Current concepts of severe asthma

J Clin Invest. 2016 Jul 1;126(7):2394-403. doi: 10.1172/JCI84144. Epub 2016 Jul 1.


The term asthma encompasses a disease spectrum with mild to very severe disease phenotypes whose traditional common characteristic is reversible airflow limitation. Unlike milder disease, severe asthma is poorly controlled by the current standard of care. Ongoing studies using advanced molecular and immunological tools along with improved clinical classification show that severe asthma does not identify a specific patient phenotype, but rather includes patients with constant medical needs, whose pathobiologic and clinical characteristics vary widely. Accordingly, in recent clinical trials, therapies guided by specific patient characteristics have had better outcomes than previous therapies directed to any subject with a diagnosis of severe asthma. However, there are still significant gaps in our understanding of the full scope of this disease that hinder the development of effective treatments for all severe asthmatics. In this Review, we discuss our current state of knowledge regarding severe asthma, highlighting different molecular and immunological pathways that can be targeted for future therapeutic development.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / blood
  • Asthma / immunology*
  • Asthma / therapy
  • Environmental Exposure
  • Humans
  • Immune System
  • Inflammation
  • Interferon-gamma / immunology*
  • Phenotype
  • Severity of Illness Index
  • Treatment Outcome


  • Anti-Asthmatic Agents
  • Interferon-gamma