Precision identification and targeted therapy for neutrophilic asthma: from molecular mechanisms to clinical translation.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing molecular mechanisms with no original clinical data or systematic review methodology.
PubMed 42488629 · doi:10.3389/fimmu.2026.1878339
What was done
This narrative review synthesizes the molecular pathogenesis, diagnostic frameworks, and emerging targeted therapies for neutrophilic asthma (defined as sputum neutrophils ≥61%), focusing on the Th17/IL-17 pathway, neutrophil extracellular traps, NLRP3 inflammasome activation, glucocorticoid resistance, and the airway microbiome.
What was found
The abstract reports no primary quantitative data or statistical effect sizes. It notes that neutrophilic asthma exhibits intrinsic resistance to glucocorticoids due to impaired neutrophil apoptosis and persistent pro-inflammatory pathway activation, and summarizes investigational targeted approaches directed at IL-17, neutrophil extracellular trap formation, inflammasome components, and airway dysbiosis.
Why it matters
Neutrophilic asthma responds poorly to standard inhaled corticosteroid regimens. Mapping its non-eosinophilic molecular endotypes provides a framework for developing targeted biological therapies for this refractory phenotype.
Limits
As a narrative review, this work does not use systematic search methodology, meta-analytic pooling, or original human trial data. Specific efficacy rates, safety outcomes, and patient sample sizes are not provided in the abstract.