Biomarker, Phenotyping and Therapeutics for Asthma

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 1736

Editor

Division of Immunology, Immunity to Infection and Respiratory Medicine, NIHR Manchester Biomedical Research Centre, Manchester, UK
Interests: asthma variability; circadian rhythm; biomarkers; diagnostics; exhaled breaths

Special Issue Information

Dear Colleagues,

Asthma is one of the most prevalent chronic airway diseases worldwide, characterised by marked clinical variability and substantial biological heterogeneity. Despite advances in our understanding, the diagnosis of asthma remains challenging, with no single definitive test, contributing to misdiagnosis and inappropriate treatment. Furthermore, although precision medicine has emerged for severe asthma through the introduction of biologic therapies, this applies to only a minority of patients; the majority continue to be managed with one-size-fits-all approaches that overlook the heterogeneity of individual disease endotypes.

This Special Issue seeks to bring together cutting-edge mechanistic and translational research that bridges fundamental biology with clinical application. We welcome studies that (i) identify and validate novel biomarkers for asthma diagnosis, endotyping and disease monitoring; (ii) provide experimental insights into asthma pathophysiology across immune, epithelial and airway mechanical pathways; (iii) apply multi-omics, exhaled breath analysis and advanced physiological measures to refine phenotyping and uncover therapeutic targets; and (iv) explore novel molecular pathways and therapeutic strategies. 

Dr. Ran Wang
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • allergy
  • biomarkers
  • pathogenesis
  • exhaled breath
  • multi-omics
  • lung physiology
  • phenotyping
  • endotypes
  • therapeutic targets

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

11 pages, 471 KB  
Article
Rescue Inhaler Overuse in Severe Asthma: A Real-World Study of Short-Acting β2-Agonist and Short-Acting Muscarinic Antagonist Use
by Elena Villamañán, Daniel Laorden, Carlos Carpio, Javier Domínguez-Ortega, Leticia De las Vecillas, David Romero, Diana Betancor, Carolina Alfonso, Susana De Andrés, Sonia Mallón, Eva Villarroya, Alejandro Soto, Carmen Sobrino, Marta Moro, Pablo Mariscal, Alicia Herrero, Santiago Quirce and Rodolfo Álvarez-Sala
Biomedicines 2026, 14(6), 1332; https://doi.org/10.3390/biomedicines14061332 - 12 Jun 2026
Viewed by 453
Abstract
Background: Overuse of short-acting reliever inhalers, particularly short-acting β2-agonists (SABAs), is linked to poor asthma control, higher exacerbation risk, and increased mortality. Data on reliever overuse in severe asthma and the role of short-acting muscarinic antagonists (SAMAs) remain limited. Objective [...] Read more.
Background: Overuse of short-acting reliever inhalers, particularly short-acting β2-agonists (SABAs), is linked to poor asthma control, higher exacerbation risk, and increased mortality. Data on reliever overuse in severe asthma and the role of short-acting muscarinic antagonists (SAMAs) remain limited. Objective: This study aims to assess the prevalence of rescue inhaler overuse in adults with severe asthma and examine its associations with maintenance therapy adherence, biologic treatment, oral corticosteroid use, asthma control, lung function, allergic sensitization, and comorbidities. Methods: We conducted a retrospective observational study of 223 adults with severe asthma followed at a tertiary multidisciplinary clinic in 2024. Clinical, functional, pharmacological, and pharmacy-dispensing records were reviewed. Rescue inhaler overuse was defined as dispensing ≥ 3 SABA and/or SAMA canisters per 12 months. Associations with clinical and treatment variables were analyzed. Results: Among 223 patients, 144 (64.6%) had a prescribed rescue inhaler; 85 (38.1%) met the criteria for overuse. Of those prescribed rescue therapy, 59.0% overused, with 47.2% classified as low overuse and 11.1% as high overuse. Overuse was more frequent in patients with maintenance adherence > 50%. Biologic therapy was associated with reduced odds of overuse, while oral corticosteroid use showed no significant effect. Poor asthma control (ACT < 20) was strongly associated with overuse. Lung function did not differ significantly, though overusers tended to have lower FEV1. Allergic sensitization was not associated with overuse; bronchiectasis was the comorbidity most frequently linked. Conclusions: Rescue inhaler overuse is common in severe asthma and closely linked to inadequate disease control. Lower overuse rates among biologic-treated patients suggest improved control reduces reliance on short-acting relievers. Systematic monitoring of reliever use may help identify high-risk patients and guide individualized management strategies. Full article
(This article belongs to the Special Issue Biomarker, Phenotyping and Therapeutics for Asthma)
Show Figures

