Search for new therapeutic targets in asthma. Review.

A review of recent publications devoted to the study of risk factors for the onset of the disease, mechanisms, diagnosis and treatment of asthma from the point of view of molecular allergology is presented. New concepts and problems in the implementation of the exposome paradigm and its practical application are considered, including genetic and epigenetic factors, environmental impact. The most relevant experimental studies are noted that contribute to further understanding of molecular and immune mechanisms with potential new targets for the development of therapeutic agents. Reliable diagnosis of asthma, endotyping of the disease and monitoring of its severity are of great importance in the treatment of asthma. The heterogeneity of asthma is due to individual genetic and epigenetic variability, exposure to individual environmental factors (depending on regional characteristics, changing climatic conditions and population distribution), which explains the occurrence of asthma is not associated only with allergies. The modern assessment and treatment of comorbid/multimorbid asthma is described, including interaction with asthma phenotypes, which is important for the formation of a new therapeutic personalized approach to precision medicine and testing of prognostic biomarkers. The results of clinical trials, multicenter international studies on the use of new approaches in the diagnosis of asthma (candidate biomarkers) based on molecular allergology and treatment in adults and children using biological preparations are given.