Approaches to the Control and Management of Asthma in the Modern Era: A Review of the Literature
DOI:
https://doi.org/10.53555/n5w14k73Keywords:
Asthma, COPD, Nanoscience, Nanomedicines, Nanotechnologies.Abstract
Asthma is a prevalent chronic illness necessitating frequent clinic appointments and possible hospitalisations. The spectrum of sickness is diverse and may fluctuate over time. In recent decades, it has been increasingly evident that asthma is not a singular disease but rather a syndrome comprising numerous phenotypes and endotypes; therefore, a universal treatment strategy may not be suitable for all people. Every asthma exacerbation should be seen as an acute pulmonary event, necessitating measures to mitigate future occurrences by suitable interventions. After an exacerbation, one can prevent future episodes by evaluating adherence and enhancing asthma management. Thorough inquiry will enable physicians to discern asthma triggers and impediments to effective asthma management, as well as comprehend health beliefs or socioeconomic challenges that may have precipitated the acute episode. Novel therapeutics utilising nanotechnologies for asthma are currently available. Recent advancements in nanoscience and medicine have facilitated the development of inhalable nanomedicines that can improve efficacy, patient adherence, and quality of life for those with asthma. This article examines new study findings in the field of nanotechnology and asthma treatment. Currently, we possess digital technologies that can facilitate an improved precision medicine approach to the management of respiratory diseases and enhance shared decision-making. Additional efforts are required to enhance the adoption of digital devices and incorporate their utilisation into individualised asthma and COPD care. In the contemporary period, these methodologies represent the most convenient and effective future outlook for the care of asthma and other respiratory problems.
References
1. Günaydın FE, Ay P, Karakaya G, Ediger D. How do we manage asthma? Assessment of knowledge, attitude, and practice patterns among pulmonologists and allergists. J Asthma. 2023 Jan; 60(1):130-138. doi: 10.1080/02770903.2022.2033261.
2. Kapri A, Pant S, Gupta N, Paliwal S, Nain S. Asthma history, current situation, an overview of its control history, challenges, and ongoing management programs: an updated review. Proceedings of the National Academy of Sciences, India Section B: Biological Sciences. 2023 Sep; 93(3):539-551. doi: 10.1007/s40011-022-01428-1.
3. Abdelhamid E, Awad A, Gismallah A. Evaluation of a hospital pharmacy-based pharmaceutical care services for asthma patients. Pharmacy Practice (Granada). 2008 Mar; 6(1):25-32. doi: 10.4321/s1886-36552008000100005.
4. Pompe E, Kwee AK, Tejwani V, Siddharthan T, Hoesein FA. Imaging-derived biomarkers in asthma: current status and future perspectives. Respiratory Medicine. 2023 Mar 1; 208:107130. doi: 10.1016/j.rmed.2023.107130.
5. Striz I, Golebski K, Strizova Z, Loukides S, Bakakos P, Hanania NA, Jesenak M, Diamant Z. New insights into the pathophysiology and therapeutic targets of asthma and comorbid chronic rhinosinusitis with or without nasal polyposis. Clinical Science. 2023 May; 137(9):727-753. doi: 10.1042/CS20190281.
6. Bosnic-Anticevich S, Bakerly ND, Chrystyn H, Hew M, van der Palen J. Advancing digital solutions to overcome longstanding barriers in asthma and COPD management. Patient Preference and Adherence. 2023 Dec 31:259-272. doi: 10.2147/PPA.S385857.
7. Jackson DJ, Gern JE. Rhinovirus infections and their roles in asthma: etiology and exacerbations. The Journal of Allergy and Clinical Immunology: In Practice. 2022 Mar 1; 10(3):673-81. doi: 10.1016/j.jaip.2022.01.006.
8. Haider S, Simpson A, Custovic A. Genetics of asthma and allergic diseases. In Allergic Diseases–From Basic Mechanisms to Comprehensive Management and Prevention 2021 Jun 4 (pp. 313-329). Cham: Springer International Publishing. doi: 10.1007/164_2021_484.
