Innate Immune System Biomarkers in Asthma in Older Age: A Mini Review.

Abstract

Asthma in older adults represents a growing and underrecognized clinical challenge, characterized by increased morbidity, mortality, and complex immunological alterations associated with aging. Although the global literature on asthma immunopathogenesis continues to expand rapidly, particularly in the areas of immunosenescence, inflammaging, and biomarker discovery, a focused synthesis of innate immune mechanisms specific to older populations remains limited. Epidemiological data indicate that asthma prevalence in individuals aged≥60 years ranges from 4% to 13%, yet this group accounts for a disproportionate share of asthma-related mortality. Age-associated physiological changes, comorbidities, and frequent underdiagnosis contribute to poorer outcomes. Emerging evidence from academic research centers highlights profound age-related alterations in epithelial integrity, neutrophil and macrophage function, cytokine regulation, and innate immune receptor signaling, resulting in asthma phenotypes that differ fundamentally from those seen in younger patients. In parallel, advances in biomarker research (including inflammatory mediators, cellular signatures, and epigenetic markers) offer new opportunities for improved phenotyping and precision management in elderly asthma. This mini-review synthesizes contemporary findings from reputable academic studies to summarize key innate immune alterations and candidate biomarkers relevant to asthma in older adults. By consolidating current evidence within a rapidly evolving field, this review aims to provide a clinically meaningful framework for researchers and clinicians seeking to better understand immune aging in asthma and to guide future investigation and targeted therapeutic strategies.