Precision Monitoring in Asthma: Biomarkers and Treatable Traits

Asthma is a heterogeneous respiratory disease in which variable symptoms, airway inflammation, exacerbation risk, and treatment response complicate efforts to achieve sustained control. Conventional stepwise management remains valuable, but a one-size-fits-all approach may overlook clinically meaningful differences between patients. Current research examines how biomarkers such as fractional exhaled nitric oxide (FeNO), blood and sputum eosinophils, periostin, and composite measures can identify inflammatory phenotypes and treatable traits. Digital tools, remote monitoring, and patient-generated data are also expanding opportunities for continuous assessment beyond the clinic. However, questions remain about the reproducibility, accessibility, and clinical utility of these measures across diverse populations and care settings. Although biomarker-informed strategies have shown promise in predicting corticosteroid responsiveness, exacerbation risk, adherence to maintenance therapy, and biologic treatment outcomes, evidence on their integration into routine practice remains uneven. Further investigation is needed to establish clinically useful thresholds, validate composite approaches, evaluate longitudinal monitoring, and determine how precision tools can improve outcomes while supporting equitable and cost-effective care.This Research Topic aims to advance evidence on the use of biomarkers, treatable traits, and digital monitoring to individualise asthma assessment and management. It will examine how these approaches can support diagnosis, phenotyping, risk stratification, treatment selection, and decisions to step up or step down therapy. Contributions may address how biomarker-guided strategies influence inhaled corticosteroid use, biologic initiation and switching, adherence to maintenance therapy, exacerbation prevention, symptom control, and long-term outcomes. The Research Topic also seeks to clarify how tools perform in real-world populations, how they can be incorporated into clinical workflows, and which combinations of clinical, biological, and digital measures provide the greatest value for patients and healthcare systems.To gather further insights into precision monitoring and treatable-traits approaches across asthma phenotypes and care settings, we welcome articles addressing, but not limited to, the following themes:- FeNO, blood eosinophils, sputum eosinophils, periostin, and other emerging biomarkers- Composite biomarker scores and multidimensional treatable-traits models- Biomarker-guided diagnosis, phenotyping, risk prediction, and prognosis- Monitoring airway inflammation and treatment response over time- Remote monitoring, wearable technologies, connected inhalers, and digital biomarkers- Patient-reported outcomes and home-based assessment of asthma control- Biomarker-informed step-up, step-down, and biologic treatment decisions- Monitoring of adherence to maintenance therapy- Prediction of exacerbations, corticosteroid responsiveness, and treatment failure- Validation, reproducibility, and clinical utility of precision-monitoring tools- Real-world implementation, workflow integration, health equity, and cost-effectiveness- Pragmatic approaches to personalised asthma management across healthcare settingsTogether, these contributions will help clarify how biomarker-guided and digitally enabled approaches can be translated into practical, patient-centred strategies that improve asthma control, optimise treatment decisions, and support more efficient routine. Topic editors: Davor Plavec, Dr Tinku Gupta, Chieko Yoshida Source: https://www.frontiersin.org/research-topics/85681/precision-monitoring-in-asthma-biomarkers-and-treatable-traits