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Defining Asthma and Allergy Phenotypes

Defining Asthma and Allergy Phenotypes. Risk factors and phenotypes vary over time. H E A L T H O U T C O M E S. M A C R O S O C I A L E N V T. E N V I R O N M E N T. M I C R O S O C I A L. S U B C L I N I C A L.

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Defining Asthma and Allergy Phenotypes

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  1. Defining Asthma and Allergy Phenotypes

  2. Risk factors and phenotypes vary over time H E A L T H O U T C O M E S M A C R O S O C I A L E N V T E N V I R O N M E N T M I C R O S O C I A L S U B C L I N I C A L LIFE COURSE PERSPECTIVE C L I N I C A L Psycho-neuro-endocrine cascades Psycho-neuro-immune cascades (Physiological Reactions)

  3. Allergy and Asthma are manifestations of complex and dynamic networks Environmental component Genetic component Allergen exposures Lifestyle Medications etc… SNPs, CNVs, etc. Genes and pathways Cell, immune, and inflammatory phenotypes, etc. Bronchoconstriction, Mucus Secretion, Hyperreactivity, IgE levels, Airway Structure

  4. Phenotypes Mentioned on Day 1 • Response to methacholine, histamine, allergen • Skin tests • Levels of chemical mediators (“smoked drum”) • Airway epithelium, histology, remodelling, function • Rhinitis • Age of Onset, Persistant vs Intermittent Patterns • Wheezing • Severity, hospitalizations, medication use • BMI • Skin phenotypes (atopic dermatitis)

  5. Phenotypes Mentioned on Day 1 (more) • Cellular Phenotypes (Eosinophils, B cells, T cells, etc.) • IgE levels • TH1 vs TH2 • IgE production • Chemical Mediators • Nitric Oxide • Proteomics (…) • Transcriptomics (…) • Metabolomics (…)

  6. Listing phenotypes is easier than defining them How do you define asthma? • Questionnaire: Do you have asthma? • Have you has asthma in the past? • Physician Diagnosis • Medical records • Use of asthma medications • Registry/Health Care Databases • etc.

  7. Having standard definitions is more important than having perfect definitions Francine Kauffman

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