Advances in asthma in 2017: Mechanisms, biologics, and genetics - 06/11/18

Doi : 10.1016/j.jaci.2018.08.033

Mitchell H. Grayson, MD ^a,^⁎ , Scott Feldman, MD ^b, Benjamin T. Prince, MSCI, MD ^a, Priya J. Patel, MD ^b, Elizabeth C. Matsui, MD, MHS ^c, Andrea J. Apter, MD, MSc, MA ^b
^a Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio
^b Section of Allergy and Immunology, Division of Pulmonary Allergy Critical Care Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pa
^c Department of Population Health, Dell Medical School, University of Texas-Austin, Austin, Tex

^∗Corresponding author: Mitchell H. Grayson, MD, 700 Children's Dr, Columbus, OH 43205.700 Children's DrColumbusOH43205

Abstract

This review summarizes some of the most significant advances in asthma research over the past year. We first focus on novel discoveries in the mechanism of asthma development and exacerbation. This is followed by a discussion of potential new biomarkers, including the use of radiographic markers of disease. Several new biologics have become available to the clinician in the past year, and we summarize these advances and how they can influence the clinical delivery of asthma care. After this, important findings in the genetics of asthma and heterogeneity in phenotypes of the disease are explored, as is the role the environment plays in shaping the development and exacerbation of asthma. Finally, we conclude with a discussion of advances in health literacy and how they will affect asthma care.

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Key words : Asthma, airway hyperreactivity, asthma biomarkers, asthma phenotypes, genetics, environment, respiratory viruses, allergens, eosinophils, helper T cells, B cells, innate lymphoid cells, neutrophils, biologic therapies, microbiome

Abbreviations used : Breg, CAMP, COPSAC, ED, FhHDM-1, ICS, ILC2, IL-4R, IL-5R, IPM, LABA, LRP-1, mDC, NMU, NO₂, ORMDL3, pDC, PD-L2, QCT, RSV, SNP, TSLP

Plan

Disclosure of potential conflict of interest: M. H. Grayson has been on the advisory board for AstraZeneca; has received research funds from the National Institutes of Health (NIH) and the Research Institute at Nationwide Children's Hospital; is an Associate Editor for the Annals of Allergy, Asthma, and Immunology; and is on the Board of Directors of the American Board of Allergy and Immunology, the Asthma and Allergy Foundation of America, and the American Academy of Allergy, Asthma & Immunology. A. J. Apter has received research funds from the NIH and Patient-Centered Outcomes Research Institute, consults for UpToDate, and is an Associate Editor of the Journal of Allergy and Clinical Immunology. The rest of the authors declare that they have no relevant conflicts of interest.