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Which Therapy for Non-Type(T)2/T2-Low Asthma.
Fabio L M Ricciardolo1, Vitina Carriero1, Francesca Bertolini1
1Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Turin, Orbassano, 10043 Turin, Italy.
Journal of Personalized Medicine
|January 21, 2022
Summary
Type 2-low asthma lacks clear definition and effective treatments, unlike Type 2-high asthma. Further research is needed to precisely characterize T2-low asthma and develop tailored therapies for patients.
Area of Science:
- Pulmonology
- Immunology
- Allergy
Background:
- Asthma classification divides patients into Type 2-high and Type 2-low (T2-low) groups.
- T2-low asthma is poorly defined, characterized by absent or non-predominant T2-high biomarkers.
- Molecular mechanisms of T2-low asthma are scarce, but include Type 1/Type 3 immune responses and non-inflammatory remodeling.
Purpose of the Study:
- To address the lack of clear definition and effective therapeutic strategies for T2-low asthma.
- To highlight challenges in T2-low asthma research, including biomarker identification and treatment efficacy.
- To emphasize the need for precise characterization for tailored asthma therapy.
Main Methods:
- Review of current understanding of T2-low asthma endotypes and molecular mechanisms.
- Analysis of treatment efficacy, including inhaled corticosteroids, macrolides, and long-acting anti-muscarinic drugs.
- Evaluation of recent clinical trial outcomes targeting T1/T3 pathways and neutrophil recruitment.
Main Results:
- Inhaled corticosteroids show limited efficacy in T2-low asthma patients.
- Macrolides and long-acting anti-muscarinic drugs demonstrate efficacy in T2-low asthma.
- Clinical trials targeting specific pathways have yielded conflicting results, potentially due to patient selection bias.
Conclusions:
- Precise characterization of T2-low asthma is crucial for developing targeted therapies.
- Further research is warranted to identify reliable biomarkers and optimize treatment strategies.
- Tailored therapeutic approaches are needed for individual T2-low asthma patients.
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