Evolving phenotypes to endotypes: is precision medicine achievable in asthma?

Diego Bagnasco, Giovanni Passalacqua, Marco Caminati, Enrico Heffler, Francesco Menzella, Laura De Ferrari, Anna Maria Riccio, Chiara Folli, Giorgio Walter Canonica

Research output: Contribution to journalReview article


Introduction: The development of biologic molecules led to a drastic change in the therapeutic approach to asthma. With the prospect of acting on different pathophysiological mechanisms of the disease, the idea of precision medicine was developed, in which a single molecule is able to modify a specific triggering mechanism. Thus, it seemed limiting to stop at the distinction of patients phenotypes and the concept of endotypes became more relevant in the therapeutic approach. Areas covered: This review deepened the topic of precision medicine through the transition from phenotyping to endotyping. We performed a review of the literature, preferring articles quoted in Medline and published in journals with an impact factor. Results showed that it is fundamental to take into consideration the role of biomarkers and the related therapies currently available for precision medicine. Expert opinion: The possible overlap of patients in different phenotypes requires a more precise classification, which considers endotypization. With the development of biological drugs able to modify and modulate some pathophysiological mechanisms of the disease, the theoretical concept of endotyping becomes practical, allowing the clinician to choose the specific mechanism to ‘attack’ in order to control the disease.

Original languageEnglish
JournalExpert Review of Respiratory Medicine
Publication statusAccepted/In press - Jan 1 2020



  • biological drugs
  • biomarkers
  • endotype
  • monoclonal antibodies
  • personalized medicine
  • phenotype
  • Precision medicine
  • severe asthma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health

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