Microbiome-Driven Precision Medicine in Asthma: Roles of Targeted Therapies and Artificial Intelligence

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVE: To evaluate the current evidence regarding airway and gut microbiome alterations in asthma pathogenesis and therapeutic response, and to examine the potential of microbiome-targeted interventions and artificial intelligence (AI)-based precision medicine. DATA SOURCES: A structured narrative literature review was conducted using PubMed, Scopus, and Google Scholar. STUDY SELECTION: Peer-reviewed original research articles, clinical studies, systematic reviews, meta-analyses, and relevant narrative reviews published in English were selected based on their relevance to asthma-associated microbiome dysbiosis, inflammatory endotypes, biologic therapies, and AI-driven analytical approaches. RESULTS: and depletion of beneficial commensals, has been associated with corticosteroid resistance, frequent exacerbations, and distinct inflammatory endotypes. Emerging microbiome-targeted interventions, including probiotics, prebiotics, synbiotics, postbiotics, engineered microbial consortia, and phage-based therapies, have demonstrated encouraging findings in preclinical and early clinical studies but require further validation. Biologic therapies targeting IgE, IL-5, IL-4Rα, and thymic stromal lymphopoietin (TSLP) have improved outcomes in selected patients, although variability in treatment response persists. AI and machine-learning approaches integrating microbiome, multi-omic, clinical, and environmental data have shown promise for identifying predictive biomarkers and supporting precision medicine; however, most models remain in the developmental stage and lack robust prospective validation. CONCLUSION: The microbiome and AI hold promise for precision asthma care, although their routine clinical implementation awaits standardized methodologies and large prospective validation studies.