ЭВОЛЮЦИЯ ПРЕДСТАВЛЕНИЙ О РОЛИ ХРОНИЧЕСКОГО ВОСПАЛЕНИЯ КАК КЛЮЧЕВОГО ЗВЕНА В ПАТОГЕНЕЗЕ БРОНХИАЛЬНОЙ АСТМЫ

Abstract

ntroduction. Asthma is considered as a heterogeneous disease. Recently, the pathophysiological mechanisms of chronic airway inflammation development have been established. However, the evolution of understanding the asthma pathogenesis is a matter of great interest. Aim. Based on literature review, our aim was to provide the key milestones in the formation of modern understandings in asthma etiology and pathogenesis. Material and methods. We searched across PubMed and eLibrary.ru databases to identify articles published in 1900-2022, using the keywords ‘bronchial asthma’, ‘history’, ‘pathogenesis’, ‘eosinophilic inflammation’, ‘endotypes’, ‘biomarkers’, ‘innate lymphoid cells’ and ‘Th2 lymphocytes’. Results and discussion. Since ancient times scientists were interested in the mechanisms of asthma development. ‘Asthma’ derived from Greek word that means ‘shortness of breath’ and ‘suffocation’. In the Middle Ages, science was scholasticism oriented, so the understandings of asthma were based only on observational studies, and the works of Hippocrates and Galen were considered irrefutable. Subsequently, in Modern times observational studies were supported by experiments and that gave the opportunity to study the asthma pathogenesis. Since the 20th century studies on identifying the roles of heredity, sensitization and mechanisms of airway inflammation have flourished and that led to the identification of asthma endotypes and phenotypes. Recent trends in the understanding of pathogenesis at molecular levels provided a personalized approach to asthma treatment. Conclusion. Thus, accumulated clinical observational and experimental data gained new insights into asthma pathogenesis and led to the development of biologics for the management of asthma. This study was funded by grant from Kazan State Medical University N2/22-10 (02.08.2022).