Immune and Inflammatory Mechanisms in Asthma: Insights into Epigenetic Modifications

Haixia Fan¹Bomeng Zhao²Huiyan Niu²Yan Li²Lu Zhai²Limantian Wang²Shudan Deng²Jie Gao²Xiaoling Gao^3*

• ¹First Hospital of Shanxi Medical University, Taiyuan, China
• ²Shanxi Medical University, Taiyuan, China
• ³Second Hospital of Shanxi Medical University, Taiyuan city, China

Background: Asthma is a chronic respiratory disease influenced by genetic and environmental factors. Emerging evidence highlights epigenetics as a key regulatory mechanism in asthma development. Objective: This research aimed to summarize current evidence on immune– epigenetic mechanisms in asthma and to identify global research hotspots through bibliometric analysis. Methods: A systematic search was conducted in the Web of Science Core Collection(WoSCC) and Scopus databases for studies published between 1980 and July 2025. Following PRISMA guidelines, duplicate removal and quality control were performed. Eligible articles were analyzed using CiteSpace, VOSviewer, and the R bibliometrix package to evaluate publication trends, countries, institutions, authors, journals, co-cited references, and keyword clusters. Results: A total of 4,020 unique publications were included. By utilizing data from both the WoSCC and Scopus, research output has risen markedly since 2010, with the United States and China leading in productivity and collaboration. Harvard University and the University of California System emerged as central institutions, while influential authors included Ian M. Adcock, Juan C. Celedón, and Peter J. Barnes. Leading journals, like Clinical Epigenetics and the Journal of Allergy and Clinical Immunology, have seen a steady increase in interdisciplinary research contributions over the years. Through keyword clustering, we identified four major research hotspots: immune and inflammatory mechanisms, epigenetic and regulatory mechanisms, environmental exposures and gene–environment interactions, and epigenetic therapies and biomarkers for precision medicine. Conclusion: Epigenetic research in asthma is rapidly expanding, with increasing international collaboration. Future efforts should focus on translating mechanistic insights into clinical applications by validating biomarkers, refining patient stratification, and advancing epigenetic-based therapeutic strategies.