Category: Non-Eosinophilic Asthma

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Shedding Light on T2-Low Asthma: A Forgotten Frontier in Asthma Research

Introduction:

Welcome to the World Asthma Foundation blog, where we strive to inform and inspire our readers in support of our mission. Today, we turn our attention to a lesser-known aspect of asthma called T2-Low asthma. While much focus has been placed on T2-High asthma, which includes allergic and non-allergic inflammation, T2-Low asthma has remained in the shadows. This subtype encompasses various forms, such as paucigranulocytic asthma, Type 1 and Type-17 inflammation, and the neutrophilic form, which is particularly common in severe or refractory cases. By exploring the realm of T2-Low asthma, we hope to raise awareness, ignite discussion, and rally the asthma community towards much-needed research and innovation.

Subheading: Unraveling the Complexity of T2-Low Asthma

Understanding T2-Low Asthma:

T2-Low asthma comprises different subtypes, including paucigranulocytic asthma, Type 1 and Type-17 inflammation, and the prevalent neutrophilic form. While T2-Low asthma is generally associated with milder symptoms, it’s important to note that the neutrophilic form can result in severe or refractory cases. By recognizing the complexities of T2-Low asthma, we can gain a deeper understanding of the challenges it poses to patients and researchers alike.

The Need for Research:

Despite its impact on patients, T2-Low asthma has received limited attention in terms of biomarkers and effective treatments. The scarcity of research on T2-Low asthma hinders progress in developing targeted therapies and diagnostic tools. By emphasizing the need for increased research efforts, we can work towards improving the lives of individuals living with T2-Low asthma.

Subheading: Key Takeaways

Key Takeaways:

T2-Low asthma encompasses various subtypes, including paucigranulocytic asthma, Type 1 and Type-17 inflammation, and the neutrophilic form.
While T2-Low asthma is generally associated with milder symptoms, the neutrophilic form can result in severe or refractory cases.
Limited research has been conducted on T2-Low asthma, leading to a lack of biomarkers and effective treatments.
Raising awareness and supporting research on T2-Low asthma is crucial to unlocking innovative solutions and improving outcomes for patients.
The World Asthma Foundation is dedicated to addressing the gaps in T2-Low asthma research and advocating for the needs of affected individuals.
Conclusion:

As we conclude our exploration of T2-Low asthma, we invite you to take action and support the cause. T2-Low asthma remains an understudied and overlooked frontier in asthma research, leaving many patients without effective treatments or biomarkers. It is our collective responsibility to raise awareness, push for solutions, improve diagnostics, and ultimately strive for a cure. By joining hands with the World Asthma Foundation, we can make a significant impact on the lives of those affected by T2-Low asthma. Together, we can transform the future of asthma care and provide hope for a brighter tomorrow.

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Non-Eosinophilic Asthma (NEA)

Although non-eosinophilic asthma (NEA) is not the best known and most prevalent asthma phenotype, its importance cannot be underestimated. NEA is characterized by airway inflammation with the absence of eosinophils, subsequent to activation of non-predominant type 2 immunologic pathways. This phenotype, which possibly includes several not well-defined subphenotypes, is defined by an eosinophil count <2% in sputum. NEA has been associated with environmental and/or host factors, such as smoking cigarettes, pollution, work-related agents, infections, and obesity. These risk factors, alone or in conjunction, can activate specific cellular and molecular pathways leading to non-type 2 inflammation.

Note from the WAF: We wish to acknowledge and thank Darío Antolín-Amérigo, Javier Domínguez-Ortega,3,4 and Santiago Quirce Department of Allergy, Hospital General de Villalba, Madrid, Spain, for their contribution to Asthma education and research.

The most relevant clinical trait of NEA is its poor response to standard asthma treatments, especially to inhaled corticosteroids, leading to a higher severity of disease and to difficult-to-control asthma. Indeed, NEA constitutes about 50% of severe asthma cases. Since most current and forthcoming biologic therapies specifically target type 2 asthma phenotypes, such as uncontrolled severe eosinophilic or allergic asthma, there is a dramatic lack of effective treatments for uncontrolled non-type 2 asthma. Research efforts are now focusing on elucidating the phenotypes underlying the non-type 2 asthma, and several studies are being conducted with new drugs and biologics aiming to develop effective strategies for this type of asthma, and various immunologic pathways are being scrutinized to optimize efficacy and to abolish possible adverse effects.