Personalized asthma management in pediatric patients based on treatment response

ABSTRACT Introduction Asthma is the most common chronic illness in the pediatric population and is characterized by substantial heterogeneity in phenotypes and treatment response. A precision medicine approach is required to advance asthma care and improve asthma morbidity in children. Areas covered We present a review of currently available biomarkers for the diagnosis and management of pediatric asthma. We discuss a core set of biomarkers recognized by the National Institute of Health Asthma Outcomes Task Force including eosinophil counts, IgE levels, and fraction of exhaled nitric oxide. We also review emerging biomarkers including periostin, thymic stromal lymphopoietin, and volatile organic compounds. These biomarkers have proven effective in differentiating asthma phenotypes and predicting and monitoring treatment response, and have led to the development of game-changing biologic therapies for pediatric asthma. Expert opinion Substantial progress has been made in the identification of key biomarkers to aid in the classification and management of pediatric asthma. However, for biomarkers to be used routinely in clinical practice, further investigations are needed to expand biomarker representation of additional asthma phenotypes. A systems biology approach is also required, combining the various ‘omic’ strategies, for precision medicine to reach its full potential in pediatric asthma management.