BackgroundSevere asthma is a heterogeneous inflammatory disease. The rise of precise immunotherapy for severe asthmatics underlines more understanding of molecular mechanisms and biomarkers. In this study, we aim to identify underlying mechanisms and hub genes that define asthma severity.MethodsDifferentially expressed genes were screened out based on bronchial epithelial brushings from mild and severe asthmatics. Then, the weighted gene co-expression network analysis was adopted to identify gene networks and the most significant module associated with asthma severity. Meanwhile, hub genes screening and functional enrichment analysis was performed. Receiver operating characteristic was conducted to validate the hub genes.ResultsWeighted gene co-expression network analysis identified 6 modules associated with asthma severity. Three modules were positively correlated (P < 0.001) with asthma severity, containing genes upregulated in severe asthmatics. Functional enrichment analysis found genes in the highlighted module mainly enriched in neutrophil degranulation and activation, leukocyte migration and chemotaxis. Hub genes identified in the module were CXCR1, CXCR2, CCR1, CCR7, TLR2, FPR1, FCGR3B, FCGR2A, ITGAM, and PLEK. Combining these hub genes possessed a moderate ability for discriminating between severe asthmatics and mild-moderate asthmatics with an area under the curve of 0.75.ConclusionOur results identified biomarkers and potential pathogenesis of severe asthma, which provides sight into treatment targets and prognostic markers.