Type 2 immunity in asthma
2018
Type 2-immunity represents the typical
adaptive responseto
allergenexposure in atopic individuals. It mainly involves Th2 cells and
immunoglobulin E, as the main orchestrators of type 2-inflammation. Recently, it has been highlighted that
allergensmay be responsible for a Th2 response beside specific IgE activation and that a number of other environmental stimuli, such as viruses and pollutants, can trigger the same pattern of inflammation beyond
atopy. Emerging data sustain a substantial role of the so-called epithelial dysfunction in asthma pathogenesis, both from anatomic and
functional pointof view. Furthermore an increasing amount of evidence demonstrates the relevance of
innateimmunity in polarizing a Th2 impaired response in asthmatic patients. Under this perspective, the complex cross-talking between airway epithelium,
innateand adaptive immunity is emerging as a major determinant of type 2-inflammation beyond
allergens. This review will include an update on the relevance of dysregulation of
innateand adaptive type 2-immunity in asthma pathogenesis, particularly severe asthma, and on the role of the
allergensthat are associated with severe asthma. Type 2-immunity also will be reviewed in the light of the current and upcoming targeted treatments for severe asthma.
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