Abstract
In this review, we discuss recent publications on asthma and review the
studies that have reported on the different aspects of the prevalence,
risk factors and prevention, mechanisms, diagnosis and treatment of
asthma. Many risk and protective factors and molecular mechanisms are
involved in the development of asthma. Emerging concepts and challenges
in implementing the exposome paradigm and its application in allergic
diseases and asthma are reviewed, including genetic and epigenetic
factors, microbial dysbiosis and environmental exposure, particularly to
indoor and outdoor substances. The most relevant experimental studies
further advancing the understanding of molecular and immune mechanisms
with potential new targets for the development of therapeutics are
discussed. A reliable diagnosis of asthma, disease endotyping and
monitoring its severity are of great importance in the management of
asthma. Correct evaluation and management of asthma
comorbidity/multimorbidity, including interaction with asthma phenotypes
and its value for the precision medicine approach and validation of
predictive biomarkers are further detailed. Novel approaches and
strategies in asthma treatment linked to mechanisms and endotypes of
asthma, particularly biologicals, are critically appraised. Finally, due
to the recent pandemics and its impact on patient management, we discuss
the challenges, relationships, and molecular mechanisms between asthma,
allergies, SARS-CoV-2 and Covid-19.