Clinical reviews in allergy & immunology
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It is now recognized that asthma incorporates a broad spectrum of syndromes with varying clinical manifestations. Future improvements in asthma treatment will require a clear characterization of these asthma phenotypes and the cellular mechanisms underlying these clinical manifestations. Herein, we will describe the current knowledge of asthma biology. ⋯ We will review the early work that led to the recognition of "asthma phenotypes." This will include the early discovery of various inflammatory subtypes in asthma and how these inflammatory subtypes correlate with response to therapy. Finally, we will describe recent discoveries in asthma biology that will include the role of the airway epithelium in asthma pathogenesis, novel cytokines important in asthma that may serve as novel therapeutic targets, and the identification of newly described innate immune cells and their role in asthma. Improved understanding of the complex biology underpinning the various asthma phenotypes is critical for our ability to optimize treatment for all patients that suffer from asthma and critical asthma syndromes.