The Pathology of Asthma: What Is Obstructing Our View?

Helena Aegerter, Bart N. Lambrecht

Research output: Contribution to journalReview articleAcademicpeer-review

37 Citations (Scopus)
81 Downloads (Pure)

Abstract

Despite the advent of sophisticated and efficient new biologics to treat inflammation in asthma, the disease persists. Even following treatment, many patients still experience the well-known symptoms of wheezing, shortness of breath, and coughing. What are we missing? Here we examine the evidence that mucus plugs contribute to a substantial portion of disease, not only by physically obstructing the airways but also by perpetuating inflammation. In this way, mucus plugs may act as an immunogenic stimulus even in the absence of allergen or with the use of current therapeutics. The alterations of several parameters of mucus biology, driven by type 2 inflammation, result in sticky and tenacious sputum, which represents a potent threat, first due to the difficulties in expectoration and second by acting as a platform for viral, bacterial, or fungal colonization that allows exacerbations. Therefore, in this way, mucus plugs are an overlooked but critical feature of asthmatic airway disease.

Original languageEnglish
Pages (from-to)387-409
Number of pages23
JournalAnnual Review of Pathology: Mechanisms of Disease
Volume18
DOIs
Publication statusPublished - 24 Jan 2023

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