9. Stikker BS, Hendriks RW, Stadhouders R. Decoding the genetic and epigenetic basis of asthma. Allergy. 2023 Apr;78(4):940-56. doi: 10.1111/all.15666.
10. Sharma D, Dutta BK, Singh AB. Dust mites population in indoor houses of suspected allergic patients of South Assam, India. International Scholarly Research Notices. 2011;2011(1):576849. doi: 10.5402/2011/576849.
11. Matucci A, Bormioli S, Nencini F, Chiccoli F, Vivarelli E, Maggi E, Vultaggio A. Asthma and chronic rhinosinusitis: how similar are they in pathogenesis and treatment responses?. International Journal of Molecular Sciences. 2021 Mar 24;22(7):3340. doi: 10.3390/ijms22073340
12. Woodruff PG, Modrek B, Choy DF, Jia G, Abbas AR, Ellwanger A, Arron JR, Koth LL, Fahy JV. T-helper type 2–driven inflammation defines major subphenotypes of asthma. American journal of respiratory and critical care medicine. 2009 Sep 1;180(5):388-95. doi: 10.1164/rccm.200903-0392OC.
13. Lambrecht BN, Hammad H. The immunology of asthma. Nature immunology. 2015 Jan;16(1):45-56. doi: 10.1038/ni.3049.
14. Wagener AH, Zwinderman AH, Luiten S, Fokkens WJ, Bel EH, Sterk PJ, van Drunen CM. dsRNA-induced changes in gene expression profiles of primary nasal and bronchial epithelial cells from patients with asthma, rhinitis and controls. Respiratory research. 2014 Dec;15:1-9. doi: 10.1186/1465-9921-15-9
15. Golebski K, Röschmann KI, Toppila‐Salmi S, Hammad H, Lambrecht BN, Renkonen R, Fokkens WJ, Van Drunen CM. The multi‐faceted role of allergen exposure to the local airway mucosa. Allergy. 2013 Feb;68(2):152-60. doi: 10.1111/all.12080.
16. Gandhi VD, Vliagoftis H. Airway epithelium interactions with aeroallergens: role of secreted cytokines and chemokines in innate immunity. Frontiers in immunology. 2015 Apr 2;6:147. doi: 10.3389/fmed.2022.954990
17. Kuruvilla ME, Lee FE, Lee GB. Understanding asthma phenotypes, endotypes, and mechanisms of disease. Clinical reviews in allergy & immunology. 2019 Apr 15;56:219-233. doi: 10.1007/s12016-018-8712-1
18. Hu Y, Chen Z, Zeng J, Zheng S, Sun L, Zhu L, Liao W. Th17/Treg imbalance is associated with reduced indoleamine 2, 3 dioxygenase activity in childhood allergic asthma. Allergy, Asthma & Clinical Immunology. 2020 Dec;16:61-0. doi: 10.1186/s13223-020-00457-7
19. Pillarisetti N, Kabra SK. Asthma: Advances in management. Indian Journal of Pediatrics. 2022 Apr; 89(4):364-365. doi: 10.1007/s12098-022-04129-9.
20. Thomas D, McDonald VM, Pavord ID, Gibson PG. Asthma remission: what is it and how can it be achieved. European Respiratory Journal. 2022 Nov 3;60(5):2102583. doi: 10.1183/13993003.02583-2021
21. Papi A, Brightling C, Pedersen SE, Reddel HK. Seminar asthma. Lancet. 2018;391:783-800. doi: 10.1016/S0140-6736(17)33311-1.
22. Liu A, Zhang Y, Yadav CP, Chen W. An Updated Systematic Review on Asthma Exacerbation Risk Prediction Models Between 2017 and 2023: Risk of Bias and Applicability. Journal of Asthma and Allergy. 2025 Dec 31:579-589. doi: 10.2147/JAA.S509260.
