Cited by 17Dermatology and Skin DiseasesAsthma and respiratory diseasesVagus Nerve Stimulation Research

Neuroimmune mechanisms of type 2 inflammation in the skin and lung

Open access
Tamari, Masato, Ver Heul, Aaron M.·2025·Allergology International

Abstract

Type 2 inflammation has a major role in barrier tissues such as the skin and airways and underlies common conditions including atopic dermatitis (AD) and asthma. Cytokines including interleukin 4 (IL-4), IL-5, and IL-13 are key immune signatures of type 2 inflammation and are the targets of multiple specific therapeutics for allergic diseases. Despite shared core immune mechanisms, the distinct structures and functions of the skin and airways lead to unique therapeutic responses. It is increasingly recognized that the nervous system has a major role in sensing and directing inflammatory processes. Indeed, crosstalk between type 2 immune activation and somatosensory functions mediates tissue-specific signatures such as itching in the skin. However, neuroimmune interactions are shaped by distinct neuronal and immune landscapes, and differ between the skin and airways. In the skin, dorsal root ganglia-derived neurons mediate pruritus via type 2 cytokines and neurogenic inflammation by mast cell or basophil activation. Conversely, vagal ganglia-derived neurons regulate airway immune responses by releasing neuropeptides/neurotransmitters such as calcitonin gene-related peptides, neuromedin U, acetylcholine, and noradrenaline. Sensory neuron-derived vasoactive intestinal peptide forms a feedback loop with IL-5, amplifying eosinophilic inflammation in the airways, a mechanism that is absent in the skin. These differences influence the efficacy of cytokine-targeted therapies. For instance, IL-4/IL-13-targeted therapies like dupilumab demonstrate efficacy in AD and allergic airway diseases, whereas IL-5-targeted therapies are effective in eosinophilic asthma but not AD. Understanding these neuroimmune interactions underscores the need for tailored therapeutic approaches to address allergic diseases where barrier tissues are involved.

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Crossref · 10.1016/j.alit.2025.02.001

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Cited by

Authors
Tamari, M., & Ver Heul, A. M.
Affiliations
National Research Institute for Child Health and Development (JP)
Corresponding author
Tamari, Masato
Venue
Allergology International
Publisher
Elsevier BV
Published
2025-04
Volume
74
Issue
2
Pages
177-186
ISSN
1323-8930 (ISSN-L)
OpenAlex
W4408260060
Cited by
17
References
134
Citations by year
2026: 10 · 2025: 7
FWCI
2.91
Type
journal article
Language
en
Open access
Locations
  • Allergology International (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Digital Commons@Becker (Washington University School of Medicine) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Mishima Kaiun Memorial Foundation (2024A-105)
  • National Center for Child Health and Development (2024C-18)
  • Japanese Society of Allergology
  • Japan Society for the Promotion of Science (24K23471)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR080219)
Topics
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Keywords
type 2 inflammation, neuroimmune interactions, atopic dermatitis, allergic asthma, pruritus, dorsal root ganglion neurons, calcitonin gene-related peptide, neuromedin U, vasoactive intestinal peptide, mast cells, basophils, eosinophilic inflammation, IL-4/IL-13, IL-5, dupilumab, barrier tissues, skin, respiratory tract
MeSH terms
Animals, Asthma, Dermatitis, Atopic, Humans, Inflammation, Lung, Skin, Neuroimmunomodulation, Cytokines

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