Medical Journal Reviews
April 2013
1. Recognition of specific subphenotypes of asthma.
Cottini M, Asero R. Asthma phenotypes today. European Annal of Allergy and Clinical Immunology. 2013; 45(1): 17-24.
Editor’s comment: In this excellent review the authors concluded that asthma is a complex syndrome, and to improve our understanding of asthma it will be necessary to classify patients according to its underlying disease mechanism rather than its clinical characteristics. The classification of patients with asthma by phenotype/endotype will facilitate future research involving testing of novel therapeutic targets and endotype-specific treatments.
2. Chronic rhinosinusitis (CRS) endotypes can be characterized by differences in responsiveness to different treatments.
Akdis CA, Bachert C, Cingi C, Dykewicz M, Hellings P et al. Endotypes and phenotypes of chronic rhinosinusitis: A PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. The Journal of Allergy and Clinical Immunology. 2013; Article in press; corrected proof published online 15 April. (doi:10.1016/j.jaci.2013.02.036)
Editor’s comment: In this comprehensive review the authors highlight that CRS consists of multiple groups of biological subtypes, or “endotypes”, which are defined by distinct pathophysiologic mechanisms that might be identified by corresponding biomarkers. Better identification of endotypes might permit individualization of therapy that can be targeted against the pathophysiologic processes of a patient’s endotype, with potential for more effective treatment and better patient outcomes.
3. Pollutants along busy roads are responsible for a large and preventable share of asthma and related acute exacerbations in European urban areas.
Perez L, Declercq C, Iñiguez C, Aguilera I, Badaloni C. Chronic burden of near-roadway traffic pollution in 10 European cities (APHEKOM network). European Respiratory Journal. 2013; published online before print, 21 March. (doi: 10.1183/09031936.00031112)
Editor’s comment: The authors estimated the burden of childhood asthma attributable to air pollution in 10 European cities by calculating the number of cases of: 1) asthma caused by near road traffic-related pollution, and 2) acute asthma events related to urban air pollution levels. Exposure to roads with high vehicle traffic, a proxy for near road traffic-related pollution, accounted for 14% of all asthma cases. When a causal relationship between near road traffic-related pollution and asthma was assumed, 15% of all episodes of asthma symptoms were attributable to air pollution.
