Biomarker | Advantages | Limits | Utility |
---|---|---|---|
Blood eosinophils | -Minimal invasive -Minimal patient effort -Easy to measure and collect in the clinical setting -Correlates with sputum eosinophilia | -Painful and difficult in some patients -Varying cut-offs used to determine predictive characteristics -Can be elevated due to other causes, such as parasitic infection | -Defines the inflammatory phenotype -Predicts exacerbations, poor asthma control and greater airway obstruction -Predicts therapeutic responses to corticosteroids and biotherapies |
Serum IgE | -Easy to measure -Identifies patients who may be candidates for Anti-IgE therapy | -Not predictive of response to Anti-IgE -Outperformed by other markers of T2 inflammation and allergen specific IgE | -Associated with asthma severity and airway remodelling |
Serum periostin | -Marker of Il-13 activity and T2 airway inflammation | -Not currently realised in the clinical setting -Can be elevated in growing children | -Predicts a greater airway obstruction and decline of lung function -Predicts therapeutic responses to biotherapies |
Sputum eosinophils | -Non invasive -Reflects the upper airways | -Difficult to collect -Not all patients can provide adequate samples -Not universally available -Requires specialized training, equipment, laboratory | -Defines the inflammatory phenotype -Predicts responses to corticosteroids and biotherapies |
FeNO | -Non invasive -Minimal patient effort -Easy to collect in the clinical setting | -Multiple confounders -Requires specialized equipment | -Identifies airways inflammation -Predicts exacerbations and airways hyperreactivity -Predicts responses to corticosteroids and several biotherapies |