Asthma is a multifaceted ailment characterized by fluctuating respiratory symptoms and variable airflow constriction. Traditionally, treatments focused on symptom management, universally applicable to all asthma types. Increased understanding has led to the classification of two major asthma endotypes: T helper type 2 (Th2) cell-high asthma, marked by type 2 cytokines, eosinophilic and allergic inflammation, and immunoglobulin E (IgE) synthesis; and Th2-low endotype, characterized by neutrophilic and systemic inflammation, associated with obesity and corticosteroid resistance. Though the pathogenesis of asthma remains incompletely understood, increasing evidence suggests a link between asthma and the interplay of "inflammation, obesity, and microbiota." The NF-κB and NLRP3 signal pathways play pivotal roles in the pathophysiological mechanisms of both asthma endotypes. Obesity and dysbiosis exacerbate systemic inflammation, particularly in relation to the Th2-low endotype. Future asthma treatments hold promises by targeting the underlying pathophysiology and personalizing interventions according to the specific endotypes. This review provides a synthesis of current research exploring the interconnected roles of inflammation, obesity, and the microbiota in asthma pathophysiology. However, further investigation is warranted to deepen our understanding and optimize therapeutic interventions for asthma management.

Victor I.K. Leung. Unraveling the Interrelationship of Microbiota, Inflammation and Obesity: Implications for the Pathophysiology of Asthma Endotypes. Frontiers in Medical Science Research (2024), Vol. 6, Issue 7: 17-35. https://doi.org/10.25236/FMSR.2024.060703.

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