Advancing precision medicine for asthma by focusing on type 2 cytokines and alarmins.

IF 3 4区医学 Q2 ALLERGY

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-06-05 DOI:10.1097/ACI.0000000000001081

Remo Poto, Andrea Portacci, Rory Chan, Gianluca Lagnese, Mattia Giovannini, Gilda Varricchi

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引用次数: 0

Abstract

Purpose of review: Asthma is a heterogeneous disease encompassing distinct phenotypes and endotypes. Advances in elucidating the pathogenic role of type 2 (T2) cytokines and epithelial-derived alarmins have profoundly reshaped our understanding of airway inflammation in asthma. This review provides an updated perspective on how these mediators contribute to asthma pathobiology and examines their integration into emerging precision medicine strategies.

Recent findings: Biologic agents targeting T2 cytokines (IL-4, IL-5, and IL-13) and alarmins (TSLP and IL-33) have demonstrated efficacy across a broad spectrum of severe asthma phenotypes. Recent evidence underscores the central role of alarmins in orchestrating both innate and adaptive immune responses within the airways. In parallel, the development of alarmin-associated molecular and clinical biomarkers is expanding patient stratification beyond traditional eosinophilic and allergic profiles.

Summary: Advancing our understanding of alarmins and T2 cytokines offers new opportunities to refine asthma endotyping, personalize therapeutic decisions, and pursue sustained disease remission. Future directions include the integration of multiomics, real-world evidence, and novel biomarker platforms to consolidate the next phase of precision medicine in asthma and optimize long-term disease modification strategies.

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通过关注2型细胞因子和警报器推进哮喘的精准医学。

综述目的：哮喘是一种异质性疾病，包括不同的表型和内型。在阐明2型（T2）细胞因子和上皮源性警报器的致病作用方面的进展已经深刻地重塑了我们对哮喘气道炎症的理解。这篇综述提供了一个关于这些介质如何促进哮喘病理生物学的最新观点，并检查了它们与新兴精准医学策略的整合。最近的研究发现：针对T2细胞因子（IL-4、IL-5和IL-13）和警报因子（TSLP和IL-33）的生物制剂已证明对广泛的严重哮喘表型有效。最近的证据强调了警报在协调气道内先天和适应性免疫反应中的核心作用。与此同时，警报相关的分子和临床生物标志物的发展正在扩大患者分层，超越传统的嗜酸性粒细胞和过敏谱。总结：提高我们对警报和T2细胞因子的理解为改进哮喘内分型、个性化治疗决策和追求持续的疾病缓解提供了新的机会。未来的方向包括整合多组学、真实世界证据和新型生物标志物平台，以巩固哮喘精准医学的下一阶段，并优化长期疾病改变策略。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.