Asthma: Current Concepts in Pathogenesis, Precision Medicine and Emerging Therapeutic Strategies

Objectives: To review current concepts in asthma pathogenesis, phenotypes, endotypes, precision medicine, biologic therapies, and emerging therapeutic strategies, with emphasis on recent advances in personalized asthma management. Data Sources: Peer-reviewed articles were identified through searches of PubMed, Scopus, Web of Science, and Google Scholar, together with relevant international asthma guidelines. Study Selection: Relevant original research articles, systematic reviews, meta-analyses, and international clinical guidelines were selected based on their relevance to asthma pathogenesis, biomarkers, precision medicine, biologic therapies, and emerging therapeutic strategies. Summary of Contents: Asthma is a heterogeneous chronic inflammatory airway disease resulting from complex interactions among genetic susceptibility, environmental exposures, epithelial dysfunction, and dysregulated immune responses. Advances in the understanding of asthma phenotypes and endotypes have facilitated biomarker-guided treatment and precision medicine. Targeted biologic therapies directed against immunoglobulin E, interleukin (IL)-5, IL-4/IL-13, and thymic stromal lymphopoietin have significantly improved outcomes in severe type 2 asthma. Emerging approaches, including treatable traits, omics technologies, pharmacogenomics, artificial intelligence, smart inhalers, nanomedicine, gene- and RNA-based therapies, and digital health, are further transforming individualized asthma care. Conclusion: Precision medicine has substantially improved asthma management through biomarker-guided therapeutic selection and targeted biologic therapy. Future research should focus on reliable biomarkers, disease-modifying therapies, non-type 2 asthma, equitable access to advanced treatments, and strategies to achieve long-term remission and disease prevention. Keywords: Asthma; Pathogenesis; Precision medicine; Biologic therapy; Phenotypes; Endotypes; Biomarkers; Emerging therapies.