Type 2 inflammation

<h2 id="molecular-biology">Molecular biology</h2>
<a href="/facts/Interleukin_25/1Q8x3yhr">IL-25</a>, <a href="/facts/Interleukin_33/M3vqf1KA">IL-33</a>, and <a href="/facts/Thymic_stromal_lymphopoietin/vYe08gBy">TSLP</a> are <a href="/facts/Damage-associated_molecular_pattern/6nTcgFu1">alarmins</a> released from damaged epithelial cells. These <a href="/facts/Cytokine/SdWpWABH">cytokines</a> mediate the activation of type 2 <a href="/facts/T_helper_cell/nhwAYkDj">T helper cells</a> (Th2 cells), <a href="/facts/ILC2/y3PzWxoG">type 2 innate lymphoid cells</a> (ILC2 cells), and <a href="/facts/Dendritic_cell/19KBuKFK">dendritic cells</a>. Th2 cells and ILC2 cells secrete <a href="/facts/Interleukin_4/FacDJ3TY">IL-4</a>, <a href="/facts/Interleukin_5/QfvdEJz3">IL-5</a> and <a href="/facts/Interleukin_13/zEaRbEqc">IL-13</a>.<a class="footnote-ref" id="fnref:3" href="#fn:3">3</a><a class="footnote-ref" id="fnref:4" href="#fn:4">4</a>
IL-4 further drives CD4+ T cell differentiation towards the Th2 subtype and induces <a href="/facts/Immunoglobulin_class_switching/q8w8PWoY">isotype switching</a> to IgE in B cells. IL-4 and IL-13 stimulate trafficking of <a href="/facts/Eosinophil/yhIKA8bE">eosinophils</a> to the site of inflammation, while IL-5 promotes both eosinophil trafficking and production.<a class="footnote-ref" id="fnref:5" href="#fn:5">5</a>

<h2 id="dysregulation-in-human-disease">Dysregulation in human disease</h2>
Type 2 inflammation has been implicated in several <a href="/facts/Chronic_condition/6CqLP41r">chronic diseases</a>:

<ul><li><a href="/facts/Asthma/7GkJvxn3">Asthma</a><a class="footnote-ref" id="fnref:6" href="#fn:6">6</a><a class="footnote-ref" id="fnref:7" href="#fn:7">7</a></li>
<li><a href="/facts/Atopic_dermatitis/DvmdVwWu">Atopic dermatitis</a><a class="footnote-ref" id="fnref:8" href="#fn:8">8</a></li>
<li><a href="/facts/Nasal_polyp/scc2WAU1">Chronic sinusitis with nasal polyps</a><a class="footnote-ref" id="fnref:9" href="#fn:9">9</a></li>
<li><a href="/facts/Eosinophilic_esophagitis/SkQ9kXek">Eosinophilic esophagitis</a><a class="footnote-ref" id="fnref:10" href="#fn:10">10</a></li>
<li><a href="/facts/Bullous_pemphigoid/PBVRRT4s">Bullous pemphigoid</a><a class="footnote-ref" id="fnref:11" href="#fn:11">11</a></li></ul>
Persons with one type 2 inflammatory disease are more likely to have other type 2 inflammatory diseases.<a class="footnote-ref" id="fnref:12" href="#fn:12">12</a>

<h2 id="pharmacological-targets">Pharmacological targets</h2>
Several medicines have been developed that target mediators of type 2 inflammation:<a class="footnote-ref" id="fnref:13" href="#fn:13">13</a>

<ul><li>IL-4-specific blockers:
<ul><li>Altrakincept</li>
<li><a href="/facts/Pascolizumab/yRkj89VW">Pascolizumab</a></li></ul></li>
<li>IL-5-specific blockers:
<ul><li><a href="/facts/Benralizumab/rn64ffCp">Benralizumab</a></li>
<li><a href="/facts/Mepolizumab/ERHfRob5">Mepolizumab</a></li>
<li><a href="/facts/Reslizumab/1QcBPcgL">Reslizumab</a></li></ul></li>
<li>IL-13-specific blockers:
<ul><li><a href="/facts/Lebrikizumab/PTynN9um">Lebrikizumab</a></li>
<li><a href="/facts/Tralokinumab/qdRnMEKa">Tralokinumab</a></li></ul></li>
<li>Dual IL-4 and IL-13 blockers:
<ul><li><a href="/facts/Dupilumab/EYSHml2o">Dupilumab</a></li></ul></li>
<li>IgE-blockers:
<ul><li><a href="/facts/Ligelizumab/tV71VkLI">Ligelizumab</a></li>
<li><a href="/facts/Omalizumab/EyDGUak5">Omalizumab</a></li></ul></li></ul>

