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

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.