Abstract
Asthma is a mysterious disease with heterogeneity in etiology, pathogenesis, and clinical phenotypes. Although ongoing studies have provided a better understanding of asthma, its natural history, progression, pathogenesis, diversified phenotypes, and even the exact epigenetic linkage between childhood asthma and adult-onset/old age asthma remain elusive in many aspects. Asthma heritability has been established through genetic studies, but genetics is not the only influencing factor in asthma. The increasing incidence and some unsolved queries suggest that there may be other elements related to asthma heredity. Epigenetic mechanisms link genetic and environmental factors with developmental trajectories in asthma. This review provides an overview of asthma epigenetics and its components, including several epigenetic studies on asthma, and discusses the epigenetic linkage between childhood asthma and adult-onset/old age asthma. Studies involving asthma epigenetics present valuable novel approaches to solve issues related to asthma. Asthma epigenetic research guides us towards gene therapy and personalized T cell therapy, directs the discovery of new therapeutic agents, predicts long-term outcomes in severe cases, and is also involved in the cellular transformation of childhood asthma to adult-onset/old age asthma.
Highlights
Asthma is well known as a noncommunicable, chronic, and heterogeneous inflammatory condition of the lower airway tract characterized by various clinical conditions that vary in severity and frequency [1, 2]
Through the review of components of epigenetic mechanisms (DNA methylation, histone modifications, and miRNAs) and genetics and environmental factors, we strongly believe that the epigenetic mechanisms are involved in the cellular transformation of childhood asthma to adult-onset/old age asthma (see Figures 3(a) and 3(b)), further research is required
Asthma is a mysterious disease with heterogeneity in etiology, pathogenesis, and clinical phenotypes under genetic influences
Summary
Asthma is well known as a noncommunicable, chronic, and heterogeneous inflammatory condition of the lower airway tract characterized by various clinical conditions that vary in severity and frequency [1, 2]. Non-T2 asthma is a neutrophilic and paucigranulocytic heterogenous type, predominant in those with adult-onset and corticosteroidresistant (less responsive), and inflammation-driven through IL-17, IL-6, and IL-23. It has airway smooth muscle or neural dysfunction and may be associated with comorbidities, such as obesity and gastroesophageal reflux disease [5, 6]. The exact linkage between childhood and adult-onset/old age asthma remains unclear. The complete natural history, pathogenesis, and heterogeneous phenotypes of asthma remain. This review is aimed at providing an overview on asthma epigenetics and its components, including asthma epigenetic studies, and discuss potential epigenetic links between childhood asthma and adult-onset/old age asthma
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