While some reports suggest an anti-inflammatory effect of spermine in the lungs (Wawrzyniak et al., 2021), spermine and other polyamines were shown to promote increased pulmonary fibrosis, airway hyperresponsiveness and asthma severity by activating the CaSR expressed in airway smooth muscle cells and epithelial cells. The gene discussed is CASR; the disease is airway hyperresponsiveness.