One of the many ways our immune system can protect us from infection is by creating inflammation to fight off the body’s “intruders” – such as viruses and bacteria. But sometimes the immune system responds even when there is no infection to fight. This overactive immune response is known as type 2 inflammation.^1,2

Scientists first discovered type 2 inflammation in the 1980s. After decades of research, we now understand that type 2 inflammation plays a role in several conditions and allergies.^2,3,4 When we better understand this immune response, we can raise awareness of possible related conditions and help improve disease and symptom management.

What Can Trigger Type 2 Inflammation?

Type 2 inflammation is an immune response that occurs when your body detects certain type of infection or allergen.¹

How and when a person gets a disease caused in part by type 2 inflammation depends on different factors, including hereditary conditions, environmental, and physical triggers.^1,5,6 Allergens (such as pollen, mold and dust mites), exercise, stress, weather, and pollutants (such as smoke) may trigger symptoms or make them worse.^7,8

What Conditions Are Connected to Type 2 Inflammation?

Type 2 inflammation can contribute to a wide range of different conditions and allergies, including various airway, skin, and gastrointestinal (gut) conditions.¹ Among others, some conditions caused in part by type 2 inflammation include:¹

• Atopic dermatitis or eczema
• Asthma
• Nasal polyps or chronic rhinosinusitis with nasal polyposis (CRSwNP)
• Prurigo nodularis (PN)
• Eosinophilic esophagitis (EoE)
• Certain food allergies
  
  

Are All of These Conditions Connected?

At first glance, these conditions – like EoE and nasal polyps or asthma and eczema – and their signs and symptoms seem unrelated. People with asthma often have coughing, wheezing, and trouble breathing. People with atopic dermatitis (the most common type of eczema) have signs and symptoms that can include intense itching and rashes on the skin.⁹ Although these conditions sound unrelated, both can be caused in part by underlying type 2 inflammation.¹

While it is possible to have only one of these conditions, people with one inflammatory or allergic condition are more likely to have others caused by the same underlying type 2 inflammation.¹ Doctors usually diagnose the more severe condition first. But it is important to talk with your doctor to help find a treatment plan that could work for you.⁵

Type 2 inflammation can show up differently for each person depending on factors like genetics and environmental triggers.^1,6

When multiple people in a family have the same – or different – allergic conditions, it could be a sign of type 2 inflammation.¹ The inflammation can show up differently from person to person. For example, a person with eczema could have a brother with asthma or a mother with nasal polyps.¹

What Is It Like Living with Type 2 Inflammation?

Type 2 inflammation can be present in chronic conditions like asthma, eczema, or EoE, even if you don’t see or feel any symptoms.¹ This may explain why conditions driven in part by type 2 inflammation can be unpredictable. People may have episodes of intense symptom flare-ups, as well as periods of time when they do not have any symptoms at all.^10,11

Living with any chronic condition can be associated with stress and anxiety. Understanding more about the underlying causes of your condition can help you navigate your health journey.^11,12,13 It’s important that you speak with your health care team about any signs or symptoms you have or have had in the past. It may also be helpful to keep a journal or take a photo of your symptoms to show your doctor during your appointment.

By advocating for yourself and helping your doctor see the whole picture of your health and your experiences, they can help you come up with a plan to manage your symptoms through daily routine changes, management approaches, or advanced therapies.

The health information contained herein is provided for general educational purposes only. Your healthcare professional is the best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.

AAFA medical review: Content summarized from Type 2 Inflammation which was reviewed March 2023 by John James, MD

US.IMM.23.09.0004 | September 2023

References
1. Gandhi, N. A., Bennett, B. L., Graham, N. M., Pirozzi, G., Stahl, N., & Yancopoulos, G. D. (2015). Targeting key proximal drivers of type 2 inflammation in disease. Nature Reviews Drug Discovery, 15(1), 35–50. https://doi.org/10.1038/nrd4624
2. Gandhi NA, Pirozzi G, Graham NM. Commonality of the IL-4/IL-13 pathway in atopic diseases. Expert review of clinical immunology. 2017 May 4;13(5):425-37. https://doi.org/10.1080/1744666X.2017.12984433.
3. Mosmann, T. R., Cherwinski, H., Bond, M. W., Giedlin, M. A., & Coffman, R. L. (1986). Two types of murine helper T cell clone. I. Definition according to profiles of lymphokine activities and secreted proteins. The Journal of Immunology, 136(7), 2348–2357. https://doi.org/10.4049/jimmunol.136.7.2348
4. Snapper, C. M., Finkelman, F. D., & Paul, W. E. (1988). Regulation of IGG1 and IGE production by interleukin 4. Immunological Reviews, 102(1), 51–75. https://doi.org/10.1111/j.1600-065x.1988.tb00741.x
5. Khan, A. H., Gouia, I., Kamat, S., Johnson, R., Small, M., & Siddall, J. (2023a). Prevalence and severity distribution of type 2 inflammation-related comorbidities among patients with asthma, chronic rhinosinusitis with nasal polyps, and atopic dermatitis. Lung, 201(1), 57–63. https://doi.org/10.1007/s00408-023-00603-z
6. Krishnan, J. A., Cloutier, M. M., & Schatz, M. (2021). National Asthma Education and prevention program 2020 guideline update: Where do we go from here? American Journal of Respiratory and Critical Care Medicine, 203(2), 164–167. https://doi.org/10.1164/rccm.202011-4236ed
7. Global Initiative for Asthma (GINA) (2023). GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION (2023 Update). https://ginasthma.org/wp-conte...ort-23_07_06-WMS.pdf
8. Sugita K, Kabashima K. Tight junctions in the development of asthma, chronic rhinosinusitis, atopic dermatitis, eosinophilic esophagitis, and inflammatory bowel diseases. Journal of leukocyte biology. 2020 May;107(5):749-62. https://doi.org/10.1002/JLB.5MR0120-230R
9. What is atopic dermatitis and how can I tell if I have it?. National Eczema Association. (2021, December 2). https://nationaleczema.org/ecz...a/atopic-dermatitis/
10. Lucendo AJ, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335-358 https://doi.org/10.1177/2050640616689525
11. Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, Chamlin SL, Cooper KD,Feldman SR, Hanifin JM, Krol A. Guidelines of care for the management of atopic dermatitis: section 3.Management and treatment with phototherapy and systemic agents. Journal of the American Academy of Dermatology. 2014 Aug 1;71(2):327-49. https://doi.org/10.1016/j.jaad.2014.03.030
12. Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., Toppila-Salmi, S., Bernal-Sprekelsen, M., Mullol, J., Alobid, I., Terezinha Anselmo-Lima, W., Bachert, C., Baroody, F., von Buchwald, C., Cervin, A., Cohen, N., Constantinidis, J., De Gabory, L., Desrosiers, M., … Zwetsloot, C. P. (2020). European position paper on Rhinosinusitis and nasal polyps 2020. Rhinology Journal, 0(0), 1–464. https://doi.org/10.4193/rhin20.600
13. Zuberbier, T., Orlow, S. J., Paller, A. S., Taïeb, A., Allen, R., Hernanz-Hermosa, J. M., Ocampo-Candiani, J., Cox, M., Langeraar, J., & Simon, J. C. (2006). Patient perspectives on the management of atopic dermatitis. Journal of Allergy and Clinical Immunology, 118(1), 226–232. https://doi.org/10.1016/j.jaci.2006.02.031