ReviewPost-screenNew concepts in asthma: clinical phenotypes and pathophysiological mechanisms

- This review gives an overview of the recently discussed phenotypes and describes possible underlying endotypes in asthma.
- The interrelationship between clinical phenotypes and molecular endotypes will be addressed.
- New therapeutic concepts, based on the improved understanding of endotypes, are introduced.

Asthma is among the most common chronic inflammatory diseases worldwide. Recent evidence indicates that the pathogenesis shows a high degree of heterogeneity. Patient subsets have been identified that exhibit different cellular and molecular patterns of dysregulation. A prominent example is eosinophilic Th2-driven asthma. These unique and molecular patterns are termed endotypes. Characterization of endotypes has broad implications for therapeutic interventions. Although ∼80% of asthmatic patients respond well to standard anti-inflammatory therapies, the remaining subset particularly consisting of severe patients requires a more specialized endotype-specific approach. This interrelationship between clinical phenotypes, molecular endotypes and endotype-specific therapies is the focus of this review.