Utility of biomarkers in the diagnosis and monitoring of asthmatic children

Paraskevi Xepapadaki, Yuichi Adachi, Cesar Fireth Pozo Beltran, Zeinab A. El-Sayed, Rene Maximiliano Gomez, Elham Hossny, Ivana Filipovic, Peter Le Souef, Mario Morais-Almeida, Michael Miligkos, Antonio Nieto, Wanda Phipatanakul, Paulo M. Pitrez, Jiu-Yao Wang, Gary W. K. Wong, Nikolaos G. Papadopoulos

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


Asthma imposes a heavy morbidity burden during childhood; it affects over 10% of children in Europe and North America and it is estimated to exceed 400 million people worldwide by the year 2025. In clinical practice, diagnosis of asthma in children is mostly based on clinical criteria; nevertheless, assessment of both physiological and pathological processes through biomarkers, support asthma diagnosis, aid monitoring, and further lead to better treatment outcomes and reduced morbidity. Recently, identification and validation of biomarkers in pediatric asthma has emerged as a top priority across leading experts, researchers, and clinicians. Moreover, the implementation of non-invasive biomarkers for the assessment and monitoring of paediatric patients with asthma, has been prioritized; however, only a proportion of them are currently included in the clinical practise. Although, the use of non-invasive biomarkers is highly supported in recent asthma guidelines for documenting diagnosis and supporting monitoring of asthmatic patients, data on the Pediatric population are limited. In the present report, the Pediatric Asthma Committee of the World Allergy Organization (WAO), aims to summarize and discuss available data for the implementation of non-invasive biomarkers in the diagnosis and monitoring in children with asthma. Information on the most studied biomarkers, including spirometry, oscillometry, markers of allergic sensitization, fractional exhaled nitric oxide, and the most recent exhaled breath markers and "omic" approaches, will be reviewed. Practical limitations and considerations based on both experts' opinion and critical review of the literature, on the utility of all "well-known" and newly introduced non-invasive biomarkers will be presented. A critical commentary on biomarkers' use in diagnosing and monitoring asthma during the COVID-19 pandemic, cost and availability of biomarkers in different settings and in developing countries, the differences on the biomarkers use between Primary Practitioners, Pediatricians, and Specialists and their role on the longitudinal aspect of asthma is provided.
Original languageEnglish
Article number100727
Number of pages16
JournalWorld Allergy Organization Journal
Issue number1
Early online date15 Dec 2022
Publication statusPublished - Jan 2023


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