Pathophysiological and Clinical Advances in Asthmatic Inflammation from the Nasopharynx to the Peripheral Airway in the Respiratory Tract Systems

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About this Research Topic

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Background

Recently, the development of asthmatic treatments targeting eosinophils, lymphocytes, and mast cells has been progressing. However, the pathophysiology of asthmatic inflammation, such as innate immunity, microbiome, and involvement of lipid mediators, remains obscure, and it is often unclear which focus is the optimal therapeutic target. Furthermore, asthmatic inflammation has many comorbidities, including allergic disorders, eosinophilic granulomatosis with polyangiitis (EGPA), chronic rhinosinusitis with nasal polyp(CRSwNP) (eosinophilic chronic rhinosinusitis (ECRS)), and chronic obstructive pulmonary disease (COPD). Poor control of asthmatic inflammation despite advances in asthmatic treatment may be partly due to various complications. These comorbidities further complicate pathological mechanisms. Therefore, asthmatic treatment based on these complications is important, and future progress in basic and clinical investigations on asthmatic inflammation is required. The relationship between microorganisms and asthma is indispensable for elucidating the pathophysiology of asthmatic inflammation, and research has been accelerating in recent years with the advent of biological drugs. Anti-IgE antibody treatment is known to suppress respiratory syncytial virus infection. Furthermore, it has been reported that eosinophil counts are low in severe patients with COVID-19 infection, and the treatment with anti-IL-5 antibodies / anti-IL-5receptor antibodies may not influence the severity of COVID19 infection in asthmatic patients. In the current global situation, the investigation of the relationship between asthmatic inflammation and COVID-19 is ongoing and unclear. Therefore, it is crucial to summarize the latest research results, and it is expected to bring great benefits to the management of patients with asthmatic inflammation. This topic aims to guide the understanding of the pathophysiology of asthma-related airway inflammation and the best treatment based on the latest findings by collecting a wide range of basic and clinical studies of cutting-edge asthmatic disorders from the upper to the lower respiratory tract systems.  Biological agents for asthma are now indicated not only for asthma but also for a wide range of diseases such as EGPA, CRSwNP (ECRS), and allergic disorders. All of these drugs have been shown to be more effective in suppressing asthmatic airway inflammation from the nasal cavity to the peripheral airways than existing therapeutic agents. Therefore, there is an increasing need to recognize asthma as a disease of the airways with asthmatic inflammation that has many complications rather than as a single disease. The goal is to deepen the general reader's understanding of the pathophysiology of asthmatic inflammation and treatment strategies of asthma-related disorders based on the latest research results. Therefore, we will collect a wide range of basic and clinical latest research on asthmatic inflammatory conditions from the nasopharynx to the lower respiratory tract, including reviews, articles, and highly interesting case reports.

Keywords: Eosinophil, Mast cell, omega3 fatty acid, Lipid mediator, cell signaling

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