Discovering Asthma Paradigms in an Evolving Landscape: Expert Perspectives

Abstract

This symposium took place during the 2018 European Respiratory Society (ERS) International Congress in Paris, France and focussed on the disease burden associated with uncontrolled persistent asthma, particularly that driven by Type 2 inflammation; the impact of Type 2 cytokines on the pathophysiology of asthma and other Type 2 inflammatory diseases; current approaches to the assessment and management of uncontrolled persistent asthma; and future aspirations for treatment. Dr Kraft discussed the epidemiology, disease burden, and unmet medical needs of patients with uncontrolled persistent asthma. These patients have an increased risk of exacerbations, morbidity, mortality, and disease progression. Many patients have evidence of Type 2 inflammation, which constitutes a heavy disease burden and is further impacted by Type 2 inflammatory comorbidities. Prof Busse considered how Type 2 inflammation drives the key pathophysiologic characteristics of asthma. Persistent Type 2 inflammation and airway remodelling contribute to a self-perpetuating vicious cycle of exacerbations and progressive loss of lung function, and, therefore, impact disease progression. Targeting specific Type 2 inflammatory pathway cytokines reduces the pathophysiological impact of asthma and other Type 2 inflammatory comorbidities. Prof Pavord examined the current thinking around the management of uncontrolled persistent asthma driven by Type 2 inflammation. Despite recent advances in patient management, unmet needs remain. Of note, biologics have limitations and some patients are ineligible for currently vailable treatments.