Biomarker |
Biosample |
Biosample |
Biosample |
Biosample |
Biosample |
Biosample |
Biosample |
Advantage |
Limitation |
Utility |
Ref |
|
Sputum |
Blood |
BALF |
Biopsies/brushings |
EBCs |
Nasal secretions |
Nasal cells |
|
|
|
|
Ezrin
|
|
+
|
+
|
+
|
+
|
|
|
Present in multiple biosamples
Useful in early diagnosis
|
Variable expression level
|
Predicts greater decline in lung function
Indicates early epithelial injury
Indicates asthma control
|
[70,72]
|
Claudin 4
|
|
+
|
|
+
|
|
|
|
A major claudin expressed in ECs
A selective sodium barrier protein
|
Mechanistic role unclear
|
Correlates with eosinophils, total IgE and lung function
Predicts inflammation and asthma severity
|
[105]
|
Claudin 18
|
|
|
|
+
|
|
|
|
Only lung-specific TJ protein
Reduced in IgE-high and eosinophilic T2high asthma
|
Mechanistic role unclear
|
Indicates epithelial permeability
|
[106]
|
CCSP16
|
+
|
+
|
+
|
|
|
|
|
Correlates with disease duration
Easy to detect in the circulation
|
Secreted by nonciliated terminal bronchiolar epithelial cells
Not applicable in all lung diseases
Some conflicting results
|
Predicts impaired lung function in adults
Marker of progressive airway damage
|
[67,68]
|
Sec14l3
|
|
|
+
|
+
|
|
|
|
Specifically expressed in airway epithelium
|
Difficult to obtain in clinical setting
|
Reflects ciliated epithelial cell integrity
Predicts airway inflammation
|
[121]
|
Osteopontin
|
+
|
+
|
+
|
+
|
|
+
|
|
Associated with eosinophils
Correlated with disease severity
|
Multicellular sources
Mechanistic role unclear
In consistency of results
|
Measures disease onset and treatment
Important indicator of childhood asthma
|
[107-109,118]
|
YKL-40
|
+
|
+
|
+
|
+
|
|
+
|
+
|
Indicative of severe, non-T2 asthma
Related to disease severity and decline in lung function
|
Requires replication in multicenter cohorts and longitudinal studies
Not a biomarker of asthma severity in children
|
Asthma diagnosis and prognosis
Distinguishes ACO and COPD
Distinguishes Asthma from COPD and healthy controls
|
[77-79]
|
Fibrinogen
|
+
|
+
|
|
|
|
|
|
Associated with airway geometry
Related to asthma severity and airway inflammation
|
|
Asthma severity and treatment response
|
[114, 115]
|
IL-33
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
Genetic associations with asthma risk
Related to the asthma severity
|
Lack of sensitive and specific assay in serum
|
Predicts asthma risk
Disease onset and asthma prevention
Response to environment and treatment
|
[34, 110, 111]
|
IL-25
|
+
|
+
|
+
|
+
|
+
|
|
+
|
Related to asthma severity and airway inflammation
Associated with lung function
|
Inconsistent between upper and lower airways
Multicellular sources
|
Defines asthma phenotypes
Response to ICS therapy
|
[112, 113]
|
MMP-9
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
Related to airway remodeling, inflammation and lung function
|
Susceptible to many factors
Multicellular sources
Difficult to detect
|
Response to glucocorticoid treatment
|
[119,
120]
|
Periostin
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
Used in phase 2/3 studies of lebrikizumab
Associated with persistent airflow limitation
|
serum levels that change with age
inconsistency of results
Increased expression in various disease
|
Phenotyping of severe asthma – T2high
Response to ICS therapy
Indicates omalizumab efficacy in asthma
|
[52-59,62]
|
TSLP
|
+
|
+
|
+
|
+
|
+
|
+
|
+
|
Genetic risk for asthma
Correlated with airflow obstruction
|
Inconsistent between upper and lower airways
Multicellular sources
|
Predicts asthma risk
Prevents remodeling
|
[110, 116, 117]
|