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Table 1 Summary of major biomarkers’ characteristics

From: Biomarkers in asthma: state of the art

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