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REVIEW article

Front. Physiol.

Sec. Metabolic Physiology

Immunometabolic Programming of Macrophages in Asthma Pathogenesis and Therapy

Provisionally accepted
Lisha  LuLisha Lu1Mengdi  ShiMengdi Shi1Wen  QinWen Qin1Mingshu  YangMingshu Yang1Xiaochang  WangXiaochang Wang1Youpeng  WangYoupeng Wang2*
  • 1Heilongjiang University of Chinese Medicine, Harbin, China
  • 2Heilongjiang University of Chinese Medicine Affiliated Second Hospital, Harbin, China

The final, formatted version of the article will be published soon.

Asthma is a heterogeneous chronic airway disease in which immune dysregulation and metabolic imbalance jointly shape inflammatory phenotypes and clinical outcomes. Growing evidence identifies pulmonary macrophages as central integrators of inflammatory cues and metabolic programs, linking acute exacerbations with long-term airway remodeling. Distinct tissue-resident and monocyte-derived macrophage subsets polarize along an M1–M2 spectrum and adopt glycolysis-dominated pro-inflammatory states or fatty acid oxidation-centered reparative states that differentially drive neutrophilic versus type 2-biased eosinophilic inflammation. Rewiring of arachidonic acid–derived eicosanoid synthesis and cholesterol handling further tailors macrophage effector functions and modulates responsiveness to glucocorticoids. Preclinical studies demonstrate that pharmacological manipulation of macrophage glucose and lipid metabolism can attenuate airway hyperresponsiveness and structural remodeling, highlighting immunometabolic circuits as promising therapeutic targets in asthma. This review summarizes current advances in macrophage ontogeny, polarization and metabolic reprogramming in the asthmatic lung. It also discusses how these insights may inform metabolism-focused, macrophage-directed interventions.

Keywords: Asthma, Glycolysis, Immunometabolism, Lipid Metabolism, macrophage

Received: 31 Oct 2025; Accepted: 18 Dec 2025.

Copyright: © 2025 Lu, Shi, Qin, Yang, Wang and Wang. 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: Youpeng Wang

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