ArticleJournal of asthma and allergy2025
Early Detection of Asthma: Exploring Inflammatory Biomarkers in Symptomatic Adults with Normal Spirometry.
Article in Journal of asthma and allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: We previously showed that individuals without a prior history of asthma, presenting with unexplained respiratory symptoms and normal spirometry, may exhibit airway hyperresponsiveness and underlying eosinophilic (T2) inflammation, features suggestive of undiagnosed early-stage asthma. Improving our understanding of the inflammatory processes that contribute to asthma onset is essential, as it may ultimately lead to earlier detection, timely intervention and improved long-term outcomes. Purpose: This study aimed to evaluate several key inflammatory biomarkers in this well-characterized population and examine their associations with clinical presentation to identify early signs of asthma. Patients and Methods: This retrospective, observational cohort sub-study included Canadian adults with respiratory symptoms and normal pre- and post-bronchodilator spirometry. Demographics and clinical data were extracted from study files. Plasma and serum levels of biomarkers associated with T2 airway inflammation and epithelial shedding, including IL-4, IL-5, IL-13, IL-25, IL-33, eotaxin, eotaxin-3, TARC, periostin and TNF-α, were measured using ELISA and multiplex electrochemiluminescent assays. Airway hyperresponsiveness was defined as a PC Results: Among 128 adults (mean age ±SD: 58.0 ±13.9 years, 52% women), 45 (35%) had T2 airway inflammation. Most biomarker levels were low or undetectable, with substantial inter-individual variability. No significant differences in biomarker levels were observed between individuals with and without airway hyperresponsiveness or T2 airway inflammation. Eotaxin levels negatively correlated with post-bronchodilator FEV Conclusion: This panel of clinically accessible T2 biomarkers may not reliably reflect early pathophysiological signs of asthma in symptomatic adults with normal spirometry. Longitudinal follow-up of this cohort, along with the integration of airway sampling, may provide further insight into the role of these biomarkers in asthma development and progression.
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