Neuroplasticity and neuroimmune interactions with type 2 inflammation in asthma

The lungs are innervated by both afferent and efferent nerve fibres that regulate key respiratory functions, including the cough reflex, airway tone, mucus secretion, and the detection of mechanical and chemical stimuli. In asthma, airway hyperresponsiveness and inflammation are, in part, modulated by the nervous system. Recent findings have identified neuroplasticity as a pathological feature of severe asthma, suggesting that altered neural remodelling contributes to disease symptoms. Additionally, growing evidence highlights bidirectional interactions between the airway nervous system and local immune cells, which play a crucial role in modulating each other's activity. In this review, we explore the emerging roles of airway neuroplasticity and neuroimmune interactions in the development of type 2 inflammation in asthma. We focus on the involvement of neuropeptides and cytokines in mediating this bidirectional crosstalk, aiming to elucidate the mechanistic link between neural remodelling and immune activation and to identify novel targets for pharmacological intervention.