Figure 1

Review

Jump to: Research

61 pages, 12517 KB  
Review
A Multilevel Redox-Based Prognostic Model for Asthma Severity: From Genotype to Serum Biomarkers
by Shukur Wasman Smail, Rebaz Hamza Salih, Blnd Azad Ismail, Ivan Sdiq Maghdid, Raya Kh. Yashooa, Taban Kamal Rasheed, Shayma Hassan Hamadamin and Christer Janson
Biomedicines 2026, 14(7), 1509; https://doi.org/10.3390/biomedicines14071509 - 3 Jul 2026
Viewed by 511
Abstract
Asthma is a heterogeneous chronic airway disease in which oxidative stress (OS) plays a central mechanistic role beyond classical immune-mediated inflammation. Reactive oxygen and nitrogen species (ROS/RNS), generated by recruited inflammatory cells and activated airway structural cells, drive epithelial injury, mucus hypersecretion, airway [...] Read more.
Asthma is a heterogeneous chronic airway disease in which oxidative stress (OS) plays a central mechanistic role beyond classical immune-mediated inflammation. Reactive oxygen and nitrogen species (ROS/RNS), generated by recruited inflammatory cells and activated airway structural cells, drive epithelial injury, mucus hypersecretion, airway remodeling, and modulate key transcription factors including nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. This review synthesizes current evidence on the multilevel redox-based determinants of asthma severity, spanning from genetic polymorphisms to circulating biomarkers. We examine serum antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), peroxiredoxins (PRDXs), and the thioredoxin (Trx) system as dynamic indicators of systemic redox status and disease severity, alongside oxidative enzymes including NADPH oxidases and dual oxidases (NOX/DUOX), xanthine oxidase (XO), and myeloperoxidase (MPO) that serve as upstream sources of airway oxidant burden. Functional genetic polymorphisms in antioxidant genes (SOD2, CAT, glutathione S-transferase mu 1/glutathione S-transferase theta 1 (GSTM1/GSTT1), heme oxygenase-1 (HO-1), NAD(P)H quinone dehydrogenase 1 (NQO1), nuclear factor erythroid 2-related factor 2/Kelch-like ECH-associated protein 1 (Nrf2/KEAP1)) and oxidative enzyme genes including nitric oxide synthase 1/2/3 (NOS1/2/3), MPO, cytochrome b-245 alpha chain (CYBA), and xanthine dehydrogenase (XDH) are reviewed as modulators of individual redox capacity and asthma susceptibility, with particular attention to gene–environment interactions. We further discuss oxidative damage biomarkers, including malondialdehyde (MDA), 8-isoprostanes, 4-hydroxynonenal, 8-oxo-7, 8-dihydro-2′-deoxyguanosine, protein carbonyls, 3-nitrotyrosine, and advanced oxidation protein products as indicators of lipid, DNA, and protein oxidation that correlate with disease activity and control. The roles of micronutrient cofactors in modulating antioxidant enzyme function and their potential as contextual biomarkers are also addressed. Additionally, emerging evidence on microRNAs (miRNAs) linked to OS biology in asthma is presented. Finally, we critically evaluate the challenges limiting clinical translation, including biomarker non-specificity, analytical variability, gene–environment complexity, and the absence of standardized reference ranges. This integrated framework supports the development of multilevel redox prognostic panels combining genetic, enzymatic, and oxidative damage readouts for improved asthma phenotyping, severity stratification, and personalized therapeutic approaches. Full article
(This article belongs to the Special Issue Biomarker, Phenotyping and Therapeutics for Asthma)
Show Figures

Figure 1

Back to TopTop