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Edited by K.F. Chung, E.H. Bel and S.E. Wenzel
Difficult-to-treat severe asthma constitutes approximately 5-10% of the asthmatic population and continues to present a considerable therapeutic challenge. Use of the pragmatic definitions of the past 10 years has led to a better delineation of these patients. This issue gathers experts in paediatric and adult severe asthma who have summarised what has been achieved in our understanding of the different phenotypes, their biomarkers and the reasons and mechanisms underlying difficult-to-treat severe asthma and the refractoriness to current treatments. This issue also provides a physician's guide to the management of severe asthma with the optimal use of the currently available therapies, while highlighting the potential approaches we need to take in order to discover more effective treatments.
1. Difficult-to-treat asthma: how serious is the problem and what are the issues?
2. Evaluation of the difficult-to-treat severe asthma patient in the clinic
3. Treatment adherence and psychosocial factors in severe asthma
4. Characteristics, definition and phenotypes of severe asthma
5. Special problems of severe asthma in childhood
6. Recent developments in the genetics of asthma susceptibility and severity
7. Pathology inflammation and cytokines of severe asthma
8. Allergic and nonallergic factors in severe asthma
9. Asthma exacerbations in relation to severe asthma
10. Fatal and near-fatal asthma
11. Fixed airway obstruction in severe asthma
12. Imaging in severe asthma
13. Airway physiology and pathophysiology in severe asthma
14. The upper airways in severe asthma
15. Epithelial-mesenchymal communication in the pathogenesis of severe asthma
16. Noninvasive assessment of inflammation in severe asthma
17. Lipid mediators in severe asthma
18. Corticosteroids: use and insensitivity in severe asthma
19. Bronchodilator therapies for severe asthma
20. New treatments for severe asthma
21. Management of difficult-to-treat severe asthma
22. Severe asthma: the way forward
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