ArticleJournal of asthma and allergy2026
Biomarker-Defined Endotypes and Clinical Phenotypes of Asthma: A Cluster-Based Analysis of Type-2 Inflammatory Patterns and Their Clinical Correlates.
Article in Journal of asthma and allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Asthma is a biologically heterogeneous disease characterized by diverse inflammatory mechanisms, yet the clinical translation of this heterogeneity into clearly defined, biomarker-driven endotypes remains limited in real-world populations. Although Type-2 (T2) inflammation predominates in many patients, the overlap between allergic and eosinophilic pathways and the identification of distinct endotypes with specific clinical correlates are not fully characterized. This study aimed to define biomarker-based asthma endotypes using unsupervised clustering and to explore their associated clinical and demographic features. Methods: In this cross-sectional study, asthmatic patients evaluated at a tertiary hospital were included. Demographics, body mass index (BMI), comorbidities, age of onset, disease duration, spirometry parameters, bronchodilator reversibility, allergic status, and inflammatory biomarkers; total IgE, blood eosinophil count (BEC), and fractional exhaled nitric oxide (FeNO), were retrieved from medical records. Standardized biomarker values were analyzed using hierarchical clustering to define asthma endotypes. Clinical and demographic differences between clusters were subsequently compared. Results: Among 162 patients, females predominated (69.1%), and overweight/obesity was common (median BMI 29.15 kg/m Conclusion: T2-high inflammation predominates in this cohort, comprising 80% of patients and segregating into clinically distinct allergic, eosinophilic, and mixed endotypes. Cluster-based stratification offers meaningful phenotyping that may support personalized biologic selection and precision management strategies.
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