As researchers’ understanding of the human body and the practice of medicine have evolved over the years, they’ve found that even when two people have the same health condition, they may have different processes happening within their bodies. Recognizing these differences can enable researchers to develop new treatments and help doctors select which treatments may work for certain people.
Somme people with asthma may have a response in their bodies called type 2 inflammation. Your doctor may prescribe you a medication to target specific parts of this inflammatory response if you have severe asthma with type 2 inflammation.
What is type 2 inflammation?
Inflammation helps your body heal and protect itself. For example, if you have a cut, get an infection, or experience exposure to an allergen, your immune system responds by starting the process of inflammation.
Type 2 inflammation is a specific kind of inflammation. It involves certain immune cells, proteins, and antibodies. With asthma, this inflammation occurs in the airways, leading to symptoms such as coughing, wheezing, or difficulty breathing.
Type 2 inflammation plays a role in other medical conditions as well, such as eczema and nasal allergies.
How do you know if you have type 2 inflammation?
If you have frequent asthma flare-ups, let your doctor know. You may notice you cough more frequently or feel short of breath even when you’re not active. You may have to reach for your rescue inhaler more than usual, or your breathing difficulties may affect your sleep.
Your doctor can do an examination, review your treatment plan, and confirm you’re taking your asthma medications correctly.
Your doctor may refer you for additional testing if you still don’t get relief. They can check your blood, mucus in your lungs, or chemicals in your breath for biomarkers. Biomarkers are measurable characteristics that provide information about your health. Some biomarkers can indicate the presence of type 2 inflammation, including:
- Eosinophils: These are white blood cells that clear out disease and infection and raise inflammation. High levels of eosinophils can cause your airway to inflame.
- Immunoglobulin E (IgE): IgE is an antibody, a protein your immune system makes. High levels occur when your body clears out an allergen or some infections.
- Fractional exhaled nitric oxide (FeNO): The amount of FeNO measured when you breathe out can show how much inflammation is present in your airway.
What are the options for treating asthma with type 2 inflammation?
Standard asthma treatment typically includes a management medication, such as inhaled corticosteroids, and a quick-acting medication to relieve sudden symptoms.
Sometimes, a doctor may prescribe an additional management medication or a short course of oral steroids if necessary. However, if you continue to experience asthma symptoms, consider taking biologics known as monoclonal antibodies to treat type 2 inflammation.
Biologic medications work by interfering with the development of inflammation. They act on IgE antibodies, eosinophils, or proteins called cytokines in your blood to lower inflammation in your airway. Examples can include:
- benralizumab (Fasenra)
- dupilumab (Dupixent)
- mepolizumab (Nucala)
- omalizumab (Xolair)
- reslizumab (Cinqair)
Unlike other asthma medications people take daily, or as necessary, people only receive biologics every few weeks as injections or as infusions into their veins. Your doctor can help determine whether a biologic is right for you and the right timeline.
As with any chronic condition, finding the most effective treatment plan can take some time. Take note of your symptoms and see whether you can identify any asthma triggers. In addition to taking your medications as directed, avoiding triggers, and making certain lifestyle changes can help you feel better and breathe easier.