Global Research Trends and Hotspots in Non-Eosinophilic Asthma: A Bibliometric and Visual Analysis

Gregorious Gandhi Krishna  Aditya; Ali Rofiq Khizna Dani; Tatum Aurora Amantha Melvin; Sri Marwanta

doi:10.20961/plexus.v5i3.3806

Authors

Gregorious Gandhi Krishna Aditya Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0009-0001-6726-6685
Ali Rofiq Khizna Dani Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Tatum Aurora Amantha Melvin Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Sri Marwanta Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia https://orcid.org/0000-0002-9105-595X

DOI:

https://doi.org/10.20961/plexus.v5i3.3806

Keywords:

non-eosinophilic asthma, inflammation, research trend, bibliometric analysis

Abstract

Introduction: Non-eosinophilic asthma represents nearly half of asthma cases and is commonly associated with poor responsiveness to corticosteroid therapy. Despite its significant clinical burden, no bibliometric study has comprehensively mapped the global research landscape of non-eosinophilic asthma. This study aimed to analyze global publication trends, scientific collaborations, and emerging research hotspots in non-eosinophilic asthma.

Methods: A bibliometric study was conducted using the Scopus database, with data retrieved on June 27, 2025. A total of 531 English-language journal articles that met the eligibility criteria were included. Data were analyzed using Scopus Analyze Results, Biblioshiny, and VOSviewer 1.6.19 to evaluate publication trends, citation performance, collaboration networks, influential publications, and keyword co-occurrence.

Results: Research output on non-eosinophilic asthma increased markedly after 2008 and peaked in 2022. China was the most productive country in terms of publications, whereas Australia achieved the highest total and average citations. Gibson PG was identified as the most productive and influential author. Keyword analysis demonstrated a shift in research focus toward non-T2 inflammatory mechanisms, neutrophilic inflammation, corticosteroid resistance, biomarkers, microbiome, obesity, and precision medicine approaches.

Conclusion: Global research on non-eosinophilic asthma has expanded substantially, reflecting a transition from conventional eosinophilic-centered concepts toward a deeper understanding of disease heterogeneity and personalized therapeutic strategies. These findings provide a comprehensive overview of current research trends and may serve as a valuable reference for future investigations and therapeutic development.

References

Borish, L. (2016). The immunology of asthma: Asthma phenotypes and their implications for personalized treatment. Annals of Allergy, Asthma & Immunology, 117(2), 108–114.

Bourdin, A., Brusselle, G., Couillard, S., Fajt, M. L., Heaney, L. G., Israel, E., et al. (2024). Phenotyping of severe asthma in the era of broad-acting anti-asthma biologics. Journal of Allergy and Clinical Immunology: In Practice, 12(4), 809–823.

Calhoun, W. J., & Chupp, G. L. (2022). The new era of add-on asthma treatments: Where do we stand? Allergy, Asthma & Clinical Immunology, 18(1), 42. https://doi.org/10.1186/s13223-022-00676-0

Campbell, C. D., Gleeson, M., & Sulaiman, I. (2023). The role of the respiratory microbiome in asthma. Frontiers in Allergy, 4. https://doi.org/10.3389/falgy.2023.1120999

Carr, T. F., Zeki, A. A., & Kraft, M. (2018). Eosinophilic and noneosinophilic asthma. American Journal of Respiratory and Critical Care Medicine, 197(1), 22–37. https://doi.org/10.1164/rccm.201611-2232PP

Chen, Y. J., Shimizu Bassi, G., Wang, Y., & Yang, Y. Q. (2022). Research hotspot and frontier analysis of traditional Chinese medicine in asthma using bibliometric methods from 1991 to 2021. Journal of Allergy and Clinical Immunology: Global, 1(4), 185–197. https://doi.org/10.1016/j.jacig.2022.07.004

Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in Pediatrics, 7, 246. https://doi.org/10.3389/fped.2019.00246

Donthu, N., Kumar, S., Mukherjee, D., Pandey, N., & Lim, W. M. (2021). How to conduct a bibliometric analysis: An overview and guidelines. Journal of Business Research, 133, 285–296. https://doi.org/10.1016/j.jbusres.2021.04.070

Esteban-Gorgojo, I., Antolín-Amérigo, D., Domínguez-Ortega, J., & Quirce, S. (2018). Non-eosinophilic asthma: Current perspectives. Journal of Asthma and Allergy, 11, 267–281.

Gohal, G., Moni, S. S., Bakkari, M. A., & Elmobark, M. E. (2024). A review on asthma and allergy: Current understanding on molecular perspectives. Journal of Clinical Medicine, 13(19).

Guo, Z., Huang, L., & Lai, S. (2024). Global knowledge mapping and emerging research trends in the microbiome and asthma: A bibliometric and visualized analysis using VOSviewer and CiteSpace. Heliyon, 10(2), e24528. https://doi.org/10.1016/j.heliyon.2024.e24528

Hammad, H., & Lambrecht, B. N. (2021). The basic immunology of asthma. Cell, 184(6), 1469–1485. https://doi.org/10.1016/j.cell.2021.02.016

Hinks, T. S. C., Levine, S. J., & Brusselle, G. G. (2021). Treatment options in type-2 low asthma. European Respiratory Journal, 57(1), 2000528.

