Published online May 8, 2015. doi: 10.5409/wjcp.v4.i2.13
Peer-review started: January 29, 2015
First decision: March 6, 2015
Revised: March 19, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: May 8, 2015
Core tip: Although asthma diagnosis is based mainly on clinical basis using history taking and physical examination, treatment options are not tailored according to the clinical phenotype. We still do not have a way to work up a given patient with asthma and to easily delineate the specific pathobiology that leads to her or his airway dysfunction. We can recognize the clinical syndromes, but we cannot spell out the steps that lead from genetic or biochemical defects to disease presentation. Thus we are left with a paradox in the study of asthma; we have effective treatments that are not biologically informative, and we have informative treatments that are less effective.