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Type 2 Inflammation in Asthma Encompasses
Allergic and Eosinophilic Phenotypes1,2

 

Type 2 asthma is a heterogeneous disease that
encompasses a range of phenotypes and biomarkers1-3

Mild
corticosteroid-naïve
or corticosteroid-
responsive
early-onset asthma

Moderate-to-severe
early-onset
corticosteroid-treated
atopic asthma

Late-onset
eosinophilic asthma

Mixed immune response,
including:

  • Type 2 factors + very
    severe characteristics
  • Autoimmunity
  • Neutrophils
  • Type 1 factors

Key Type 2 inflammatory cytokines4-6


Use of serum IgE levels, blood eosinophils,
or FeNO alone as asthma biomarkers
may fail to accurately characterize the
broad spectrum of Type 2 inflammation
in asthma7,8

  • a Muraro A et al, 2016.4
  • b Brusselle GG et al, 2013.6
  • Adapted from Ray A et al, 2015.6
Reliance on only a narrow range
of biomarkers may leave patients with
Type 2 inflammation in asthma
suboptimally controlled7,8
 

Go deeper into the science behind Type 2 inflammation in asthma


EOS, eosinophils; FeNO, fractional exhaled nitric oxide.

References:
  1. Wenzel SE. Emergence of biomolecular pathways to define novel asthma phenotypes: type-2 immunity and beyond. Am J Respir Cell Mol Biol. 2016;55(1):1-4.
  2. Robinson D, Humbert M, Buhl R, et al. Revisiting type 2-high and type 2-low airway inflammation in asthma: current knowledge and therapeutic implications. Clin Exp Allergy. 2017;47(2):161-175.
  3. Ray A, Raundhal M, Oriss TB, Ray P, Wenzel SE. Current concepts of severe asthma. J Clin Invest. 2016;126(7):2394-2403.
  4. Muraro A, Lemanske RF Jr, Hellings PW, et al. Precision medicine in patients with allergic diseases: airway diseases and atopic dermatitis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2016;137(5):1347-1358.
  5. Brusselle GG, Maes T, Bracke KR. Eosinophilic airway inflammation in nonallergic asthma. Nat Med. 2013;19(8):977-979.
  6. Ray A, Oriss TB, Wenzel SE. Emerging molecular phenotypes of asthma. Am J Physiol Lung Cell Mol Physiol. 2015;308(2):L130-L140.
  7. Albers FC, Müllerová H, Gunsoy NB, et al. Biologic treatment eligibility for real-world patients with severe asthma: the IDEAL study. J Asthma. 2018;55(2):152-160.
  8. Korevaar DA, Westerhof GA, Wang J, et al. Diagnostic accuracy of minimally invasive markers for detection of airway eosinophilia in asthma: a systematic review and meta-analysis. Lancet Respir Med. 2015;3(4):290-300.