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The possibility of differentiating underlying pathophysiological mechanisms and grouping patients within disease phenotypes has highlighted the heterogeneity of asthma in terms of onset, natural course, and response to treatment. Cluster analysis integrating data collection and multidimensional approaches to ...

The possibility of differentiating underlying pathophysiological mechanisms and grouping patients within disease phenotypes has highlighted the heterogeneity of asthma in terms of onset, natural course, and response to treatment. Cluster analysis integrating data collection and multidimensional approaches to phenotype asthma has shown that some of the molecular and biological traits are associated with the functional behavior of the damaged airways. Small airways involvement, air trapping, mucus plaques, bronchiectasis, basal membrane remodeling, and the smooth muscle hyperreactivity are some of the clues revealing the tight interconnection between immunological pathways and the clinical journey of patients. Going deeper into this topic within asthma research is mandatory to complete the road to a full personalized medicine approach.

Multidisciplinary approaches are applicable for research studies in the field of pathophysiological mechanisms of asthmatic airways. One of the most intriguing fields of research can be the attempt of matching functional, pathological, and biochemical findings of airway dysfunction with the unique natural history of the patient leading to optimized personal management. Proposals of an algorithm for asthma phenotyping and management integrated clinical features with biologically derived biomarkers leading to the identification of subgroups of patients to predict prognosis and therapeutic response. Airway functional characteristics can be included within decision trees. To this aim, the application of innovative devices, lung function or gas ventilation techniques, imaging approaches, and challenge and provocation experiments can lead to a deeper definition of airway dysfunction traits in asthma. Moreover, gene expression and transcriptomic experimental models, as well as immunophenotyping or immunohistochemical cellular studies can help in elucidating the underlying biological mechanism.

This Research Topic encourages the scientist to present data concerning models of environmental exposures, pathological findings in animal and human models, application of lung function methodology, and imaging techniques concerning airway dysfunction of asthma phenotypes.
In particular, the description of small airways involvement, air trapping, fixed airflow obstruction, mucus plaques, bronchiectasis, remodeling, and smooth muscle hyperreactivity can be related to clinical and immunological traits. In addition, observations regarding asthma comorbidities, such as chronic rhinosinusitis, allergic bronchopulmonary aspergillosis (ABPA), or eosinophilic granulomatosis with polyangiitis (EGPA), overlap with chronic obstructive pulmonary disease (COPD) traits, or therapeutic response to steroids or biologics represent a further extension of knowledge enriches the insight in this field.

We welcome submissions of different article types to this collection, especially reviews, mini-reviews, and original research papers.
Even though abstract submission is not mandatory, we encourage all interested researchers to submit an abstract before submitting their manuscript. Abstracts do not have to coincide with the final abstract of the manuscripts.

Keywords: airway inflammation, air trapping, fixed airflow obstruction, mucus plaques, bronchiectasis, remodeling, smooth muscle, phenotype, small airways, airway hyperreactivity, asthma


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