The presentation, pathobiology, and prognosis of asthma are highly heterogeneous and challenging for clinicians to diagnose and treat. In addition to the adaptive immune response that underlies allergic inflammation, innate immune mechanisms are increasingly recognized to be critical mediators of the eosinophilic airway inflammation present in most patients with asthma. Efforts to classify patients by severity and immune response have identified a number of different clinical and immune phenotypes, indicating that the innate and adaptive immune responses are differentially active among patients with the disease. Advances in the detection of these subgroups using clinical characteristics and biomarkers have led to the successful development of targeted biologics. This has moved us to a more personalized approach to managing asthma. Here we review the emerging endotypes of asthma and the biologics that have been developed to treat them.

中文翻译：

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新兴的哮喘内异型治疗。

哮喘的表现，病理生物学和预后高度异质，对临床医生进行诊断和治疗具有挑战性。除了构成过敏性炎症基础的适应性免疫反应外，越来越多的先天免疫机制被认为是大多数哮喘患者中嗜酸性气道炎症的关键介质。根据严重程度和免疫反应对患者进行分类的努力已经确定了许多不同的临床和免疫表型，表明先天性和适应性免疫反应在患有该疾病的患者中具有不同的活性。利用临床特征和生物标记物检测这些亚组的进展已导致靶向生物制剂的成功开发。这使我们转向了一种更加个性化的哮喘控制方法。