Introduction

Asthma is a heterogeneous, long-term inflammatory airway disease, a pathological condition characterized by a spectrum of clinical manifestations, including wheezing, dyspnea, chest constriction and a persistent cough, coupled with a restriction in expiratory airflow. It remains a major global health challenge affecting all age groups, with disease burden varying across regions, genders and socioeconomic strata, and disproportionately impacting low-income populations [1]. In 2021, asthma was responsible for an estimated 260.48 million prevalent cases, 37.87 million newly diagnosed cases, 436.19 thousand fatalities and 21.42 million disability-adjusted life years (DALYs) worldwide. South Asia bore the highest burden, contributing 45.12 million prevalent cases, 7.69 million incident cases, 348.21 thousand deaths and 9.87 million DALYs [2]. India contributes dispropare moreonately to the global asthma burden, with 34.3 million cases (13.09 % of the global total) and mortality and DALY rates more than two-fold higher than global averages [3]. A pronounced urban-rural disparity exists, with urban prevalence reported at 45 % compared to rural regions and asthma showing a higher prevalence among individuals from higher socioeconomic backgrounds in India [4]. Current asthma management relies predominantly on synthetic pharmacological agents, including antihistamines, decongestants, expectorants, mucolytics, bronchodilators, cough suppressants and biologic therapies [5-6]. Inhaled corticosteroids (ICs), either alone or in combination with long-acting β₂-adrenergic agonists (LABA), remain the cornerstone of therapy [7].

Although these treatments effectively control airway inflammation and bronchoconstriction, their long-term clinical utility is limited by several adverse outcomes, including glucocorticoid-associated complications, increased susceptibility to infections, metabolic disorders, neoplasms, worsening asthma and nasopharyngitis, as well as a substantial economic burden [6,8]. These safety and tolerability concerns significantly impair patient compliance and long-term therapeutic outcomes. The limitations associated with conventional therapies have intensified the need for safer, cost-effective and better-tolerated alternatives, thereby driving growing interest in herbal and natural product-based interventions for asthma management (8).

Herbal and natural product-based therapies are increasingly being explored as supportive options in asthma management, particularly in combination with conventional treatment [9-10]. Across many traditional medical systems, plant-derived remedies have long been used for respiratory conditions, and their therapeutic effects are rarely attributed to a single compound [11]. Instead, most herbal preparations contain multiple bioactive constituents that may act on different biological processes simultaneously. Findings from experimental models and clinical observations suggest that such formulations can alleviate airway inflammation, influence immune responses and reduce oxidative stress, often with acceptable tolerability [12-13]. At the same time, the presence of numerous interacting components complicates mechanistic interpretation, as these effects cannot be readily explained using classical single-target pharmacological models. As a result, the molecular basis of many herbal interventions in asthma remains only partially understood, highlighting the need for analytical strategies capable of capturing multi-component and multi-pathway interactions, such as network pharmacology [14-17].

Network pharmacology provides a comprehensive systems-level framework that effectively captures the intrinsic complexity of asthma by elucidating interactions among bioactive compounds, disease-associated genes and interconnected signalling pathways, thereby enabling a more comprehensive understanding of disease modulation. In contrast to the traditional “one drug-one target” paradigm that underpins most conventional therapies, this approach emphasizes multi-compound and multi-target interactions, making it particularly suited to decoding the therapeutic potential and synergistic mechanisms of herbal medicines. Consequently, network pharmacology provides a rational and integrative strategy for identifying novel mechanisms of action and multi-pathway interventions relevant to asthma management [7].

Many studies have employed network pharmacology to explore herbal medicines in asthma; however, these findings are scattered across the literature and are rarely examined together. As a result, a unified understanding of how multi-component herbal interventions act through multiple molecular targets in asthma is still incomplete.

This review, therefore, aims to critically evaluate the use of network pharmacology to elucidate the molecular mechanisms underlying asthma management, with a particular focus on herbal and natural product--based therapies. The present review surveys network pharmacology investigations of asthma that utilize phytoconstituent-target identification, protein-protein interaction (PPI) networks, enrichment analyses and docking-based validation. Where available, evidence from experimental validation is also considered. Viewing these studies as a whole reveals a pattern in molecular targets and signalling pathways that are relevant to asthma, offering guidance for the development of improved multi-target treatment strategies.