Gene–Environment Interactions in Childhood Asthma: From Prenatal Exposures to Targeted Interventions

Asthma is one of the most common chronic respiratory diseases affecting both children and adults worldwide. Its pathogenesis is driven by complex interactions between genetic susceptibility and environmental exposures. Investigating gene-environment (G × E) interactions holds significant potential to elucidate the regulatory genetic architecture underlying individual responses to environmental risk factors in childhood asthma. In this review, we systematically summarize the environmental exposure factors during prenatal and postnatal periods and analyze their independent effects on the risk of childhood asthma. Secondly, we explore the role of G × E interactions in asthma from three perspectives: statistical interaction, mechanistic interaction, and epigenetic-mediated interaction. Finally, we evaluate current treatment and intervention strategies, distinguish established recommendations for the general population from emerging and exploratory methods, and point out existing limitations. Our analysis reinforces that investigating G × E interactions is a robust approach for uncovering the molecular mechanisms underlying childhood asthma. Despite substantial technical challenges and unresolved questions regarding generalizability and heterogeneity, such investigative strategies are expected to enhance our understanding of asthma endotypes and the development of more effective, precision-based preventive and therapeutic interventions.