Type 2 Inflammation: An Often Overlooked Contributor to Asthma

The Next Breath Editorial Team

December 2019

12/5/2019 12:00:00 AM

UNDERSTANDING SEVERE ASTHMA

Dr. Lawrence Sher, Medical Director at Palos Verdes Medical Group and a physician at Peninsula Research Associates, discusses type 2 inflammation, an underlying cause of a certain type of asthma,1 and what true asthma “control” could look like.

Many people associate asthma symptoms and attacks with outside allergens such as pollen, changes in the weather or even air pollution.2 But for many people, an important contributor to uncontrolled, persistent asthma symptoms may be inside their bodies: type 2 inflammation.1

"Inflammation is an important process in the body to fight off infections, but there can sometimes be too much of a good thing," says Dr. Lawrence Sher, Medical Director at Palos Verdes Medical Group and a physician at Peninsula Research Associates. "Excessive type 2 inflammation, in particular, is an overactive immune response that can contribute to the symptoms of asthma.”1

The excessive type 2 inflammation, an overactive immune system response, can also mean that patients may have one or more type 2 inflammatory diseases of varying levels of severity.1

Looking Inside: Type 2 Inflammation and Asthma

While some of the underlying causes of asthma remain a mystery, doctors have a better understanding today about how type 2 inflammation might be affecting asthma symptoms in many of their patients.1,3,4

Type 2 inflammation – and specifically the inflammatory pathway – is at the root of many of the changes that occur inside the lungs of someone with moderate-to-severe asthma, including increased mucus production and airway obstruction, and hyper-responsiveness to allergens.5

As a result, people can live with persistent asthma symptoms such as coughing, wheezing, and difficulty breathing.6,7 Although some patients may have learned to live with these symptoms, they may not realize that they actually have uncontrolled asthma, according to Dr. Sher.

"Type 2 inflammation not only can contribute to persistent asthma symptoms, but if the symptoms are left untreated, can also put people at risk to life-threatening asthma attacks,"4,6,7 Dr. Sher says. "Those severe attacks – or exacerbations – are more likely to bring people to the emergency room or to the hospital."4,6,7

Talking to Your Doctor about a Personalized Treatment Plan

Asthma has different contributing factors – some outside and some inside the body – and there is no "one-size-fits-all" treatment.8 For some patients living with asthma, the current standard of care therapies may not adequately address their symptoms.6,7

Researchers are continuing to explore the role of type 2 inflammation in moderate-to-severe asthma. Recent studies have found that inhibiting sources of type 2 inflammation may help improve symptoms of asthma, which could lead to lower rates of asthma attacks and hospitalization.1,8

“For those who are experiencing persistent asthma symptoms—a potential sign of uncontrolled asthma, talk to your doctor about treatments that may help better control the underlying cause of their disease," Dr. Sher says. "Every treatment has benefits and risks, so patients should discuss the options with their doctors who can help make recommendations."

References

  1. 1. Gandhi NA, BL Bennett, NM Graham, et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov 2016;15(1):35-50.
  2. 2. Centers for Disease Control and Prevention. Common Asthma Triggers. 2010. Available at: https://www.cdc.gov/asthma/triggers.html. Last accessed March 2019.
  3. 3. National Institues of Health. So you have asthma. 2007. Available at: https://www.nhlbi.nih.gov/files/docs/public/lung/have_asthma.pdf. Last accessed August 2019.
  4. 4. Gandhi NA, Pirozzi G, Graham NMH. Commonality of the IL-4/IL-13 pathway in atopic diseases. Expert Rev. Clin. Immunol 2017; 13:5, 425-437.
  5. 5. Robinson, D., Humbert, M., Buhl, R., Cruz, A., Inoue, H., Korom, S., Hanania, N. and Nair, P. Revisiting Type 2-high and Type 2-low airway inflammation in asthma: current knowledge and therapeutic implications. Clinical & Experimental Allergy 2017;47(2):161-175.
  6. 6. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2019. Available at: https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-June-2019-wms.pdf. Last accessed October 2019.
  7. 7. Price D, Fletcher M, van der Molen T. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med 2014;24:14009.
  8. 8. Guilleminault, L., Ouksel, H., Belleguic, C., Le Guen, Y., Germaud, P., Desfleurs, E., Leroyer, C. and Magnan, A. (2017). Personalized medicine in asthma: from curative to preventive medicine. European Respiratory Review 26(143), p.160010.

Date of Approval: November 2019 | RES.19.10.0004

Type 2 Inflammation: An Often Overlooked Contributor to Asthma

The Next Breath Editorial Team

12/5/2019 12:00:00 AM

12/5/2019 12:00:00 AM

Dr. Lawrence Sher, Medical Director at Palos Verdes Medical Group and a physician at Peninsula Research Associates, discusses type 2 inflammation, an underlying cause of a certain type of asthma,1 and what true asthma “control” could look like.

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Type 2 Inflammation: An Often Overlooked Contributor to Asthma

The Next Breath Editorial Team

12/5/2019 12:00:00 AM

12/5/2019 12:00:00 AM

Dr. Lawrence Sher, Medical Director at Palos Verdes Medical Group and a physician at Peninsula Research Associates, discusses type 2 inflammation, an underlying cause of a certain type of asthma,1 and what true asthma “control” could look like.

YOU MAY NOT BE “SICK,” BUT TALK WITH YOUR DOCTOR ABOUT BETTER ASTHMA CONTROL

The Next Breath Editorial Team

1/1/2020 12:00:00 AM

1/1/2020 12:00:00 AM

Better asthma control is possible. Use these tips to jump-start a conversation with your doctor about addressing your symptoms.

How One Woman Refused to Let Asthma Control Her Life

The Next Breath Editorial Team

12/1/2019 12:00:00 AM

12/1/2019 12:00:00 AM

Tammy was diagnosed with asthma as an infant. Throughout her childhood, her asthma was severe but under control with help from her doctor, who prescribed an inhaler and other medicines.

THE A-HA ASTHMA MOMENT THAT HELPED LYNN TAKE BACK CONTROL

The Next Breath Editorial Team

11/5/2019 12:00:00 AM

11/5/2019 12:00:00 AM

Lynn talks about the moment when she realized her asthma was uncontrolled and she needed to make a change.

ARE THESE 5 MYTHS PREVENTING YOU FROM ASTHMA CONTROL?

The Next Breath Editorial Team

10/2/2019 12:00:00 AM

10/2/2019 12:00:00 AM

People living with asthma often overestimate their level of control. That’s why we’ve looked at five common myths about asthma and unpacked the facts.

WELCOME TO THE NEXT BREATH BLOG!

The Next Breath Editorial Team

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We’re excited to launch The Next Breath Blog! Learn more about what you’ll read from us.

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