Biomarkers in asthma: are they really useful in the management of the disease?

Pierluigi Paggiaro, Elena Bacci, and Federico Dente Cardio-Thoracic and Vascular Department, University of Pisa, Italy

Because the pathophysiologic background of asthma is a chronic inflammatory process, which is responsible for structural persistent abnormalities of the airway wall and then for the clinical manifestations of the disease, the availability of simple, feasible and repeatable tools for the assessment of the characteristics and the severity of the basic inflammatory process has been considered as an important objective in the asthma management. Bronchoalveolar lavage and bronchial biopsies obtained by fiberopticbroncoscopy have been used in many studies with the aim to investigate the characteristics of the airway inflammation and remodeling in patients with different asthma severity, and for the assessment of the efficacy of asthma treatment, but obviously this invasive procedure (which however may be performed safely also in severe asthmatics) cannot be used as a method for monitoring over time the level of airway inflammation.

The examination of the spontaneous or (more frequently) induced sputum, and of the exhaled air represents simple tools which may be repeated several times without inconvenience for the patient, and which have been submitted to a large work of standardization and validation.

In these biological matrices, some cell types and several chemical components have been measured, and new chemokines or cytokines are continuously detected in the supernatant of the induced sputum or in the exhaled air. These observations had mainly a pathophysiologic relevance, in terms of the demonstration that specific pathways or biomarkers involved in the pathophysiology of asthma may be measured in the airways, with some correlations with clinical aspects of the disease. However, only few biomarkers have been studied in terms of potential usefulness in the asthma management.

Bibliografia

  1. Diamant Z, Boot JD, Mantzouranis E, Flohr R, Sterk PJ, Gerth van Wijk R. Biomarkers in asthma andallergic rhinitis.PulmPharmacolTher. 2010 Dec;23(6):468-81.
  2. Bakakos P, Schleich F, Alchanatis M, Louis R. Induced sputum in asthma: from bench tobedside.Curr Med Chem. 2011;18(10):1415-22.

Informazioni utili


Prof. Pierluigi Paggiaro

-È Professore Straordinario in Malattie dell'Apparato Respiratorio presso l’Università di Pisa

-Ha scritto e collaborato alla stesura di numerosi lavori sulla Fisiopatologia delle Malattie dell’Apparato Respiratorio

-Dirige la Sezione Autonoma di Fisiopatologia Respiratoria Universitaria, presso l’Azienda Universitaria Ospedaliera di Pisa

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