{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:12:58Z","timestamp":1790280778106,"version":"4.1.0"},"reference-count":131,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Background: Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous chronic airway disorders characterized by complex interactions among inflammation, immune dysregulation, environmental exposures, and tissue remodeling. Conventional clinical classifications based on symptoms, lung function, and exacerbation history often fail to fully capture the biological mechanisms underlying disease progression and therapeutic variability. Methods: This narrative review summarizes current evidence regarding the biological and clinical significance of YKL-40, mannose-binding lectin (MBL), and epigenetic remodeling in asthma and COPD, with particular emphasis on the inflammation\u2013epigenetic axis and its potential role in disease phenotyping and precision medicine. Results: Available evidence suggests that YKL-40, MBL, and epigenetic signatures represent complementary biomarker layers reflecting tissue remodeling, innate immune variability, and cumulative inflammatory adaptation, respectively. Chronic inflammatory signaling, oxidative stress, and epigenetic remodeling may contribute to persistent molecular memory and phenotypic stabilization, providing a mechanistic framework for understanding disease heterogeneity and progression. Advances in multi-omics technologies, artificial intelligence, and machine learning are further supporting the development of integrated multimarker models. Conclusions: YKL-40, MBL, and epigenetic signatures should currently be considered complementary research variables rather than validated clinical tools. Their translation requires disease-specific assay standardization, prospective evaluation against prespecified outcomes, external validation, and evidence that biomarker-guided decisions improve patient care.<\/jats:p>","DOI":"10.3390\/biom16081114","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:09:42Z","timestamp":1785398982000},"page":"1114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From Airway Inflammation to Molecular Remodeling: Integrating YKL-40, MBL and Epigenetic Biomarkers in Asthma and COPD"],"prefix":"10.3390","volume":"16","author":[{"given":"Simona Maria","family":"Borta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Silviu","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Department of Intensive Care and Emergency Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1192-1452","authenticated-orcid":false,"given":"Romana Olivia","family":"Pope\u021biu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Alexandra","family":"Vulciu","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana","family":"\u0218tirbu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia Roberta","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Science, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"},{"name":"Clinical Laboratory of Medical Analyses, Arad County Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly nr 2-4, 310037 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denisa","family":"Goldi\u0219","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Science, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"},{"name":"Clinical Laboratory of Medical Analyses, Arad County Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly nr 2-4, 310037 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa Alexandra","family":"Rus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius Radu","family":"Roman","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Str. Universit\u0103\u021bii nr 1, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Chioreanu","sequence":"additional","affiliation":[{"name":"Department of Otorinolaryngology, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radmila-Anca","family":"Bugari","sequence":"additional","affiliation":[{"name":"Department of Otorinolaryngology, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Zdrem\u021ban","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"},{"name":"Department of Otorinolaryngology, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Georgiana","family":"Firu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9542-0035","authenticated-orcid":false,"given":"Imola","family":"Donath-Miklos","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Science, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University from Arad, B-dul Revolu\u021biei nr. 94-96, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","unstructured":"Global Initiative for Asthma (GINA) (2026, July 16). 2026 GINA Strategy Report. 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