A substantial proportion of asthma has its origins in childhood but attempts to identify modifiable exposures that trigger asthma inception have yielded disappointing results. Asthma is not a single disease entity but instead consists of a number of phenotypes that share common features perhaps with different etiologies and pathophysiological pathways leading to disease.
Greater understanding of the genetic pathways underpinning asthma has also led to some insights into asthma endotypes that manifest as different clinical phenotypes. However, the challenge to translate these findings into interventions to change the natural history of asthma has yet to be overcome. Technological advances are driving the creation of massive data resources that can be brought to bear on this problem. Whether they will finally solve the problem of phenotypic complexity in asthma remains to be discovered. If they do, the possibility of personalized interventions for asthma may eventually be realized. Read the full text review below.
Childhood asthma phenotypes (click to enlarge the image):
A 2012 study described 2 "new" phenotypes for young children with wheezing: "boys atopic multiple-trigger" and "girls nonatopic uncontrolled wheeze". JACI, 2012.
Algorithm for the diagnosis and management of early childhood asthma, JACI, 2012:
Childhood asthma phenotypes in the twenty-first century. Breathe June 1, 2014 vol. 10 no. 2 100-108, doi: 10.1183/20734735.014613
(free full text)