New insights into the pathogenesis of asthma
Open accessAbstract
Historical perspectiveAsthma is a disease whose ability to cause episodic symptomatology has been appreciated since antiquity.Although the fine points of the definition can be debated, it is reasonable to think of asthma as a pulmonary disorder characterized by the generalized reversible obstruction of airflow and to define reversibility as a greater than 12% increase in the patient's forced expiratory volume in 1 second (FEV 1 ) that occurs either spontaneously or with therapy.Airway hyperresponsiveness, an exaggerated bronchospastic response to nonspecific agents such as methacholine and histamine or specific antigens, is the physiologic cornerstone of this disorder.A diagnosis of asthma is established based on a history of recurrent wheeze, cough, or shortness of breath, reversible airway obstruction demonstrated by pulmonary-function testing, and, in cases where questions exist, a methacholine challenge demonstrating airway hyperresponsiveness.It has long been assumed that patients with asthma experience intermittent attacks and have relatively normal lung function during intervening periods.More recent studies have demonstrated that asthma can cause progressive lung impairment and, in some patients, eventuate in partially reversible or irreversible airway obstruction.Any discussion of asthma must take into account the recent increase in its prevalence.Since approximately 1980, the frequency of this disorder has almost doubled.As a result of this "epidemic," asthma now affects approximately 8-10% of the population in the US, is the leading cause of hospitalization among children less than 15 years of age, and costs society billions of dollars annually.This increase in prevalence is not simply due to diagnostic transference or increased diagnostic awareness, since asthma mortality rates have also increased during this interval.
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Asthma is controlled by Th2 immune response, which leads to high levels of IgE, airway eosinophilia, and mucus production.
“Asthma is controlled by Th2 immune response, which leads to the high levels of IgE, airway eosinophilia, and mucus production [18].”
From Picroside II Attenuates Airway Inflammation by Downregulating the Transcription Factor GATA3 and Th2-Related Cytokines in a Mouse Model of HDM-Induced Allergic Asthma (2016) · cites this paper as [18]
The Th1/Th2 paradigm section says Th2 responses predominate in asthmatic airways and elicit eosinophilia. The section on chronic effector functions of Th2 cytokines links IL-13 to mucus metaplasia. The copy does not state that Th2 responses cause high IgE levels, and describing asthma as wholly controlled by Th2 responses overstates its account. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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- Authors
- Elias, J. A., Lee, C. G., Zheng, T., Ma, B., Homer, R. J., & Zhu, Z.
- Affiliations
- Yale University (US)
- Corresponding author
- Elias, Jack A.
- Venue
- Journal of Clinical Investigation
- Published
- 2003-02-01
- Volume
- 111
- Issue
- 3
- Pages
- 291-297
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC151878
- OpenAlex
- W2073310243
- Cited by
- 407
- References
- 22
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 12 · 2020: 5 · 2019: 11 · 2018: 9 · 2017: 16 · 2016: 14 · 2015: 22 · 2014: 18 · 2013: 24 · 2012: 21
- FWCI
- 18.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Doris Duke Charitable Foundation
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- asthma pathogenesis, airway hyperresponsiveness, reversible airway obstruction, methacholine challenge, asthma prevalence, asthma mortality, bronchospasm, history of asthma
- MeSH terms
- Animals, Asthma, Humans, Mice, Transgenic, Models, Biological, Th1 Cells, Th2 Cells, Mice
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