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Expert Rev Respir Med. 2018 Sep;12(9):733-743. doi: 10.1080/17476348.2018.1505507. Epub 2018 Aug 7.

The concepts of asthma endotypes and phenotypes to guide current and novel treatment strategies.

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a Istanbul University, Institute of Child Health , Department of Pediatric Basic Sciences , Istanbul , Turkey.
b Istanbul University, Aziz Sancar Institute of Experimental Medicine , Department of Immunology , Istanbul , Turkey.
c Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Christine K├╝hne-Center for Allergy Research and Education , Davos , Switzerland.


Asthma, a common, non-communicable chronic disease affects over 300 million individuals worldwide. The Western world lifestyle is claimed to be responsible for this high and increasing prevalence. Asthma has been defined as a syndrome with various phenotypes and endotypes, allergic asthma and type 2 asthma being the most frequent. A great increase in prevalence of allergic diseases has necessitated intensive investigations both for understanding the underlying mechanisms and for the development of novel therapy options with long-term efficacy and limited side-effects. Allergic patients demonstrate unique presentations with variable visible characteristics and disease outcomes depending on different molecular mechanisms, related to influence of genes and epigenetic control by micro- and macro-environment. Areas covered: This article reviews the definition of asthma phenotypes and possible endotypes, advances in allergy-immunology field and contemporary personalized therapy options for asthma. Expert commentary: Better understanding of the complex immune network of allergic inflammation and key players of immunity is continuously being provided for clarification of asthma sub-types. Successful therapy of asthma requires better definition of underlying pathogenesis, which sequentially could end up with 'custom-tailored' individualized, evidence-based and more precise therapy options; a new era termed as 'precision medicine'. Endotype, phenotype, theratype and biomarker terms arise as major keywords in precision/personalized medicine.


Allergy; asthma; biomarker; endotype; genotype; phenotype; precision medicine; theratype

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