Alladina Jehan, Medoff Benjamin D, Cho Josalyn L
Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Immunol Rev. 2025 Mar;330(1):e70016. doi: 10.1111/imr.70016.
Asthma is a common chronic respiratory disease characterized by the presence of airway inflammation, airway hyperresponsiveness, and mucus hypersecretion. Repeated asthma exacerbations can lead to progressive airway remodeling and irreversible airflow obstruction. Thus, understanding and preventing asthma exacerbations are of paramount importance. Although multiple endotypes exist, asthma is most often driven by type 2 airway inflammation. New therapies that target specific type 2 mediators have been shown to reduce the frequency of asthma exacerbations but are incompletely effective in a significant number of asthmatics. Furthermore, it remains unknown whether current treatments lead to sustained changes in the airway or if targeting additional pathways may be necessary to achieve asthma remission. Activation of innate immunity is the initial event in the inflammatory sequence that occurs during an asthma exacerbation. However, there continue to be critical gaps in our understanding of the innate immune response to asthma exacerbating factors. In this review, we summarize the current understanding of the role of innate immunity in asthma exacerbations and the methods used to study them. We also identify potential novel therapeutic targets for asthma and future areas for investigation.
哮喘是一种常见的慢性呼吸道疾病，其特征为气道炎症、气道高反应性和黏液分泌过多。反复的哮喘发作可导致进行性气道重塑和不可逆的气流阻塞。因此，了解和预防哮喘发作至关重要。尽管存在多种内型，但哮喘最常见的驱动因素是2型气道炎症。已证明针对特定2型介质的新疗法可降低哮喘发作的频率，但对相当数量的哮喘患者并不完全有效。此外，目前的治疗是否会导致气道持续变化，或者是否需要针对其他途径才能实现哮喘缓解仍不清楚。固有免疫激活是哮喘发作期间发生的炎症序列中的初始事件。然而，我们对哮喘加重因素的固有免疫反应的理解仍存在关键差距。在这篇综述中，我们总结了目前对固有免疫在哮喘发作中的作用的理解以及用于研究它们的方法。我们还确定了哮喘潜在的新型治疗靶点和未来的研究领域。
