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Clinical Reviews in Allergy & Immunology

, Volume 56, Issue 2, pp 219–233 | Cite as

Understanding Asthma Phenotypes, Endotypes, and Mechanisms of Disease

  • Merin E. Kuruvilla
  • F. Eun-Hyung Lee
  • Gerald B. LeeEmail author
Article

Abstract

The model of asthma as a single entity has now been replaced by a much more complex biological network of distinct and interrelating inflammatory pathways. The term asthma is now considered an umbrella diagnosis for several diseases with distinct mechanistic pathways (endotypes) and variable clinical presentations (phenotypes). The precise definition of these endotypes is central to asthma management due to inherent therapeutic and prognostic implications. This review presents the molecular mechanisms behind the heterogeneity of airway inflammation in asthmatic patients. Asthma endotypes may be broadly regarded as type 2 (T2) high or T2-low. Several biologic agents have been approved for T2-high asthma, with numerous other therapeutics that are incipient and similarly targeted at specific molecular mechanisms. Collectively, these advances have shifted existing paradigms in the approach to asthma to tailor novel therapies.

Keywords

Asthma Phenotypes Endotypes T2 disease Non-T2 disease 

Notes

Acknowledgments

We would like to thank Sandhya Khurana and Jen Kwong for their excellent comments on the manuscript.

Compliance with Ethical Standards

Conflict of Interest

F.E.-H.L. is the founder of MicroBplex, Inc. M.E.K. and G.B.L. have no conflicts of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Not applicable.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, Department of MedicineEmory UniversityAtlantaUSA
  2. 2.Division of Pulmonary, Allergy & Immunology, Cystic Fibrosis, and Sleep, Department of PediatricsEmory UniversityAtlantaUSA
  3. 3.Lowance Center for Human ImmunologyEmory UniversityAtlantaUSA

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