Introduction Part I -- The spectrum of asthma epidemiology -- Disease prevalence and burden -- Climate considerations in asthma and impacts of climate change -- Asthma across the ages: children, women, and the elderly -- Asthma as a systemic disease: neurologic, cardiac and metabolic changes in asthma -- Social determinants of health in asthma -- Part II. Mechanistic heterogeneity in asthma, -Phenotypes and endotypes -- Heterogeneity of treatment response to asthma (including mild-moderate asthma) -- Regional airway involvement: Imaging heterogeneity in ventilation, mucus and remodeling -- Biobehavioral determinants of asthma, including CNS influences and dietary/nutrition -- Integrative/ Systems levels studies -- Part III. Severe and difficult to treat asthma endotypes -- Definition, phenotyping of severe asthma, including cluster analysis -- Asthma exacerbations: patient features and potential long-term implications -- Innate inflammation driven remodeling -- Adaptive immunity and remodeling -- PartIV. Influence of heterogeneity on approaches to management -- Approaches to management of asthma -- Guidelines for stepped care and self-monitoring -- Global considerations in asthma treatment - management in low resource settings -- Update on biomarker-driven approaches and precision medicine- adaptive clinical trials e.g., PRECISE -- Conclusion and future directions.