Asthma as a Neuroendocrine–Immune Network Disorder: Implications for precision diagnosis, endotyping, and therapeutic management
Year: 2026
Type: article
Abstract: Background: Asthma has traditionally been viewed as a chronic inflammatory airway disease driven by immune dysregulation.However, this paradigm does not fully explain the marked heterogeneity in clinical presentation, treatment response,and disease progression. Increasing evidence supports a broader model in which neurologic, endocrine, and immunologic systemsinteract to regulate airway function.Objective: The objective was to review evidence that supports asthma as a neuroendocrine–immune (NEI) network disorder and to examine implications for precision diagnosis and management.Methods: This is a narrative review of literature that integrates immunologic, neurobiological, and endocrine mechanisms. in asthma pathogenesis, with emphasis on T helper cell pathways, neurogenic signaling, and hypothalamic-pituitary-adrenal axis activity.Results: Asthma arises from interactions among multiple systems. Environmental and psychological triggers are processed by the central nervous system and modulate immune responses through neural and endocrine pathways. Distinct inflammatory endotypes,including T helper type 2 (Th2) and Th17-driven pathways, give rise to diverse clinical phenotypes. Bidirectional communicationbetween the airway and brain establishes feedback loops that contribute to disease persistence and variability.Conclusion: Viewing asthma as an NEI network disorder provides a unifying framework that links molecular mechanisms to clinical heterogeneity. This perspective supports a precision medicine approach that integrates immune, neuroendocrine, and systemic factors to improve diagnosis and therapeutic strategies
Author: Joseph A Bellanti
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204229995