REVIEW article
Front. Immunol.
Sec. T Cell Biology
T Cell Heterogeneity in Asthma Pathogenesis: From Immunological Mechanisms to Biological Targeted Therapies
Provisionally accepted
- Xiamen University, Xiamen, China
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Severe and overlapping asthma endotypes—particularly steroid-insensitive disease—remain undertreated, highlighting the need for a T-cell–centered synthesis. This review frames asthma heterogeneity through the interplay of T-cell axes, with Th2 pathways shaping T2-high disease and Th17/Treg imbalance characterizing T2-low features and much of steroid resistance. Building on this framework, we map therapies to mechanism: IL-4Rα and IL-5/IL-5R blockade chiefly mitigate Th2-dominated circuits, whereas upstream alarmin inhibition (e.g., TSLP) modulates epithelial–immune cues that influence both T2-high biology and selected T2-low processes. We then outline what is needed to translate mechanisms into decisions—integrated biomarkers to refine endotypes and mechanism-guided switching or combinations, with emphasis on T2-low populations where unmet need is greatest. By linking T-cell biology to therapeutic leverage points, the review offers a concise path from mechanism to patient stratification and more rational treatment choices.
Keywords: Asthma, CD4+ T cell, Th1/Th2, ILC2, Th17/Treg, targeted therapy
Received: 03 Jul 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Qifeng, Zhu, Guo, FU and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
GUO FU
Xiao-bin Zhang
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