From Chronic Inflammation to Remodeling: Anthocyanins in the Context of Asthma Management

Asthma is a prevalent chronic disease posing substantial health and economic challenges globally. Its progression involves key hallmarks such as inflammation and airway remodeling, mediated by multiple inflammatory biomarkers and pathways. Despite the availability of potent therapeutic options, many patients continue to suffer from uncontrolled asthma. The plasminogen activator inhibitor-1 (PAI-1) signaling pathway is critical in asthma exacerbation and remodeling, with elevated PAI-1 levels linked to disease progression. Anthocyanins (ACNs), potent antioxidants and anti-inflammatory compounds, have shown promise in asthma management. Epidemiological studies associate higher ACN intake with a lower risk of asthma and improved lung function. Preclinical models further demonstrate ACNs' effectiveness in reducing asthma-related inflammatory cytokines, chemokines, and signaling pathways. Additionally, a human trial suggests ACNs can improve symptom control and lung function. While no direct evidence links ACNs to PAI-1 reduction in asthma, studies in other chronic conditions show ACNs reduce PAI-1 levels, supporting their potential role in asthma. This suggests a promising avenue for exploring their effects on airway remodeling. The lack of robust human studies remains a gap. Future research should focus on establishing direct evidence of ACNs' impact on PAI-1 levels and remodeling in asthma, providing novel insights into managing asthma as an adjunct.