Mechanisms and Treatment of Type 2 High and Low Asthma Endotypes.

Clin Exp Allergy

Department of Pulmonary Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.

Published: June 2025


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Asthma is a complex, heterogeneous disease characterised by clinical phenotypes demonstrating distinct and overlapping immunological mechanisms, classified into type-2 high and type-2 low asthma endotypes. Both allergic and eosinophilic non-allergic asthma are driven through an underlying type-2 high-endotype, which can be targeted using therapeutic approaches such as allergen-specific immunotherapy (AIT) for allergic asthma and biologics. AIT demonstrates efficacy for the treatment of allergic asthma. Approved biologics for asthma management include using various interleukin antagonists and anti-immunoglobulin E, with Tezepelumab offering promising treatments for both type-2 high and type-2 low asthma patients. Novel therapeutic candidates, such as Itepekimab and depemokimab, have demonstrated promising results in a Phase 2 clinical trial in moderate-to-severe asthma patients.

Download full-text PDF

Source
http://dx.doi.org/10.1111/cea.70084DOI Listing

Publication Analysis

Top Keywords

low asthma
12
asthma
9
asthma endotypes
8
type-2 high
8
high type-2
8
type-2 low
8
allergic asthma
8
asthma patients
8
type-2
5
mechanisms treatment
4

Similar Publications

Asthma-OSA Overlap Syndrome: A Distinct Endophenotype?

Respir Med

September 2025

Department of Public Health and Infectious Diseases, Pulmonology Unit, Policlinico Umberto I, "Sapienza" University of Rome, 00185 Rome, Italy.

Purpose: Asthma and obstructive sleep apnea (OSA) are two respiratory diseases that often may coexist, resulting in Alternative Overlap Syndrome (aOVS), which is still underestimated and underdiagnosed.

Objectives: This state-of-art review aims to describe the current evidence on aOVS, including its pathophysiology, clinical, functional and therapeutic implications. A secondary objective is to assess whether aOVS can be identified as a distinct endophenotype needing personalized diagnostic and therapeutic strategies.

View Article and Find Full Text PDF

Energy burden and asthma prevalence in U.S. cities: An emerging social determinant of health.

Sci Total Environ

September 2025

Department of Environmental Health Sciences, College of Integrated Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA; Department of Population and Community Health, College of Public Health, The University of North Texas Health Science Center at Fort Worth, For

Background: Energy burden, defined as the inability to afford residential energy consumption, is a pressing public health issue globally and in the U.S. However, its impact on asthma remains largely unknown.

View Article and Find Full Text PDF

Association between residential greenness and allergic diseases among adolescents in South Korea: A nationwide representative study.

Pediatr Allergy Immunol

September 2025

Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.

Background: Residential greenness is an important environmental factor potentially influencing the development of allergic diseases in adolescents; however, its impact remains understudied in South Korea. This study aimed to examine the association between residential greenness and allergic disease prevalence using nationally representative data.

Method: We analyzed data from 1,130,598 adolescents (7-12th grade) participating in the Korean Youth Risk Behavior Web-based Survey (2007-2024).

View Article and Find Full Text PDF

Emerging systemic treatments for asthma and allergic diseases: New tricks, same dog?

J Allergy Clin Immunol Pract

September 2025

Associate Professor of Medicine, Medical Director of Clinical Asthma Research, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center. Electronic address:

Asthma and allergic diseases are heterogeneous conditions driven by complex immunological pathways, with type 2 (T2) inflammation being a key but not exclusive component. Advances in immunology have spurred interest in a breadth of mechanisms and innovative therapeutic strategies, including novel targets, extended dosing intervals, and combined-target therapies. This clinical commentary provides a critical overview of ongoing clinical trials and emerging evidence supporting the use of these therapies in asthma and other allergic conditions.

View Article and Find Full Text PDF

Background: High doses of maintenance inhaled corticosteroids (ICS) in asthma may achieve only modest additional clinical benefit beyond low-to-medium doses and are associated with an increased risk of adverse systemic effects. The ICS dose-response relationship when administered as maintenance combination ICS/long-acting beta-agonist (LABA) therapy is uncertain.

Research Question: What is the ICS dose-response of maintenance ICS/LABA therapy?

Methods: A systematic review of randomized controlled trials (RCTs) allocating participants to >1 ICS dose category, per Global Initiative for Asthma categorization, administered in combination ICS/LABA inhalers was conducted.

View Article and Find Full Text PDF