The Potential Neural Nuclei and Circuits Underlying Asthma: A Comprehensive Review

BACKGROUND: Asthma is a common chronic inflammatory airway disease, characterized clinically by recurrent wheezing, shortness of breath, chest tightness, and cough. The roles of inflammatory cells such as T cells, eosinophils, and basophils in asthma are now well established. Recent studies have further revealed that the nervous system is not merely a "bystander" to the inflammatory response. Consequently, the peripheral nerves and the neural nuclei involved in asthma have attracted increasing research interest. SUMMARY: This review summarizes the currently identified peripheral and central nerves implicated in transmitting airway inflammatory signals in asthma. It describes the principal mechanisms through which various brain nuclei - including nucleus tractus solitarius, paraventricular nucleus, and amygdala - participate in asthma regulation. We also discuss whether these nuclei interact to form specific neural circuits that modulate the disease. First-line anti-inflammatory medications remain ineffective for a subset of patients, and current pharmacological interventions targeting neural pathways show limited clinical efficacy. KEY MESSAGES: A clear elucidation of the neural circuits regulating asthma would advance our understanding of its pathogenesis, offer new directions and targets for drug development, and raise the possibility of treating asthma through direct central nervous system interventions.