23. Liu A, Zhang Y, Yadav CP, Chen W. An Updated Systematic Review on Asthma Exacerbation Risk Prediction Models Between 2017 and 2023: Risk of Bias and Applicability. Journal of Asthma and Allergy. 2025 Dec 31:579-589. doi: 10.2147/JAA.S509260
24. Sobieraj DM, Baker WL. Medications for asthma. Jama. 2018 Apr 10;319(14):1520. doi: 10.1001/jama.2018.3808.
25. Espada-Sánchez M, Sáenz de Santa María R, Martín-Astorga MD, Lebrón-Martín C, Delgado MJ, Eguiluz-Gracia I, Rondón C, Mayorga C, Torres MJ, Aranda CJ, Cañas JA. Diagnosis and treatment in asthma and allergic rhinitis: past, present, and future. Applied Sciences. 2023 Jan 18;13(3):1273. https://doi.org/10.3390/app13031273
26. Harvey ES, Langton D, Katelaris C, Stevens S, Farah CS, Gillman A, Harrington J, Hew M, Kritikos V, Radhakrishna N, Bardin P. Mepolizumab effectiveness and identification of super-responders in severe asthma. European Respiratory Journal. 2020 May 21;55(5). doi: 10.1183/13993003.02420-2019.
27. Thomas D, Harvey ES, McDonald VM, Stevens S, Upham JW, Katelaris CH, Kritikos V, Gillman A, Harrington J, Hew M, Bardin P. Mepolizumab and oral corticosteroid stewardship: data from the Australian Mepolizumab Registry. The Journal of Allergy and Clinical Immunology: In Practice. 2021 Jul 1;9 (7):2715-2724. doi: 10.1016/j.jaip.2021.01.028.
28. FitzGerald JM, Emery P. Modifying the trajectory of asthma—are there lessons from the use of biologics in rheumatology. The Lancet. 2017 Mar 18;389(10074):1082-1084. doi: 10.1016/S0140-6736(17)30600-1.
29. Ajeganova S, Huizinga T. Sustained remission in rheumatoid arthritis: latest evidence and clinical considerations. Therapeutic advances in musculoskeletal disease. 2017 Oct;9(10):249-262. doi: 10.1177/1759720X17720366.
30. Koski RR, Grzegorczyk KM. Comparison of monoclonal antibodies for treatment of uncontrolled eosinophilic asthma. Journal of Pharmacy Practice. 2020 Aug;33(4):513-522. doi: 10.1177/0897190019840597.
31. Kardas G, Panek M, Kuna P, Damiański P, Kupczyk M. Monoclonal antibodies in the management of asthma: Dead ends, current status and future perspectives. Frontiers in Immunology. 2022 Dec 6;13:983852. doi: 10.3389/fimmu.2022.983852.
32. Doroudian M, O’Neill A, Mac Loughlin R, Prina-Mello A, Volkov Y, Donnelly SC. Nanotechnology in pulmonary medicine. Current opinion in pharmacology. 2021 Feb 1;56:85-92. doi: 10.1016/j.coph.2020.11.002
33. Drmosh QA, Olanrewaju Alade I, Qamar M, Akbar S. Zinc oxide‐based acetone gas sensors for breath analysis: a review. Chemistry–An Asian Journal. 2021 Jun 14;16(12):1519-1538. doi: 10.1002/asia.202100303.
34. Escarrer-Jaume M, Juliá-Benito JC, Quevedo-Teruel S, Del Prado AP, Sandoval-Ruballos M, Quesada-Sequeira F, Álvaro-Lozano M. Changes in epidemiology and clinical practice in IgE-mediated Allergy in children. Anales de Pediatría (English Edition). 2021 Jul 1;95(1):56.e1- 56.e8. doi: 10.1016/j.anpede.2021.04.002.
35. Ren J, Liu Y, Yao Y, Feng L, Zhao X, Li Z, Yang L. Intranasal delivery of MSC-derived exosomes attenuates allergic asthma via expanding IL-10 producing lung interstitial macrophages in mice. International Immunopharmacology. 2021 Feb 1;91:107288. doi: 10.1016/j.intimp.2020.107288.
