RT Journal Article
T1 The Utility of Nasal Challenges to Phenotype Asthma Patients.
A1 Bentabol-Ramos, Guillermo
A1 Saenz de Santa Maria-Garcia, Rocio
A1 Vidal-Diaz, Monica
A1 Eguiluz-Gracia, Ibon
A1 Testera-Montes, Almudena
K1 NSAID-exacerbated respiratory disease
K1 allergic asthma
K1 asthma phenotypes
K1 biomarker
K1 nasal challenge
AB Asthma is a heterogeneous disease in terms of both phenotype and response to therapy. Therefore, there is a great need for clinically applicable tools allowing for improved patient classification, and selection for specific management approaches. Some interventions are highly helpful in selected patients (e.g., allergen immunotherapy or aspirin desensitization), but they are costly and/or difficult to implement. Currently available biomarkers measurable in peripheral blood or exhaled air display many limitations for asthma phenotyping and cannot identify properly the specific triggers of the disease (e.g., aeroallergens or NSAID). The united airway concept illustrates the relevant epidemiological and pathophysiological links between the upper and lower airways. This concept has been largely applied to patient management and treatment, but its diagnostic implications have been less often explored. Of note, a recent document by the European Academy of Allergy and Clinical Immunology proposes the use of nasal allergen challenge to confirm the diagnosis of allergic asthma. Similarly, the nasal challenge with lysine acetylsalicylate (L-ASA) can be used to identify aspirin-sensitive asthma patients. In this review, we will summarize the main features of allergic asthma and aspirin-exacerbated respiratory disease and will discuss the methodology of nasal allergen and L-ASA challenges with a focus on their capacity to phenotype the inflammatory disease affecting both the upper and lower airways.
YR 2022
FD 2022-04-27
LK http://hdl.handle.net/10668/21151
UL http://hdl.handle.net/10668/21151
LA en
DS RISalud
RD Apr 11, 2025