Inflammation and Immune Dysregulation Across Respiratory Diseases: From Cellular Mechanisms to Therapeutic Targets

Lung inflammation and immune dysregulation are central to the pathogenesis of a broad spectrum of respiratory diseases, yet the cellular and molecular mechanisms underlying these processes remain incompletely understood. This review examines mechanisms of pulmonary inflammation across major respiratory diseases, including asthma, chronic obstructive pulmonary disease, acute lung injury/acute respiratory distress syndrome, and pulmonary fibrosis. We discuss the roles of dysregulated innate and adaptive immunity, persistent inflammation, tissue remodeling, and impaired resolution in the pathogenesis of respiratory diseases, thereby highlighting mechanisms that are broadly conserved across these conditions as well as those that diverge in a disease-specific manner. This synthesis offers a framework for understanding pulmonary immune dysregulation and identifying new biomarkers and therapeutic strategies to restore pulmonary immune homeostasis. We also discuss how endotyping, single-cell transcriptomics, spatial biology, and multi-omics approaches are refining mechanistic understanding and enabling precision immunomodulatory interventions.