Etiopathogenesis of Bronchial Asthma and Modern Molecular Diagnostic Methods
Keywords:
bronchial asthma, etiopathogenesis, T_h2 endotype, target cytokines, FeNO, component-resolved diagnostics, molecular biomarkersAbstract
This scientific article analyzes the multifactorial etiopathogenesis of bronchial asthma, the mechanisms of chronic immune inflammation of the airways, and the phenotypes and endotypes of the disease. The article elucidates the T_h2-high and Non-T_h2 immunological pathways, the cytokine network, and airway remodeling processes at the molecular level. Furthermore, it demonstrates the role of the most modern molecular and genetic methods in BA diagnostics—such as biomarker analysis component-resolved diagnostics, pharmacogenetics, and mass parallel sequencing technologies—using examples from international clinical practice.
References
[1] Global Initiative for Asthma (GINA), "Global Strategy for Asthma Management and Prevention," GINA Guidelines, 2025. [Online]. Available: ginasthma.org.
[2] A. Papi et al., "Asthma," Lancet, vol. 391, no. 10122, pp. 783–800, Mar. 2018.
[3] E. Israel and H. K. Reddel, "Severe and Difficult-to-Treat Asthma in Adults," N. Engl. J. Med., vol. 390, no. 11, pp. 1012–1025, Mar. 2024.
[4] S. E. Wenzel, "Asthma phenotypes: the evolution from clinical to molecular approaches," Nat. Med., vol. 18, no. 5, pp. 716–725, May 2012.
[5] H. Hammad and B. N. Lambrecht, "Barrier epithelial cells and the control of type 2 airway inflammation," Immunity, vol. 54, no. 4, pp. 643–657, Apr. 2021.
[6] H. K. Reddel et al., "Gaining control over difficult-to-treat asthma: Moving from guidelines to clinical practice," Eur. Respir. J., vol. 61, no. 2, p. 2201020, Feb. 2023.
[7] B. N. Lambrecht and H. Hammad, "The immunology of asthma," Nat. Immunol., vol. 16, no. 1, pp. 45–56, Jan. 2015.
[8] E. D. Bateman et al., "Global strategy for asthma management and prevention: GINA executive summary," Eur. Respir. J., vol. 31, no. 1, pp. 143–178, Jan. 2008.
[9] S. E. Wenzel et al., "Dupilumab efficacy and safety in adults with uncontrolled persistent asthma," N. Engl. J. Med., vol. 368, no. 26, pp. 2455–2466, Jun. 2013.
[10] J. V. Fahy, "Type 2 inflammation in asthma — present in most, absent in some," Nat. Rev. Immunol., vol. 15, no. 1, pp. 57–65, Jan. 2015.
[11] P. G. Gibson et al., "Mepolizumab for severe eosinophilic asthma: A randomized, double-blind, placebo-controlled trial," Lancet, vol. 384, no. 9949, pp. 1189–1197, Sep. 2014.
[12] I. D. Pavord et al., "Mepolizumab for severe eosinophilic asthma (DREAM): A multicentre, double-blind, placebo-controlled trial," Lancet, vol. 380, no. 9842, pp. 651–659, Aug. 2012.
[13] National Heart, Lung, and Blood Institute, "2020 Focused Updates to the Asthma Management Guidelines," J. Allergy Clin. Immunol., vol. 146, no. 6, pp. 1217–1270, Dec. 2020.
[14] G. Brusselle and G. Koppelman, "Biologic therapies for severe asthma," N. Engl. J. Med., vol. 386, no. 2, pp. 157–171, Jan. 2022.
[15] C. E. Brightling et al., "Targeting TNF-alpha in severe asthma," N. Engl. J. Med., vol. 354, no. 10, pp. 1034–1042, Mar. 2006.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Scholastic: Journal of Natural and Medical Education
This work is licensed under a Creative Commons Attribution 4.0 International License.
