Advances in asthma in 2016: Designing individualized approaches to management

J Allergy Clin Immunol. 2017 Sep;140(3):671-680. doi: 10.1016/j.jaci.2017.06.015. Epub 2017 Jul 12.

Abstract

In this year's Advances in Asthma review, we discuss viral infections in asthmatic patients and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long-term sequelae of childhood asthma, patient-centered outcomes research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase. The 2 biggest drivers of asthma severity are an allergy pathway starting with allergic sensitization and an environmental tobacco smoke pathway. In addition, allergic sensitization and blood eosinophils can be used to select medications for management of early asthma in young children. These current findings, among others covered in this review, represent significant steps toward addressing rapidly advancing areas of knowledge that have implications for asthma management.

Keywords: Air quality; airway hyperreactivity; allergen immunotherapy; allergen sensitization; allergy; asthma; biomarkers; chronic obstructive pulmonary disease; climate; eosinophils; exacerbation; exhaled nitric oxide; genetics; ligelizumab; medication adherence; microbiome; patient-centered outcomes; pregnancy; prenatal exposures; respiratory syncytial virus; rhinovirus; roflumilast; tiotropium.

Publication types

  • Review

MeSH terms

  • Air Pollution
  • Animals
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • Asthma / genetics
  • Asthma / microbiology
  • Biomarkers
  • Climate
  • Comorbidity
  • Humans
  • Lung / microbiology
  • Patient Outcome Assessment
  • Precision Medicine
  • Risk Factors
  • Virus Diseases / epidemiology

Substances

  • Biomarkers