Diagnosis and Management of T2-High Asthma

J Allergy Clin Immunol Pract. 2020 Feb;8(2):442-450. doi: 10.1016/j.jaip.2019.11.020.

Abstract

Type 2 (T2) inflammation plays a key role in the pathogenesis of asthma. IL-4, IL-5, and IL-13, along with other inflammatory mediators, lead to increased cellular eosinophilic inflammation. It is likely that around half of all patients with asthma have evidence of T2-high inflammation. Sputum and blood eosinophils, exhaled nitric oxide, blood IgE levels, and airway gene expression markers are frequently used biomarkers of T2-high asthma. Individuals with T2-high asthma tend to have several features of increased asthma severity, including reduced lung function and increased rates of asthma exacerbations, and T2-high patients demonstrate distinct pathologic features including increased airway remodeling and alterations in airway mucus production. Several monoclonal antibodies are now available to treat individuals with T2-high asthma and these medications significantly reduce asthma exacerbation rates.

Keywords: Asthma; Biomarkers in asthma; Monoclonal antibody therapy; Type 2 inflammation.

MeSH terms

  • Asthma* / diagnosis
  • Asthma* / drug therapy
  • Biomarkers
  • Eosinophilia*
  • Eosinophils
  • Humans
  • Interleukin-13
  • Interleukin-4
  • Interleukin-5
  • Nitric Oxide
  • Sputum

Substances

  • Biomarkers
  • IL4 protein, human
  • IL5 protein, human
  • Interleukin-13
  • Interleukin-5
  • Interleukin-4
  • Nitric Oxide