Abstract

Asthma is the most common chronic respiratory disease in childhood. The diagnosis of asthma is based on clinical history, airflow limitation and bronchial reactivity. Asthma treatment focuses on control of the condition; in cases of particular respiratory symptoms, the use of rescue medications, limited daily activity and lung function tests are taken into consideration. However, lung function and symptoms do not always reflect underlying airway inflammation and response to therapy. Consequently, objective parameters of airway inflammation could represent asignificant adjunctive tool for the clinician in tailored management of the disease.

In recent years researchhas focused on biomarkers to identify phenotype, inflammation, pathobiological pathways and to guide the clinician in the diagnosis and personalized management of asthma. More feasible tests in the pediatric population are the collection of exhaled breath condensate (EBC) and the measurement of exhaled nitric oxide (FeNO), which are the most popular tests in practice. Other markers that might predict asthma exacerbation are volatile organic compounds (VOCs) that indicate airway inflammation and the level of asthma control.

Nowadays, the variability and low reproducibility of exhaled biomarkers due to the lack of methodological standardization of pre-collection, collection, post-collection and interpretation of conditions could represent a drawback in clinical practice. Despite these limitations, several biomarkers have been shown to be helpful in distinguishing patients with asthma from healthy children.