Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Department of Biomedical Sciences, Graduate School of Ajou University, Suwon, Korea.
Korean J Intern Med. 2024 Mar;39(2):215-227. doi: 10.3904/kjim.2023.299. Epub 2024 Feb 6.
Asthma is characterized by airway obstruction and inflammation, and presents significant diagnostic and treatment challenges. The concept of endotypes has improved understanding of the mechanisms of asthma and has stimulated the development of effective treatment strategies. Sputum profiles may be used to classify asthma into two major inflammatory types: type 2-high (T2H) and type 2-low (T2L) asthma. T2H, characterized by elevated type 2 inflammation, has been extensively studied and several effective biologic treatments have been developed. However, managing T2L is more difficult due to the lack of reliable biomarkers for accurate diagnosis and classification. Additionally, conventional anti-inflammatory therapy does not completely control the symptoms of T2L; therefore, further research is needed to identify effective biologic treatments. This review provides new insights into the clinical characteristics and underlying mechanisms of severe T2L and investigates potential therapeutic approaches to control the disease.
哮喘的特征是气道阻塞和炎症,并呈现出重大的诊断和治疗挑战。内型概念提高了对哮喘机制的理解,并刺激了有效治疗策略的发展。痰谱可用于将哮喘分为两种主要的炎症类型:2 型高(T2H)和 2 型低(T2L)哮喘。T2H 的特点是 2 型炎症升高,已经进行了广泛的研究,并开发了几种有效的生物治疗方法。然而,由于缺乏可靠的生物标志物来进行准确的诊断和分类,因此管理 T2L 更为困难。此外,常规抗炎治疗并不能完全控制 T2L 的症状;因此,需要进一步研究以确定有效的生物治疗方法。本综述提供了对严重 T2L 的临床特征和潜在机制的新见解,并探讨了控制该疾病的潜在治疗方法。