m6A modification in allergic airway diseases: a narrative review from a cellular perspective

N6-methyladenosine (m6A) represents the most prevalent modification on eukaryotic RNA and plays a critical role in nearly all stages of RNA expression regulation. Extensive research demonstrates that the dysregulation of m6A modification plays a significant role in the disruption of epithelial barriers, the induction of oxidative stress, the activation of inflammatory cells, and the remodeling of airways, all of which are characteristic pathological features of allergic airway diseases (AADs). Given the distinct roles of various cell types in the progression and resolution of AADs, understanding how m6A functions across cellular contexts is essential for a comprehensive understanding of the disease's pathological mechanisms. This review begins by outlining the fundamental biological characteristics of m6A modification. Subsequently, we explore how dynamic m6A modifications affect AADs progression from the perspectives of airway epithelial cells, innate immune cells, and adaptive immune cells, emphasizing the pivotal regulatory role of m6A in epithelial-immune crosstalk. We then summarize how cellular context shapes the functional heterogeneity of m6A modification and discuss the potential underlying mechanisms. Finally, we summarize the latest progress in the use of m6A-related enzymes as tools for disease prediction, therapeutic intervention, and evaluation of allergen immunotherapy efficacy, and discuss the opportunities and challenges associated with the clinical translation of m6A-targeted therapeutic strategies.