Iwaszko, I., Specjalski, K., Chełmińska, M., & Niedoszytko, M. (2025). Neutrophilic asthma—From mechanisms to new perspectives of therapy. Journal of Clinical Medicine, 14, 7137.

Kapri, A., Pant, S., Gupta, N., Paliwal, S., & Nain, S. (2022). Asthma history, current situation, an overview of its control history, challenges, and ongoing management programs: An updated review. Proceedings of the National Academy of Sciences, India Section B.

Kim, R. Y., Pinkerton, J. W., Essilfie, A. T., Robertson, A. A. B., Baines, K. J., Brown, A. C., et al. (2017). Role for NLRP3 inflammasome-mediated, IL-1β-dependent responses in severe, steroid-resistant asthma. American Journal of Respiratory and Critical Care Medicine, 196(3), 283–297.

Kuruvilla, M. E., Lee, F. E. H., & Lee, G. B. (2019). Understanding asthma phenotypes, endotypes, and mechanisms of disease. Clinical Reviews in Allergy & Immunology, 56(2), 219–233.

Liye, L., Hui, Z., Fuchun, H., & Hua, L. (2024). Research progress of airway inflammation in asthma: A bibliometric analysis. Medicine, 103(29), e38842.

Miethe, S., Karsonova, A., Karaulov, A., & Renz, H. (2020). Obesity and asthma. Journal of Allergy and Clinical Immunology, 146(4), 685–693. https://doi.org/10.1016/j.jaci.2020.08.011

Mohammad, Y., & Brough, G. (2019). The impact of conflict on asthma. Journal of Thoracic Disease, 11(7), 3202–3206.

Nabe, T. (2020). Steroid-resistant asthma and neutrophils. Biological and Pharmaceutical Bulletin, 43(1), 31–35.

Olejnik, A. E., & Kuźnar-Kamińska, B. (2024). Association of obesity and severe asthma in adults. Journal of Clinical Medicine, 13, 3474.

Öztürk, O., Kocaman, R., & Kanbach, D. K. (2024). How to design bibliometric research: An overview and a framework proposal. Review of Managerial Science, 18(11), 3333–3361. https://doi.org/10.1007/s11846-024-00738-0

Pang, Z., Wang, G., Gibson, P., Guan, X., Zhang, W., Zheng, R., et al. (2019). Airway microbiome in different inflammatory phenotypes of asthma: A cross-sectional study in Northeast China. International Journal of Medical Sciences, 16(3), 477–485.

Passas, I. (2024). Bibliometric analysis: The main steps. Encyclopedia, 4(2), 1014–1025.

Pembrey, L., Barreto, M. L., Douwes, J., Cooper, P., Henderson, J., Mpairwe, H., et al. (2018). Understanding asthma phenotypes: The World Asthma Phenotypes (WASP) international collaboration. ERJ Open Research, 4(3).

Pembrey, L., Brooks, C., Mpairwe, H., Figureueiredo, C. A., Oviedo, A. Y., Chico, M., et al. (2023). Asthma inflammatory phenotypes on four continents: Most asthma is non-eosinophilic. International Journal of Epidemiology, 52(2), 611–623.

Picado, C., Garcia de la Fuente, A., Arismendi, E., & Roca-Ferrer, J. (2025). Next decade research in asthma: Broad omics-based exploration versus targeted airway epithelium studies. Journal of Clinical Medicine, 14, 8186.

Ricciardolo, F. L. M., Carriero, V., & Bertolini, F. (2021). Which therapy for non-type(T)2/T2-low asthma. Journal of Personalized Medicine, 12(1).

Simpson, J. L., Daly, J., Baines, K. J., Yang, I. A., Upham, J. W., Reynolds, P. N., et al. (2015). Airway dysbiosis: Haemophilus influenzae and Tropheryma in poorly controlled asthma. European Respiratory Journal, 47(3), 792–800.

Stanescu, S., Kirby, S. E., Thomas, M., Yardley, L., & Ainsworth, B. (2019). A systematic review of psychological, physical health factors, and quality of life in adult asthma. NPJ Primary Care Respiratory Medicine, 29(1), 1–11. https://doi.org/10.1038/s41533-019-0149-3

Sze, E., Bhalla, A., & Nair, P. (2020). Mechanisms and therapeutic strategies for non-T2 asthma. Allergy, 75(2), 311–325. https://doi.org/10.1111/all.13985

Tashiro, H., Kurihara, Y., Kuwahara, Y., & Takahashi, K. (2024). Impact of obesity in asthma: Possible future therapies. Allergology International, 73(1), 48–57.

Wang, M., Gao, P., Wu, X., Chen, Y., Feng, Y., Yang, Q., et al. (2016). Impaired anti-inflammatory action of glucocorticoid in neutrophils from patients with steroid-resistant asthma. Respiratory Research, 17, 1–9.

Yang, X., Li, H., Ma, Q., Zhang, Q., & Wang, C. (2018). Neutrophilic asthma is associated with increased airway bacterial burden and disordered community composition. BioMed Research International, 2018, 9230234.

Yuan, L., Tao, J., Wang, J., She, W., Zou, Y., Li, R., et al. (2025). Global, regional, national burden of asthma from 1990 to 2021, with projections of incidence to 2050: A systematic analysis of the Global Burden of Disease Study 2021. eClinicalMedicine, 80, 1–11.