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Download 20170117-Update in Asthma 2015.pdf
Judul Update in Asthma 2015
Abstract Our understanding of asthma has evolved
over time from a singular disease to a
complex of various phenotypes, with
varied natural histories, physiologies, and
responses to treatment as outlined in a
conceptual overview by Gauthier and
colleagues (1).
Although most patients with asthma
traditionally have been treated uniformly
with bronchodilators and corticosteroids,
these therapies admittedly had varying
degrees of success, particularly in more
severe disease. Similarly, despite initial
studies that identified an underlying type 2
inflammation in the airways of patients with
asthma, biological therapies targeted toward
these type 2 pathways were unsuccessful in
all patients. These observations led to
increased interest in phenotyping asthma.
Clinical approaches, both biased and later
unbiased/statistical approaches to large
asthma patient cohorts, identified a variety
of patient characteristics, but they also
consistently identified the importance of age
at onset of disease and the presence of
eosinophils in determining clinically
relevant phenotypes (2). These paralleled
molecular approaches to phenotyping that
developed an understanding that not all
patients share a type 2 inflammatory
pattern (3).