36. Cao M, Zhan M, Wang Z, Wang Z, Li XM, Miao M. Development of an orally bioavailable isoliquiritigenin self-nanoemulsifying drug delivery system to effectively treat ovalbumin-induced asthma. International journal of nanomedicine. 2020 Nov 13:8945-8961. doi: 10.2147/IJN.S269982
37. Nasab DM, Taheri A, Athari SS. Design and fabrication of gold nanoparticles for anti-asthma drug delivery. Archives of Medical Laboratory Sciences. 2020;6:1-7. https://doi.org/10.22037/amls.v6.32580
38. Ahmad A. Pharmacological strategies and recent advancement in nano-drug delivery for targeting asthma. Life. 2022 Apr 18;12(4):596. doi: 10.3390/life12040596
39. Vellopoulou K, Bakakos P. Stelios Loukides, Nikos Maniadakis & Georgia Kourlaba. The Economic Burden of Asthma in Greece: A Cross-Sectional Study. Appl Health Econ Health Policy. 2019 Oct;17(5):629-640. doi: 10.1007/s40258-019-00469-4.
40. Lavorini F, Barreto C, van Boven JF, Carroll W, Conway J, Costello RW, Dahl BH, Dekhuijzen RP, Holmes S, Levy M, Molimard M. Spacers and valved holding chambers—the risk of switching to different chambers. The Journal of Allergy and Clinical Immunology: In Practice. 2020 May 1;8(5):1569-73. doi: 10.1016/j.jaip.2019.12.035.
41. Eikholt AA, Wiertz MB, Hew M, Chan AH, van Boven JF. Electronic monitoring devices to support inhalation technique in patients with asthma: a narrative review. Current Treatment Options in Allergy. 2023 Mar;10(1):28-52.
42. Chan AH, Pleasants RA, Dhand R, Tilley SL, Schworer SA, Costello RW, Merchant R. Digital inhalers for asthma or chronic obstructive pulmonary disease: a scientific perspective. Pulmonary Therapy. 2021 Dec;7(2):345-76. doi: 10.1007/s41030-021-00167-4.
43. Chrystyn H, Audibert R, Keller M, Quaglia B, Vecellio L, Roche N. Real-life inhaler adherence and technique: Time to get smarter!. Respiratory Medicine. 2019 Oct 1;158:24-32. doi: 10.1016/j.rmed.2019.09.008.
44. Bosnic-Anticevich S, Bakerly ND, Chrystyn H, Hew M, van der Palen J. Advancing digital solutions to overcome longstanding barriers in asthma and COPD management. Patient preference and adherence. 2023 Dec 31:259-272. doi: 10.2147/PPA.S385857.
45. Baldacci S, Simoni M, Maio S, Angino A, Martini F, Sarno G, Cerrai S, Silvi P, Pala AP, Bresciani M, Paggiaro P. Prescriptive adherence to GINA guidelines and asthma control: an Italian cross sectional study in general practice. Respiratory medicine. 2019 Jan 1;146:10-17. doi: 10.1016/j.rmed.2018.11.001.
46. Kouri A, Kaplan A, Boulet LP, Gupta S. New evidence-based tool to guide the creation of asthma action plans for adults. Canadian Family Physician. 2019 Feb 1;65(2):103-106.
47. Rank MA, Volcheck GW, Li JT, Patel AM, Lim KG. Formulating an effective and efficient written asthma action plan. InMayo Clinic Proceedings 2008 Nov 1 (Vol. 83, No. 11, pp. 1263-1270. doi: 10.4065/83.11.1263.
48. Abtahi H, Amini S, Gholamzadeh M, Gharabaghi MA. Development and evaluation of a mobile-based asthma clinical decision support system to enhance evidence-based patient management in primary care. Informatics in Medicine Unlocked. 2023 Jan 1;37:101168. DOI: 10.1016/j.imu.2023.101168.
49. .Fain SB, Gonzalez-Fernandez G, Peterson ET, Evans MD, Sorkness RL, Jarjour NN, Busse WW, Kuhlman JE. Evaluation of structure-function relationships in asthma using multidetector CT and hyperpolarized He-3 MRI. Academic radiology. 2008 Jun 1;15(6):753-762. doi: 10.1016/j.acra.2007.10.019.
