Severe Asthma Phenotypes: Challenges and Options for Control

Authors

  • Parameswaran Nair, MD, PhD, FRCP, FRCPC McMaster University; St. Joseph’s Healthcare

DOI:

https://doi.org/10.58931/cait.2023.3143

Abstract

The practice of medicine has evolved from “arm-chair medicine” through “evidence-based medicine” to “precision medicine”. Medical literature has seen a proliferation of the use of the phrases “precision medicine” and “personalized medicine,” with little distinction made between the two. While both strategies promote individualizing patient care, precision medicine is guided by information based on the genes, proteins, metabolites, and other biomarkers in the human body. In addition to these biological markers, personalized medicine would consider various social, economic, behavioural, and environmental factors that might be specific to a particular individual in planning a treatment strategy unique to that individual. The term P4 Medicine (Predictive, Preventive, Personalized and Participatory) has also been proposed to reflect the increased understanding and implications of the pathobiology of disease on management strategies.1 The use of biologics and cell-based therapies, particularly in cancer therapeutics, has demonstrated the power of these strategies.2 This brief review will focus on how this strategy is currently being applied in the management of severe asthma.

Author Biography

Parameswaran Nair, MD, PhD, FRCP, FRCPC, McMaster University; St. Joseph’s Healthcare

Dr. Parameswaran Nair graduated in 1989 from the University of Kerala Medical College in Trivandrum in India. He trained in Internal Medicine and in Respiratory Medicine at the University of Kerala, Royal Sussex County and Royal Sunderland Hospitals in the UK, and at McMaster University in Canada, where he did his doctoral thesis on leukotriene biology in asthma. He is currently the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases & Professor of Medicine in the Division of Respirology at McMaster University, an Adjunct Professor of Medicine at McGill University, and a Staff Respirologist at the Firestone Institute for Respiratory Health at St. Joseph’s Healthcare Hamilton. At the Firestone Institute, through inter-disciplinary clinics, he looks after patients with severe asthma and other complex airway and eosinophilic disorders, and provides access to them for biologics, molecular microbiology, novel pulmonary imaging, and bronchial thermoplasty, and opportunities to participate in research programs. His laboratory, funded by federal and provincial agencies, the Canada Research Chair program, AllerGen National Centre of Excellence, and industry partners, characterizes the types of bronchitis in airway diseases using biomarkers in sputum, identifies mechanisms of persistent bronchitis and airway hyperresponsiveness, and explores targeted therapies using small molecules and biologics. The patient-centred translational research program has been recognized by the Fellowships of the Canadian Academy of Health Sciences, the European Respiratory Society and the American College of Chest Physicians, the ATS Ann Woolcock Award, and the Asthma Society of Canada Bastable-Potts award, and has contributed to over 300 peer-reviewed publications (H-index 67, >21,000 citations) in major respiratory, allergy, and general medical journals. These observations, including 6 publications in the New England Journal of Medicine, paved the way for the development and approval of biologics that are currently available to treat patients with severe asthma.

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Severe Asthma Phenotypes: Challenges and Options for Control

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Published

2023-05-01

How to Cite

1.
Nair P. Severe Asthma Phenotypes: Challenges and Options for Control . Can Allergy Immunol Today [Internet]. 2023 May 1 [cited 2024 Oct. 18];3(1):24–32. Available from: https://canadianallergyandimmunologytoday.com/article/view/3-1-nair

Issue

Volume 3, Issue 1, May 2023

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Articles