Immunomodulatory potential of apolipoproteins and their mimetic peptides in asthma: Current perspective

Asthma prevailed as a common inflammatory disease affecting mainly the lower respiratory tract, with notable inflammation in the upper airways leading to significant morbidity and mortality. An extensive search for a new therapeutic target is continuously being carried out. Still, the majority have failed in the trials, and eventually, the drugs, including β₂-adrenergic agonists, muscarinic antagonists, and certain corticosteroids, remain the backbone for asthma control. Numerous endogenous factors aid in maintaining the normal homeostasis of the lungs and prevents disease progression. One among them is the apolipoproteins which are different sets of lipoprotein moieties that not only aid in the transport and metabolism of lipids but also impart immunomodulatory roles in various pathologies. Modern research joins the links between the immunomodulatory nature of apolipoproteins in chronic respiratory diseases like asthma and COPD, which can assist in ameliorating the disease progression. Recent studies have elucidated the protective roles of apoA-I and apoE in asthma. This has enabled the utilization of certain apolipoprotein-mimetic peptides to treat these severe pulmonary diseases in the long run. In this review, we have described the prominent and probable mechanistic roles of apolipoproteins like apoA-I, apoB, apoE, apoJ, and apoM in the pathogenesis and treatment of asthma along with the development of apoA-I and apoE-mimetics as a cardinal treatment strategy for eosinophilic as well as corticosteroid resistant neutrophilic asthma.