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This review examines a comprehensive endotype\u2010phenotype framework for asthma assessment with an emphasis on characteristics beyond T2 inflammatory status alone. Endo\u2010phenotype assessment can be performed across three domains: clinical (symptoms, exacerbations, co\u2010morbidities), structural and physiological, and inflammatory endotype. The clinical domain includes mucus hypersecretion, perception of airway narrowing, and obesity\u2010related asthma. Airway remodelling is the central, structural endo\u2010phenotype that defines asthma, given its relationship with fixed airflow limitation, airway hyperresponsiveness, small airway dysfunction, lung function decline, and asthma severity. However, it is the most difficult parameter to measure, and it is increasingly recognised that there is a critical need to be able to measure it longitudinally, beyond bronchial biopsy. Finally, T2\u2010high asthma is relatively well characterised with several effective anti\u2010inflammatory therapies available, including a range of biologics. In contrast, T2\u2010low asthma remains a heterogenous and potentially difficult to characterise endo\u2010phenotype, although some treatment studies have demonstrated benefit when subjects have been appropriately characterised and selected. Emerging multi\u2010omic approaches may enhance the detailed characterisation of patients in future. Adopting an endo\u2010phenotype framework allows clinicians and researchers to confront the complexity of asthma, better manage patients with a precision medicine approach and enhance mechanistic understanding, which is critical for new therapeutics to be developed for asthma.<\/jats:p>","DOI":"10.1002\/resp.70322","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:26:18Z","timestamp":1791357978000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Asthma: From Phenotypes to Endotypes\u2014Beyond Type\u00a02 Inflammation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-5585","authenticated-orcid":false,"given":"Mario","family":"Fernando","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Royal North Shore Hospital  St Leonards New South Wales Australia"},{"name":"Northern Clinical School, Faculty of Health and 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