• Tara F Carr and Monica Kraft.
• Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona. Electronic address: tcarr@deptofmed.arizona.edu.
• Ann. Allergy Asthma Immunol. 2018 Oct 1; 121 (4): 414-420.

ObjectiveSevere asthma can be classified into phenotypes and endotypes, which may inform clinicians about inflammatory pathways leading to disease and ultimately guide optimal therapeutic strategy. Biomarkers, objectively measurable characteristics of the disease, are of increasing interest to clinicians and researchers as powerful tools to distinguish among the severe asthma phenotypes and endotypes. The objective of this review is to highlight current knowledge of biomarker applications to identify phenotypes and endotypes of severe asthma.Data SourcesSources used include observational cohorts, clinical trials, translational studies, comprehensive reviews, and expert/taskforce statements.Study SelectionsIncluded studies were selected for their relevance to the topic and for strength of data or study design.ResultsIn severe asthma, biomarkers can be used for diagnosis of phenotype or endotype, can also be predictive of clinical outcomes or response to therapy, and may be dynamic with time or therapy. Fully determining phenotype or endotype of severe asthma will require interpretation of combinations of commercially available biomarkers.ConclusionBiomarkers have multiple potential clinical applications in severe asthma. Novel biomarkers may add accuracy to this field.Copyright © 2018 Elsevier Ltd. All rights reserved.

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