusing on the predictive value of biomarkers for the therapeutic response to biologics in SA, we first summarize the level of prediction achieved by T2 biomarkers (blood eosinophils, FeNO) and then review whether data support the predictive value of upper airway diagnosis on such outcomes. Post hoc analysis of most studies with T2 biologics suggests that chronic rhinosinusitis with nasal polyps (CRSwNP) and, to a lower extent, allergic rhinitis may help in predicting clinical response. Considering that T2 biologics are now also approved for the treatment of severe CRSwNP, diagnosis of upper airway disease is a key step in determining eligibility for such therapy.
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spelling pubmed-100734322023-04-06 Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma Cottin, Sophie Doyen, Virginie Pilette, Charles Front Med (Lausanne) Medicine Asthma is a heterogeneous disease sharing airway instability but with different biology, risk factors, and response-to-therapy patterns. Biologics have revolutionized the one-size-fits-to-all approach to personalized medicine in severe asthma (SA), which relies on the identification of biomarkers that define distinct endotypes. Thus, blood eosinophils and, to some extent, exhaled nitric oxide (FeNO) can predict the response to approved anti-type 2 (T2) biologics (anti-IgE, anti–IL-5, and anti–IL-4R alpha), whereas age at onset and comorbidities such as anxiety/depression, obesity, reflux, and upper airway disease (UAD) also influence therapeutic responses in SA. In this article, focusing on the predictive value of biomarkers for the therapeutic response to biologics in SA, we first summarize the level of prediction achieved by T2 biomarkers (blood eosinophils, FeNO) and then review whether data support the predictive value of upper airway diagnosis on such outcomes. Post hoc analysis of most studies with T2 biologics suggests that chronic rhinosinusitis with nasal polyps (CRSwNP) and, to a lower extent, allergic rhinitis may help in predicting clinical response. Considering that T2 biologics are now also approved for the treatment of severe CRSwNP, diagnosis of upper airway disease is a key step in determining eligibility for such therapy. Frontiers Media S.A. 2023-03-22 /pmc/articles/PMC10073432/ /pubmed/37035303 http://dx.doi.org/10.3389/fmed.2023.1129300 Text en Copyright © 2023 Cottin, Doyen and Pilette. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Cottin, Sophie
Doyen, Virginie
Pilette, Charles
Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title_full Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title_fullStr Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title_full_unstemmed Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title_short Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
title_sort upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073432/
https://www.ncbi.nlm.nih.gov/pubmed/37035303
http://dx.doi.org/10.3389/fmed.2023.1129300
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