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Mechanisms of Airway Inflammation in Asthma
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Mechanisms of Airway Inflammation in Asthma

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy in Clinical Medicine".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 1788

Special Issue Editor

Dr. Kathleen Haley

E-Mail Website
Guest Editor
Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
Interests: pulmonary hypertension; asthma; acute respiratory distress syndrome; critical care

Special Issue Information

Dear Colleagues,

Recently, our understanding of inflammation in asthma has changed dramatically. This change has been driven in part by studies examining inflammation in patients with severe asthma, who have the greatest burden of asthma morbidity and mortality. These investigations have provided a deeper understanding of key factors modulating inflammation in asthma and have identified multiple phenotypes within asthma. While eosinophilic and Type 2 inflammation are critical inflammatory pathways for many asthmatics, other asthma patients have predominantly non-Type 2 inflammation, such as patients with obesity-associated asthma and patients with neutrophilic-predominant asthma. A greater understanding of the inflammatory processes in asthma has led to novel therapies targeting specific molecular targets. Additionally, the detailed characterization of inflammatory mechanisms active in different asthma phenotypes has facilitated the targeting of therapies to those patients most likely to respond. This individualized treatment approach allows patients to achieve greater control of their disease while minimizing the use of medications with long-term severe side effects, such as systemic steroids. This special issue of Journal of Personalized Medicine will review several of the major advances in our knowledge regarding inflammation in asthma and how this heightened understanding of the pathophysiology of asthma has led to innovative therapeutic approaches for this disease.

Dr. Kathleen Haley
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • asthma
  • inflammation in asthma
  • targeted therapies
  • acute respiratory distress syndrome
  • chronic lung diseases
  • critical care

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Published Papers (2 papers)

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Research

14 pages, 526 KB  
Article
Real-World Effectiveness of Tezepelumab in Severe Asthma: A Comparative Analysis of High and Low T2 Phenotypes
by Eusebi Chiner, Ignacio Boira, Mónica Antón, María Ángeles Bernabeu, Celia Cuevas, Paula Fernández, Violeta Esteban and Mónica Llombart
J. Pers. Med. 2026, 16(3), 167; https://doi.org/10.3390/jpm16030167 - 18 Mar 2026
Viewed by 543
Abstract
Background: Tezepelumab has demonstrated efficacy in severe uncontrolled asthma (SUA), although real-world evidence remains limited. Methods: We included patients with SUA who completed at least 6 months of treatment. Lung function, eosinophil counts, IgE, FeNO, comorbidities, and changes in asthma control [...] Read more.
Background: Tezepelumab has demonstrated efficacy in severe uncontrolled asthma (SUA), although real-world evidence remains limited. Methods: We included patients with SUA who completed at least 6 months of treatment. Lung function, eosinophil counts, IgE, FeNO, comorbidities, and changes in asthma control were assessed using ACT, ACQ, the VAS, and quality of life (AQLQ), as well as severe exacerbations (hospital admissions and emergency visits), oral corticosteroid (OCS) courses, OCS withdrawal/dose reduction, and reductions in maintenance and reliever medication. Response was evaluated using the FEOS and EXACTO scales. Baseline (T0) and 6-month (T6) outcomes were compared in the overall cohort and according to T2-high (eosinophilic/allergic) vs. T2-low phenotype. Results: A total of 33 patients were analyzed (58 ± 12 years; 94% women), with a high burden of comorbidities (88%), mainly rhinosinusitis (79%), obesity (41%), and smoking (37%). Of these, 45.5% had received prior biologic therapy. All patients were on high-dose ICS + LABA, frequently with LAMA and other controllers; 30% were on maintenance OCS. In the previous year, 49% had been hospitalized, 97% had attended the emergency department, and 100% required OCS courses. After 10 ± 3 months, the overall group showed significant improvement in VAS, ACT, ACQ, and AQLQ (p < 0.001), with a reduction in eosinophils, but no significant change in FEV1%. Severe exacerbations, emergency visits, hospitalizations, and OCS courses decreased markedly (p < 0.001). Among 10 patients on maintenance OCS, OCS were discontinued in 7 and reduced in 3; maintenance/reliever medication was also reduced. The T2-high phenotype showed a higher likelihood of “complete response” (52% vs. 17% in non-T2), although “good response” predominated in non-T2; this difference was significant (p = 0.04). Conclusions: Tezepelumab improved asthma control and reduced healthcare utilization and corticosteroid use in both T2 and non-T2 patients, achieving clinical remission in 40%, with better outcomes in T2. Full article
(This article belongs to the Special Issue Mechanisms of Airway Inflammation in Asthma)
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11 pages, 1320 KB  
Article
A Categorical ANCOVA Approach to Severity Endophenotype-Specific Genome-Wide Association Studies in Childhood Asthma
by Shraddha Piparia, Parham Hadikhani, John Ziniti, Julian Hecker, Alvin T. Kho, Rinku Sharma, Juan C. Celedón, Michael J. McGeachie, Scott T. Weiss and Kelan G. Tantisira
J. Pers. Med. 2026, 16(1), 32; https://doi.org/10.3390/jpm16010032 - 5 Jan 2026
Viewed by 502
Abstract
Objective: Asthma is a complex and heterogeneous syndrome, making it hard to predict disease progression and suitable treatments. One strategy for reducing this uncertainty is to define genetic subtypes, or endophenotypes, that capture shared biological mechanisms. Most genome-wide studies, however, compare one subgroup [...] Read more.
Objective: Asthma is a complex and heterogeneous syndrome, making it hard to predict disease progression and suitable treatments. One strategy for reducing this uncertainty is to define genetic subtypes, or endophenotypes, that capture shared biological mechanisms. Most genome-wide studies, however, compare one subgroup against all others within a single cohort and rarely replicate their findings. We aimed to determine whether simultaneously modeling all asthma endophenotypes improves the discovery and replication of genetic associations compared with the standard one-versus-rest approach. Methods: We analyzed common single-nucleotide polymorphisms (SNPs) in the Childhood Asthma Management Program (CAMP) using an analysis of covariance (ANCOVA) across all severity-related endophenotypes, adjusting for age, sex, and ancestry principal components. SNPs showing genome-wide significance were tested for replication in the Genetics of Asthma in Costa Rican Children Study (GACRS). For comparison, we performed traditional one-versus-rest logistic regression analyses within each cohort, using identical covariates and endophenotype labels. Results: The ANCOVA identified 244 genome-wide significant SNPs in CAMP, of which six unique loci replicated in GACRS. In contrast, logistic regression recovered only four significant contrasts from those six loci in CAMP and replicated just one in GACRS. Conclusions: Our findings highlight genetic variants that are associated with asthma severity endophenotypes and demonstrate that modeling all clinical subtypes simultaneously can reveal biologically meaningful signals that are missed by standard pairwise design. Full article
(This article belongs to the Special Issue Mechanisms of Airway Inflammation in Asthma)
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