Pathogenetic Aspects of Bronchial Asthma Phenotyping

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Abstract

INTRODUCTION: During a many-year history of its study, bronchial asthma (BA) has gone through the stages of numerous classifications. The introduction of specific biological therapy of BA permitted to speak about the phenotypes of the disease.

AIM: Presentation of the main pathophysiological mechanisms for isolation of endotypes and phenotypes of BA.

The diagnosis of phenotype of BA is based on the pathophysiological mechanisms of its development, which permit to evaluate the dynamics of the disease, make the diagnosis and predict the course of the disease. The most complicated aspect of BA phenotyping is severe forms of the disease characterized by a combination of different phenotypes. This impedes evaluation of specific pathogenetic mechanisms and administration of the optimal therapy for the patient.

CONCLUSION: The diagnosis of BA phenotypes permits to identify specific pathogenetic mechanisms and thereby personalize the treatment.

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About the authors

Yuriy Yu. Byalovskiy

Ryazan State Medical University

Author for correspondence.
Email: b_uu@mail.ru
ORCID iD: 0000-0002-6769-8277

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ryazan

Sergey I. Glotov

Ryazan State Medical University

Email: sergeyglot@mail.ru
ORCID iD: 0000-0002-4445-4480

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Ryazan

Irina S. Rakitina

Ryazan State Medical University

Email: rakitina62@gmail.com
ORCID iD: 0000-0002-9406-1765

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Ryazan

Anna N. Ermachkova

City Polyclinic No. 12

Email: anna.vyunova@bk.ru
ORCID iD: 0000-0002-2770-3414
Russian Federation, Ryazan

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2. Fig. 1. Molecular mechanisms of the pathogenesis of bronchial asthma in a group of patients with high Th2 level. Notes: IL — interleukin; Th2 cells — type 2 T helper cells; TSLP — thymic stromal lymphopoietin; DC — dendritic cells; IgE — immunoglobulin E; PGD2 — prostaglandins D2; CysLT — cysteinyl leukotrienes; ECP — eosinophilic cationic proteins; EDN — eosinophil-derived neurotoxin; EPx — eosinophil peroxidase; MBP — major alkaline protein.

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