Plasma proteins elevated in severe asthma despite oral steroid use and unrelated to Type-2 inflammation.

Asthma is a prevalent chronic inflammatory disease with many different phenotypes sharing common clinical manifestations of episodic breathlessness, wheezing, cough, airflow obstruction (usually reversible) and airway hyperresponsiveness. The underpinning pathobiology may however be widely different. As individuals respond differently to treatments targeting specific pathways, better predictive biomarkers are required to improve patient selection, guide treatment and monitor responses. Currently available Type-2 asthma biomarkers do not adequately enable endotyping, which is required for personalised treatment. Another major clinical challenge is the identification of biomarkers reflecting non-Type-2 asthma, which is often more severe and lacking effective treatments.

With the overall aim being biomarker discovery, the international consortium ChAMP (Centre for Allergy Research highlights Asthma Markers of Phenotype), involving researchers from The Human Protein Atlas (HPA) program developed an affinity proteomics panel focused on proteins with potential involvement in airway or systemic inflammation. Protein selection was based on literature reviews, database searches and recent research findings. The four main biological processes reflected by the proteins were 1) immune response, 2) lipid mediator pathways (predominantly sphingolipids), 3) signal transduction and 4) extracellular matrix. The panel was enriched in non-Type-2-related proteins to address the unmet clinical need in this particular subgroup. Specifically, the objective was to examine plasma protein associations with asthma severity and oral corticosteroid (OCS) treatment. Furthermore, the researchers aimed to test the hypothesis that specific plasma protein profiles can identify unique molecular subgroups of asthma patients.

Read the full article in European Respiratory Journal