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P Campo,1 F Rodríguez,2
S Sánchez-García,3 P Barranco,4 S
Quirce,4 C Pérez-Francés,5 E
Gómez-Torrijos,6 R Cárdenas,6 JM
Olaguibel,7 J Delgado8
Severe Asthma Workgroup of the SEAIC Asthma Committee |
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1 UGC Allergy, Hospital
General de Málaga, Málaga, Spain
2 Department of Allergy, Hospital
Universitario Marqués de Valdecilla, Santander, Spain
3 Allergy Section, Hospital Infantil
Universitario Niño Jesús, Madrid, Spain
4 Department of Allergy, Hospital La Paz
Institute for Health Research (IdiPAZ), Madrid, Spain
5 Department of Allergy, Hospital
Universitario Dr. Peset, Valencia, Spain
6 Department of Allergy, Hospital General
Universitario de Ciudad Real, Ciudad Real, Spain
7 Department of Allergy, Complejo
Hospitalario de Navarra, Pamplona, Spain
8 UGC Allergy, Hospital Universitario Virgen
Macarena, Sevilla, Spain |
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Abstract |
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Severe asthma is a
heterogeneous
disease that affects
only 5%-10% of
asthmatic patients,
although it accounts
for a significant
percentage of the
consumption of
health care
resources. Severe
asthma is
characterized by the
need for treatment
with high doses of
inhaled
corticosteroids and
includes several
clinical and
pathophysiological
phenotypes. To a
large extent, this
heterogeneity
restricts
characterization of
the disease and, in
most cases, hinders
the selection of
appropriate
treatment. In recent
years, therefore,
emphasis has been
placed on improving
our understanding of
the various
phenotypes of severe
asthma and the
identification of
biomarkers for each
of these phenotypes.
Likewise, the
concept of the
endotype has been
gaining acceptance
with regard to the
various subtypes of
the disease, which
are classified
according to their
unique functional or
pathophysiological
mechanism. This
review discusses the
most relevant
aspects of the
clinical and
inflammatory
phenotypes of severe
asthma, including
severe childhood
asthma and the
various endotypes of
severe asthma. The
main therapeutic
options available
for patients with
uncontrolled severe
asthma will also be
reviewed.
Key words:
Severe asthma.
Biomarkers. Endotype.
Phenotype.
Treatment. |
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