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doi: 10.2147/CEG.S325945 125 PeriasamySLinCHNagarajanBSankaranarayananNVDesaiURLiuMY

Other important factors include an altered microbiome, genetic, and often toxic environmental factors such as mold and mycotoxins

Here are some possible reasons why:

Genetic variations in enzymes of the leukotriene synthetic pathway may cause some individuals with asthma to produce cysteinyl-leukotrienes (cys-LTs) to a greater extent than other patients, predisposing them to more severe asthma symptoms (particularly poorer lung function), and perhaps defining those individuals who may show the best clinical responses to LTRA therapy