50. Jung JW, Kwon JW, Kim TW, Lee SH, Kim KM, Kang HR, Park HW, Lee CH, Goo JM, Min KU, Cho SH. New insight into the assessment of asthma using xenon ventilation computed tomography. Annals of Allergy, Asthma & Immunology. 2013 Aug 1;111(2):90-95. doi: 10.1016/j.anai.2013.04.019.
51. Mussell GT, Marshall H, Smith LJ, Biancardi AM, Hughes PJ, Capener DJ, Bray J, Swift AJ, Rajaram S, Condliffe AM, Collier GJ. Xenon ventilation MRI in difficult asthma: initial experience in a clinical setting. ERJ open research. 2021 Sep 27;7(3) :00785-2020.. doi: 10.1183/23120541.00785-2020.
52. Park HW, Jung JW, Kim KM, Kim TW, Lee SH, Lee CH, Goo JM, Min KU, Cho SH. Xenon ventilation computed tomography and the management of asthma in the elderly. Respirology. 2014 Apr;19(3):389-95. doi: 10.1111/resp.12242.
53. Altes TA, Mugler III JP, Ruppert K, Tustison NJ, Gersbach J, Szentpetery S, Meyer CH, de Lange EE, Teague WG. Clinical correlates of lung ventilation defects in asthmatic children. Journal of Allergy and Clinical Immunology. 2016 Mar 1;137(3):789-796. doi: 10.1016/j.jaci.2015.08.045.
54. Mussell GT, Marshall H, Smith LJ, Biancardi AM, Hughes PJ, Capener DJ, Bray J, Swift AJ, Rajaram S, Condliffe AM, Collier GJ. Xenon ventilation MRI in difficult asthma: initial experience in a clinical setting. ERJ open research. 2021 Sep 27;7(3) :00785-2020. doi: 10.1183/23120541.00785-2020.
55. Exarchos KP, Beltsiou M, Votti CA, Kostikas K. Artificial intelligence techniques in asthma: a systematic review and critical appraisal of the existing literature. European Respiratory Journal. 2020 Sep 3;56(3). 2000521. doi: 10.1183/13993003.00521-2020.
56. .Jiang F, Jiang Y, Zhi H, Dong Y, Li H, Ma S, Wang Y, Dong Q, Shen H, Wang Y. Artificial intelligence in healthcare: past, present and future. Stroke and vascular neurology. 2017 Dec 1;2(4). https://doi.org/10.1136/svn-2017-000101
57. Chan R, Lipworth BJ. Impact of biologic therapy on the small airways asthma phenotype. Lung. 2022 Dec;200(6):691-696. doi: 10.1007/s00408-022-00579-2.
58. Menzies-Gow A, Bafadhel M, Busse WW, Casale TB, Kocks JW, Pavord ID, Szefler SJ, Woodruff PG, de Giorgio-Miller A, Trudo F, Fageras M. An expert consensus framework for asthma remission as a treatment goal. Journal of Allergy and Clinical Immunology. 2020 Mar 1;145(3):757-765. doi: 10.1016/j.jaci.2019.12.006.
59. Incorvaia C, Al‐Ahmad M, Ansotegui IJ, Arasi S, Bachert C, Bos C, Bousquet J, Bozek A, Caimmi D, Calderón MA, Casale T. Personalized medicine for allergy treatment: allergen immunotherapy still a unique and unmatched model. Allergy. 2021 Apr;76(4):1041-1052. doi: 10.1111/all.14575.
60. Scheiblhofer S, Thalhamer J, Weiss R. DNA and mRNA vaccination against allergies. Pediatric Allergy and Immunology. 2018 Nov;29(7):679-688. doi: 10.1111/pai.12964.
61. Durham SR, Shamji MH. Allergen immunotherapy: past, present and future. Nature Reviews Immunology. 2023 May;23(5):317-328. doi: 10.1038/s41577-022-00786-1.