Unfortunately, the assessment of current asthma control does not always provide sufficient information for one to make optimal decisions about asthma management. Ideally, one would like to know a patient’s underlying asthma phenotype and current disease activity on treatment in order to provide the optimum pharmacologic interventions.
Characterization of the patients’ asthma phenotype will become increasingly important in the development of targeted therapies. Measurement of pathophysiological markers may help to characterize asthma phenotype and provide additional information about the future risk of an exacerbation and other adverse outcomes.
It is unlikely, however, that there will be a single pathophysiological biomarker that will facilitate the uniform assessment of asthma in all patients to ensure the ideal application of all drug and biological therapies for every asthma phenotype. The morbidity and mortality of asthma will be impacted in a positive fashion as our understanding of underlying causes of exacerbations increases.
Such future developments may lead to better drugs for attenuating the inflammatory process associated with chronic persistent asthma phenotypes. Hopefully, that time will come soon. Ultimately, the clinical expression of the syndrome we call asthma must be assessed and interpreted within the context of its multiple phenotypes, fully appreciating the influence of socioeconomic status, race, and the clinical environment.1
Michael B. Foggs, MD, FAAAAI, FACAAI, FCCP, is chief of allergy and immunology, Advocate Health Care, Chicago.
Reference
1. Foggs MB. Influence of socioeconomic status, race, and clinical environment on asthma care. Resp Digest. 2005;7(2):1-13.
