Applying precision medicine to the heterogeneity of asthma attacks

Recent studies have highlighted the heterogeneity of asthma attacks across clinical, etiological, and therapeutic dimensions. Biomarker-informed assessments using blood eosinophils, exhaled nitric oxide (FeNO), and point-of-care microbial molecular testing have improved the evaluation of attacks. Observational studies and trials have explored biomarker-guided management to reduce OCS and antibiotic use, potentially improving outcomes. Distinct inflammatory and OCS-response profiles were identified in patients on biologics, emphasizing the complexity of attacks and the importance of residual (untreated) type-2 inflammatory pathways. Studies on the airway microbiome revealed that microbial dysbiosis is associated with clinical and inflammatory clusters.