Towards personalized medicine for the treatment of equine asthma

Although horses with asthma share similar clinical signs, the heterogeneity of the disease in terms of severity, triggering factors, inflammatory profile, and pathological features has hindered our ability to define biologically distinct subgroups. The recognition of phenotypes and endotypes could enable the development of precision medicine, including personalized, targeted therapy, to benefit affected horses. While in its infancy in horses, this review outlines the phenotypes of equine asthma and discusses how knowledge gained from targeted therapy in human medicine can be applied to evaluate the potential opportunities for personalized medicine in equine asthma and to suggest avenues for research to advance this emerging field. •Therapies targeting phenotypes/endotypes are used for human patients who responded poorly to standard therapies.•Valuable insights and areas for future research can be derived from the knowledge gained from targeted therapy in humans.•Multicentre studies are needed to improve our understanding of equine phenotypes and their response to targeted therapy.•The available data on personalized medicine in equine asthma is insufficient to draw conclusions about its effectiveness.