Wenwen Wu , Vanessa M. McDonald , Gang Wang , Peter Gerard Gibson
{"title":"The value of treatable traits across the spectrum of adult asthma severity","authors":"Wenwen Wu , Vanessa M. McDonald , Gang Wang , Peter Gerard Gibson","doi":"10.1016/j.pccm.2025.08.002","DOIUrl":null,"url":null,"abstract":"<div><div>Asthma is a heterogeneous condition characterized by diverse clinical phenotypes and variable treatment responses, underscoring the limitations of the traditional “one-size-fits-all” stepwise management paradigm. The treatable traits (TTs) approach, a precision medicine framework, targets individualized, clinically relevant characteristics spanning pulmonary, extrapulmonary, and behavioral domains. This review synthesizes current evidence on the prevalence and impact of TTs across the spectrum of asthma severity—mild, moderate, and severe. Although severe asthma is associated with a greater overall burden of TTs, patients with mild-to-moderate disease frequently present with substantial trait-related challenges, including persistent symptoms and exacerbations. Key traits, such as eosinophilic inflammation, fixed airflow limitation, obesity, gastroesophageal reflux disease, and psychological comorbidities, vary in prevalence yet exert influence across all severity strata. Super-traits, including T2 inflammation and suboptimal inhaler adherence, warrant prioritization owing to their broad therapeutic implications. Optimal implementation requires tailored strategies in both primary and tertiary care, supported by multidisciplinary collaboration, patient engagement, and resource-efficient diagnostic tools. While barriers include limited clinician awareness and integration into existing workflows, enablers such as decision aids and structured education can facilitate adoption. The TTs model represents a promising pathway toward personalized asthma care, with the potential to improve outcomes across all severities.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 182-192"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chinese medical journal pulmonary and critical care medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772558825000489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Asthma is a heterogeneous condition characterized by diverse clinical phenotypes and variable treatment responses, underscoring the limitations of the traditional “one-size-fits-all” stepwise management paradigm. The treatable traits (TTs) approach, a precision medicine framework, targets individualized, clinically relevant characteristics spanning pulmonary, extrapulmonary, and behavioral domains. This review synthesizes current evidence on the prevalence and impact of TTs across the spectrum of asthma severity—mild, moderate, and severe. Although severe asthma is associated with a greater overall burden of TTs, patients with mild-to-moderate disease frequently present with substantial trait-related challenges, including persistent symptoms and exacerbations. Key traits, such as eosinophilic inflammation, fixed airflow limitation, obesity, gastroesophageal reflux disease, and psychological comorbidities, vary in prevalence yet exert influence across all severity strata. Super-traits, including T2 inflammation and suboptimal inhaler adherence, warrant prioritization owing to their broad therapeutic implications. Optimal implementation requires tailored strategies in both primary and tertiary care, supported by multidisciplinary collaboration, patient engagement, and resource-efficient diagnostic tools. While barriers include limited clinician awareness and integration into existing workflows, enablers such as decision aids and structured education can facilitate adoption. The TTs model represents a promising pathway toward personalized asthma care, with the potential to improve outcomes across all severities.