Asthma is a chronic inflammatory disease of the respiratory tract. The chronic inflammation causes the airways to swell, making them highly sensitive and narrowed. The swelling can occur randomly or after triggers such as allergies, smoke, air pollution, and exercise. The main symptoms are wheezing, shortness of breath, and coughing, which may temporarily worsen and lead to asthma attacks.
How many people have asthma?
Asthma is one of the most common chronic diseases, affecting more than 300 million people worldwide. Asthma affects people of all ages and often begins in childhood, although it can also first appear in adults.
How is asthma treated?
The symptoms of asthma can usually be controlled by treatment with inhalers for relief or prevention. However, patients with severe asthma may have persistent problems and difficulty controlling their asthma symptoms with treatment, which increases the risk of asthma attacks.
How is asthma diagnosed?
The current diagnosis of asthma is based on variable expiratory limitation measured by forced expiratory volume in 1 second (FEV1), family history, and symptoms.
The medical need for biomarkers in asthma is to enable precision medicine. First, a diagnostic biomarker that identifies different subtypes would be of value because of the heterogeneity of the disease. Identification of subtypes would also allow better stratification of patients enrolled in clinical trials.
Second, a predictive biomarker to select patients likely to respond to a therapeutic drug in clinical trials could reduce the duration and size of studies needed to determine therapeutic efficacy.
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Chronic airway inflammation and swelling in asthma leads to the restructuring of airway wall components, including alteration of the extracellular matrix (ECM). A normal repair response creates a balance between extracellular matrix (ECM) proteins being degraded and rebuilt, but this balance is disturbed in chronic inflammation.
The disturbed balance leads to marked tissue turnover in asthma, which can be quantified by Protein Fingerprint biomarkers in a serological sample.
While several diagnostic biomarkers exist in the field of asthma that subtype asthma patients, their ability to predict response to treatment is limited. Therefore, there is still a medical need for biomarkers that can predict response to treatment. This can be achieved by characterizing structural changes in tissues and linking them to a specific asthma subtype.
Protein Fingerprint biomarkers can be measured in serum and used to accurately quantify changes in tissue remodeling in individual patients.
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Protein Fingerprint biomarkers measured in serum are generally elevated in asthma patients compared with healthy individuals and correlate with airway resistance.
Lung tissue degradation, as measured by MMP-degraded collagen type IV α3-chain (C4Ma3), is increased in asthma patients with high eosinophil counts and asthma patients with a high type 2 cytokine profile.
Protein Fingerprint biomarkers measured in serum are associated with exacerbations in asthmatic patients.
Protein fingerprint biomarkers are predictive of clinical response, being elevated in responders compared with non-responders at baseline. Effective treatments further suppress Protein Fingerprint biomarkers.
Lung tissue degradation, quantified by MMP-degraded collagen type IV α3-chain (C4Ma3), is increased in responders compared with non-responders at baseline.
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