With monoclonal antibodies being a relatively new therapy option for patients with severe chronic airway diseases, asthma, allergic rhinitis, and chronic rhinosinusitis (CRS), researchers completed a review of the physiological and pathomechanisms of monoclonal antibodies, covering recent study findings on their use as a treatment option for patients with severe airway diseases. They note that “airway mucosa acts as a relative barrier, modulating antigenic stimulation and responding to environmental pathogen exposure with a specific, self-limited response,” adding that in severe asthma, CRS, or both, “genome-environmental interactions lead to dysbiosis, aggravated inflammation, and disease.” Single or combined type 1, 2, and 3 immunological response pathways are invoked in healthy conditions, the authors continue, which generates cytokine, chemokine, innate cellular, and T helper (Th) responses meant to eliminate viruses, helminths, and extracellular bacteria or fungi. “Although the pathomechanisms are not fully known, the majority of severe airway diseases are related to type 2 high inflammation,” they conclude. “Type 2 cytokines interleukins (IL) 4, 5, and 13, are orchestrated by innate lymphoid cell (ILC) and Th subsets leading to eosinophilia, immunoglobulin E (IgE) responses, and permanently impaired airway damage.”