Conclusions and Future Directions

  • William J. Calhoun
  • Allan R. Brasier
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 795)


Considerable variation exists in the clinical expression of asthma. As detailed in the corresponding section of this monograph, the heterogeneity of asthma is expressed clinically, by commonly observable characteristics, but these clinical phenotypes overlap and have indistinct borders. By a variety of assessment technologies and approaches (epidemiologic, physiologic, and clinical), this syndromic disease defies clear and unambiguous classification. Collectively, clinical phenotyping has not led to reliable categories of asthma that inform treatment, predict progression of lung function abnormalities, or define risk for exacerbations and death. It is for this reason that—omics approaches have been explored, and by which new stratagems for molecular phenotyping have been developed.


Translational Research Personalized Medicine Lung Function Abnormality Indistinct Border Academic Health Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Bhakta NR, Woodruff PG (2011) Human asthma phenotypes: from the clinic, to cytokines, and back again. Immunol Rev 242(1):220–232. doi: 10.1111/j.1600-065X.2011.01032.x PubMedCrossRefGoogle Scholar
  2. Bhavnani SK, Victor S, Calhoun WJ, Busse WW, Bleecker E, Castro M, Brasier AR (2011) How cytokines co-occur across asthma patients: from bipartite network analysis to a molecular-based classification. J Biomed Inform 44(Suppl 1):S24–S30. doi: 10.1016/j.jbi.2011.09.006 PubMedCrossRefGoogle Scholar
  3. Borner K, Contractor N, Falk-Krzesinski HJ, Fiore SM, Hall KL, Keyton J, Stokols D, Trochim W, Uzzi B (2010) A multi-level systems perspective for the science of team science. Sci Transl Med 2(49):49cm24. doi: 10.1126/scitranslmed.3001399 PubMedCrossRefGoogle Scholar
  4. Brasier AR, Victor S, Boetticher G, Ju H, Lee C, Bleecker ER, Calhoun WJ (2008) Molecular phenotyping of severe asthma using pattern recognition of bronchoalveolar lavage-derived cytokines. J Allergy Clin Immunol 121:30–37PubMedCrossRefGoogle Scholar
  5. Brasier AR, Victor S, Ju H, Busse WW, Curran-Everett D, Bleecker E, Calhoun WJ (2010) Predicting intermediate phenotypes in asthma using bronchoalveolar lavage-derived cytokines. Clin Transl Sci 3(4):147–157. doi: 10.1111/j.1752-8062.2010.00204.x PubMedCrossRefGoogle Scholar
  6. Calhoun WJ, Wooten K, Bhavnani S, Anderson KE, Freeman JE, Brasier AR (2013) The CTSA as an exemplar framework for developing multidisciplinary translational teams. Clin Transl Sci 60(1):60–71. doi: 10.1111/cts.12004 CrossRefGoogle Scholar
  7. Disis ML, Slattery JT (2010) The road we must take: multidisciplinary team science. Sci Transl Med 2(22):22cm9. doi: 10.1126/scitranslmed.3000421 PubMedCrossRefGoogle Scholar
  8. Falk-Krzesinski HJ, Borner K, Contractor N, Fiore SM, Hall KL, Keyton J, Uzzi B (2010) Advancing the science of team science. Clin Transl Sci 3(5):263–266. doi: 10.1111/j.1752-8062.2010.00223.x PubMedCrossRefGoogle Scholar
  9. Hamburg MA, Collins FS (2010) The path to personalized medicine. N Engl J Med 363(4):301–304. doi: 10.1056/NEJMp1006304 PubMedCrossRefGoogle Scholar
  10. Jones BF, Wuchty S, Uzzi B (2008) Multi-university research teams: shifting impact, geography, and stratification in science. Science 322(5905):1259–1262. doi: 10.1126/science.1158357 PubMedCrossRefGoogle Scholar
  11. Khoury MJ, Gwinn M, Yoon PW, Dowling N, Moore CA, Bradley L (2007) The continuum of translation research in genomic medicine: how can we accelerate the appropriate integration of human genome discoveries into health care and disease prevention? Genet Med 9:665–674PubMedCrossRefGoogle Scholar
  12. Moore WC, Bleecker ER, Curran-Everett D, Erzurum SC, Ameredes BT, Bacharier L, Wenzel SE (2007) Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol 119(2):405–413PubMedCrossRefGoogle Scholar
  13. Pillai RR, Divekar R, Brasier A, Bhavnani S, Calhoun WJ (2012) Strategies for molecular classification of asthma using bipartite network analysis of cytokine expression. Curr Allergy Asthma Rep 12(5):388–395. doi: 10.1007/s11882-012-0279-y PubMedCrossRefGoogle Scholar
  14. Sung NS, Crowley WF Jr, Genel M, Salber P, Sandy L, Sherwood LM, Rimoin D (2003) Central challenges facing the national clinical research enterprise. JAMA 289(10):1278–1287PubMedCrossRefGoogle Scholar
  15. Wenzel SE, Busse WW (2007) Severe asthma: lessons from the severe asthma research program. J Allergy Clin Immunol 119(1):14–21PubMedCrossRefGoogle Scholar
  16. Woodruff PG, Modrek B, Choy DF, Jia G, Abbas AR, Ellwanger A, Fahy JV (2009) T-helper type 2-driven inflammation defines major subphenotypes of asthma. Am J Respir Crit Care Med 180(5):388–395. doi: 10.1164/rccm.200903-0392OC PubMedCrossRefGoogle Scholar
  17. Woolf SH (2008) The meaning of translational research and why It matters. JAMA 299(2):211–213PubMedCrossRefGoogle Scholar
  18. Wuchty S, Jones BF, Uzzi B (2007) The increasing dominance of teams in production of knowledge. Science 316(5827):1036–1039PubMedCrossRefGoogle Scholar
  19. Zerhouni EA (2007) Translational research: moving discovery to practice. Clin Pharmacol Ther 81(1):126–128PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • William J. Calhoun
    • 1
  • Allan R. Brasier
    • 2
  1. 1.Department of Internal MedicineUniversity of Texas Medical BranchGalvestonUSA
  2. 2.University of Texas Medical BranchGalvestonUSA

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