<h2 id="references">References</h2>

<ol>
<li id="fn:1">Allen, Judith E.; Sutherland, Tara E. (2014-08-01). "Host protective roles of type 2 immunity: Parasite killing and tissue repair, flip sides of the same coin". Seminars in Immunology. 26 (4): 329–340. doi:10.1016/j.smim.2014.06.003. ISSN 1044-5323. PMC 4179909. PMID 25028340. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179909" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179909</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></li>
<li id="fn:2">Gandhi, Namita A.; Bennett, Brandy L.; Graham, Neil M. H.; Pirozzi, Gianluca; Stahl, Neil; Yancopoulos, George D. (2016-01-01). "Targeting key proximal drivers of type 2 inflammation in disease". Nature Reviews Drug Discovery. 15 (1): 35–50. doi:10.1038/nrd4624. ISSN 1474-1784. PMID 26471366. S2CID 2421591. <a href="https://www.nature.com/articles/nrd4624" target="_blank">https://www.nature.com/articles/nrd4624</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></li>
<li id="fn:3">Allen, Judith E.; Sutherland, Tara E. (2014-08-01). "Host protective roles of type 2 immunity: Parasite killing and tissue repair, flip sides of the same coin". Seminars in Immunology. 26 (4): 329–340. doi:10.1016/j.smim.2014.06.003. ISSN 1044-5323. PMC 4179909. PMID 25028340. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179909" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179909</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></li>
<li id="fn:4">Hong, Haiyu; Liao, Shumin; Chen, Fenghong; Yang, Qintai; Wang, De-Yun (2020). "Role of IL-25, IL-33, and TSLP in triggering united airway diseases toward type 2 inflammation". Allergy. 75 (11): 2794–2804. doi:10.1111/all.14526. ISSN 1398-9995. PMID 32737888. S2CID 220908481. <a href="https://doi.org/10.1111%2Fall.14526" target="_blank">https://doi.org/10.1111%2Fall.14526</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></li>
<li id="fn:5">Gandhi, Namita A.; Bennett, Brandy L.; Graham, Neil M. H.; Pirozzi, Gianluca; Stahl, Neil; Yancopoulos, George D. (2016-01-01). "Targeting key proximal drivers of type 2 inflammation in disease". Nature Reviews Drug Discovery. 15 (1): 35–50. doi:10.1038/nrd4624. ISSN 1474-1784. PMID 26471366. S2CID 2421591. <a href="https://www.nature.com/articles/nrd4624" target="_blank">https://www.nature.com/articles/nrd4624</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></li>
<li id="fn:6">Fahy, John V. (2015). "Type 2 inflammation in asthma — present in most, absent in many". Nature Reviews Immunology. 15 (1): 57–65. doi:10.1038/nri3786. ISSN 1474-1733. PMC 4390063. PMID 25534623. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390063" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390063</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></li>
<li id="fn:7">Akdis, Cezmi A.; Arkwright, Peter D.; Brüggen, Marie-Charlotte; Busse, William; Gadina, Massimo; Guttman-Yassky, Emma; Kabashima, Kenji; Mitamura, Yasutaka; Vian, Laura; Wu, Jianni; Palomares, Oscar (2020). "Type 2 immunity in the skin and lungs". Allergy. 75 (7): 1582–1605. doi:10.1111/all.14318. ISSN 1398-9995. PMID 32319104. S2CID 216075178. <a href="/wiki/Emma_Guttman-Yassky" target="_blank">/wiki/Emma_Guttman-Yassky</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></li>
<li id="fn:8">Akdis, Cezmi A.; Arkwright, Peter D.; Brüggen, Marie-Charlotte; Busse, William; Gadina, Massimo; Guttman-Yassky, Emma; Kabashima, Kenji; Mitamura, Yasutaka; Vian, Laura; Wu, Jianni; Palomares, Oscar (2020). "Type 2 immunity in the skin and lungs". Allergy. 75 (7): 1582–1605. doi:10.1111/all.14318. ISSN 1398-9995. PMID 32319104. S2CID 216075178. <a href="/wiki/Emma_Guttman-Yassky" target="_blank">/wiki/Emma_Guttman-Yassky</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></li>
<li id="fn:9">Hulse, K. E.; Stevens, W. W.; Tan, B. K.; Schleimer, R. P. (2015). "Pathogenesis of nasal polyposis". Clinical & Experimental Allergy. 45 (2): 328–346. doi:10.1111/cea.12472. PMC 4422388. PMID 25482020. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422388" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422388</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></li>
<li id="fn:10">Hill, David A.; Spergel, Jonathan M. (2016). "The Immunologic Mechanisms of Eosinophilic Esophagitis". Current Allergy and Asthma Reports. 16 (2): 9. doi:10.1007/s11882-015-0592-3. ISSN 1529-7322. PMC 4913464. PMID 26758862. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913464" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913464</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></li>
<li id="fn:11">Werth, Victoria P.; Murrell, Dédée F.; Joly, Pascal; Heck, Renata; Orengo, Jamie M.; Ardeleanu, Marius; Hultsch, Verena (2024-12-01). "Pathophysiology of Bullous Pemphigoid: Role of Type 2 Inflammation and Emerging Treatment Strategies (Narrative Review)". Advances in Therapy. 41 (12): 4418–4432. doi:10.1007/s12325-024-02992-w. ISSN 1865-8652. PMC 11550233. PMID 39425892. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550233" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550233</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></li>
<li id="fn:12">Khan, Asif; Gouia, Imène; Kamat, Siddhesh; Ortiz, Benjamin; Johnson, Robert; Siddall, James; Small, Mark (2020-09-07). "Type 2 inflammation-related comorbidities among patients with asthma, chronic rhinosinusitis with nasal polyps, and atopic dermatitis". European Respiratory Journal. 56 (suppl 64): 232. doi:10.1183/13993003.congress-2020.232. ISSN 0903-1936. S2CID 229017279. <a href="https://erj.ersjournals.com/content/56/suppl_64/232" target="_blank">https://erj.ersjournals.com/content/56/suppl_64/232</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></li>
<li id="fn:13">Gandhi, Namita A.; Bennett, Brandy L.; Graham, Neil M. H.; Pirozzi, Gianluca; Stahl, Neil; Yancopoulos, George D. (2016-01-01). "Targeting key proximal drivers of type 2 inflammation in disease". Nature Reviews Drug Discovery. 15 (1): 35–50. doi:10.1038/nrd4624. ISSN 1474-1784. PMID 26471366. S2CID 2421591. <a href="https://www.nature.com/articles/nrd4624" target="_blank">https://www.nature.com/articles/nrd4624</a> <a href="#fnref:13" class="footnote-back-ref">↩</a></li>
</ol>

Type 2 inflammation open-in-new

Type 2 inflammation