Wheezy lungs in the sneezy seasons of life: Asthma risk factors, immunomodulation and inflammatory dynamics

Standard medical interventions, such as lifestyle interventions, inhaled medication and antihistamines, are not sufficient in approximately 5% of asthma patients; their asthma is defined as ‘severe asthma'.
Treatment options in those patients also consist of suppression of specific immunological pathways aimed at type 2 inflammation by monoclonal antibodies or “biologicals”. Despite the availability of these treatment options, some patients will still not reach adequate
asthma control.
This is currently an unmet need that might result in overtreatment. In the past years, treatment of asthma has developed towards a more personalized approach taking the T2 status into account. This thesis comprises studies on risk factors for the
development of asthma later in life and the effects of time and exacerbations on persistence and nature of asthma inflammation. Also, immunomodulation with bacterial lysates is being described, to prevent asthma exacerbations in children and adults, with uncontrolled asthma and recurrent exacerbations.