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Revisiting Type 2‐high and Type 2‐low airway inflammation in asthma: current knowledge and therapeutic implications
Abstract
Summary: Asthma is a complex respiratory disorder characterized by marked heterogeneity in individual patient disease triggers and response to therapy. Several asthma phenotypes have now been identified, each defined by a unique interaction between genetic and environmental factors, including inflammatory, clinical and trigger‐related phenotypes. Endotypes further describe the functional or pathophysiologic mechanisms underlying the patient's disease. type 2‐driven asthma is an emerging nomenclature for a common subtype of asthma and is characterized by the release of signature cytokines IL ‐4, IL ‐5 and IL ‐13 from cells of both the innate and adaptive immune systems. A number of well‐recognized biomarkers have been linked to mechanisms involved in type 2 airway inflammation, including fractional exhaled nitric oxide, serum IgE, periostin, and blood and sputum eosinophils. These type 2 cytokines are targets for pharmaceutical intervention, and a number of therapeutic options are under clinical investigation for the management of patients with uncontrolled severe asthma. Anticipating and understanding the heterogeneity of asthma and subsequent improved characterization of different phenotypes and endotypes must guide the selection of treatment to meet individual patients’ needs.
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“Bronchial inflammation of atopic asthma is coordinated by cells of the adaptive immune system but also by ILC2s of the innate response, which together induce a type 2 response.39”
From Global issues in allergy and immunology: Parasitic infections and allergy (2017) · cites this paper as [39]
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Metadata
- Authors
- Robinson, D., Humbert, M., Buhl, R., Cruz, A. A., Inoue, H., Korom, S., Hanania, N. A., & Nair, P.
- Affiliations
- Department of Respiratory Medicine Severe Asthma Service UCLH NHS Trust London UK
- Service de Pneumologie Hôpital Bicêtre Assistance Publique Hôpitaux de Paris University Paris‐Sud Université Paris‐Saclay INSERM U999 Le Kremlin‐Bicêtre France
- Pulmonary Department Mainz University Hospital Mainz Germany
- ProAR‐Center of Excellence in Asthma Federal University of Bahia School of Medicine Salvador Brazil
- Department of Pulmonary Medicine Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan
- F. Hoffmann‐La Roche Ltd Basel Switzerland
- Section of Pulmonary and Critical Care Medicine Baylor College of Medicine Houston TX USA
- Division of Respirology Department of Medicine McMaster University Hamilton ON Canada
- ORCID
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2017-01-30
- Volume
- 47
- Issue
- 2
- Pages
- 161-175
- ISSN
- 0954-7894
- 1365-2222
- Cited by
- 357
- References
- 5
- Language
- en
- Funders
- AstraZeneca
- Chiesi Farmaceutici
- Roche
- Teva Pharmaceutical Industries
- Boehringer Ingelheim
- GlaxoSmithKline
- Novartis
- Merck Sharp and Dohme
- Astellas Pharma US
- Pfizer
- Sanofi
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