How Type 2 Inflammation Contributes to Asthma, COPD, and Allergic Conditions

Do you live with persistent, moderate-to-severe asthma, COPD, allergies, eczema or hives? Inflammation is often a major factor in the severity of your symptoms. It could also be a factor if your condition is hard to treat. When inflammation is severe and causes difficult-to-control symptoms, it's called Type 2 inflammation.

Type 2 inflammation could be the underlying cause of your condition. It could also be the reason you have more than one condition.

What is Type 2 inflammation?

Type 2 inflammation is an overactive immune response that causes excess inflammation in the body. It plays a key role in many allergic, respiratory and skin diseases.

Type 2 inflammation is believed to be caused by genetic and environmental factors. It can be triggered by allergens (pollen, mold, dust mites, or pet dander) and irritants (pollutants). It can also arise from viruses and bacteria, weather changes, stress or exercise. Sometimes inflammation may occur without an apparent trigger.

Health conditions that may be affected by Type 2 inflammation include:

• Moderate to severe asthma
• Eosinophilic asthma
• COPD
• Aspirin-Exacerbated Respiratory Disease (AERD)
• Allergic rhinitis
• Severe chronic rhinosinusitis with nasal polyps (CRSwNP)
• Chronic urticaria (chronic hives)
• Moderate to severe atopic dermatitis (eczema)
• Food allergies
• Eosinophilic esophagitis (EoE)
• Sleep apnea

Symptoms involving Type 2 inflammation vary depending on your condition. Chronic inflammation can lead to long-term symptoms and tissue damage if it is not well managed.

What is the science behind Type 2 inflammation?

Type 2 inflammation can be driven by high levels of antibodies called immunoglobulin E (IgE). It can also be driven by high levels of eosinophils, a type of white blood cell.

IgE is designed to help the body fight off allergens, certain irritants, and parasitic infections. It binds to immune cells such as mast cells and basophils that trigger the release of histamine and proteins called cytokines. This can cause Type 2 inflammation that is severe and chronic, especially in allergic conditions.

Other key cytokines (called IL-4, IL-5 and IL-13) recruit and activate the eosinophils. When there are too many eosinophils in the blood, they can contribute to severe or ongoing Type 2 inflammation.

How do you know if you have Type 2 inflammation?

If you think your condition is affected by Type 2 inflammation, talk with a doctor, preferably a specialist such as an allergist. Doctors can diagnose Type 2 inflammation through blood tests that measure IgE and eosinophil levels. High levels indicate that Type 2 inflammation is present.

If you have asthma or COPD, a breathing test for your lungs called fractional exhaled nitric oxide (FeNO) can also indicate Type 2 inflammation.

What treatments are recommended for Type 2 inflammation?

Medications are available for people with diseases caused or worsened by Type 2 inflammation. Biologics are increasingly prescribed to help treat these conditions. They are used when standard treatments like corticosteroids or antihistamines are not effective. Biologics work at the cellular level, with the goal of stopping symptoms before they can start. They aim to reduce the levels of IgE and/or eosinophils that cause inflammation in the body.

It's important to work together with your doctor to decide what course of treatment is best for you. Consider the severity of your symptoms and discuss what previous medications or treatments you have tried. Your healthcare provider can help you find out if Type 2 inflammation is connected to your medical condition.

Learn more at Type2Inflammation.org.