Modern approaches to diagnosis and treatment of respiratory epithelial dysfunction

The integrity of the respiratory epithelium protects the airways from the penetration of external harmful agents. Impairments in the structure and function of the epithelial barrier can lead to chronic inflammatory processes that underlie the pathogenesis of numerous allergic and inflammatory respiratory diseases, particularly in children. Аim - to review contemporary scientific literature on the role of epithelial barrier dysfunction in the development of allergic diseases, and to examine methods for the diagnosis and treatment of respiratory epithelial dysfunction (RED) based on the latest scientific evidence. An analysis of literature from international databases, including PubMed, ScienceDirect, and Google Scholar, for the period 2018-2025 was conducted. RED involves the disruption of its structural integrity, leading to a compromised barrier function and increased permeability to external agents such as allergens, pollutants, and pathogens. In patients with asthma, a decreased expression of proteins that form tight junctions between epithelial cells is observed, constituting a critical pathogenetic mechanism in the development of respiratory allergic diseases. The combined use of modern methods—such as histological and immunohistochemical analyses, electron microscopy, mass spectrometry, proteomics, and the study of alarmins — allows for a more effective assessment of the respiratory epithelial barrier's status. Modern therapeutic strategies for RED are aimed at restoring the structure and function of epithelial tight junctions. Conclusions. RED is a key factor in the development of asthma and other respiratory diseases, especially in the pediatric population. Early diagnosis and timely intervention to enhance epithelial barrier function are critical for achieving successful disease control. Future research prospects include the development of novel preventive and therapeutic approaches aimed at restoring and maintaining the integrity of the respiratory epithelium. The authors declare no conflict of interest.