When Shreaya was just 2 years old, she was diagnosed with a food allergy. She also had eczema. Her mom – who is a doctor – quickly realized there could be a connection between the two conditions. Armed with knowledge, she took Shreaya to an allergist. She was diagnosed with asthma and allergies to peanuts, lentils, soy, coconut, nuts, and shellfish.
The connection Shreaya’s mom recognized is called type 2 inflammation, which could be present in people with several chronic inflammatory conditions.
Recognizing the Connection Between Type 2 Inflammation and Allergic, Atopic, or Other Conditions
Several conditions can be caused in part by type 2 inflammation. These include:
- Asthma
- Atopic dermatitis or eczema
- Eosinophilic esophagitis (EoE)
- Prurigo nodularis (PN)
- Nasal polyps or chronic rhinosinusitis with nasal polyps (CRSwNP)
- Certain food and environmental allergies1
“Each of these conditions can be caused in part by the same overactive inflammation,” explained Dr. Todd Mahr, a board-certified allergist and immunologist and Executive Medical Director at the American College of Allergy, Asthma and Immunology (ACAAI). “Symptoms for each disease can appear so differently that many people do not realize they may be related, connected by the same immune response. Understanding the connection is important to ensuring each patient is treated properly for their condition(s).”
Doctors told Raelle – who lives with eczema, asthma, and seasonal and food allergies – that her conditions were connected.
“My doctors told me that each of these conditions was basically the same issue in my body, showing up in different ways,” said Raelle. “I thought about them as a ‘trifecta’ but didn’t know they were all potentially caused by the same type 2 inflammation.”
It is common for someone with one inflammatory condition or allergy to have another caused by the same inflammation.1 Type 2 inflammation can appear in different ways in different people and may vary based on factors like genetics and environmental triggers.1,2
Genetics are thought to play a factor in the presence of type 2 inflammation, according to Dr. Mahr.1,2 “When I see a patient with any condition that can be caused in part by type 2 inflammation, I always ask them about their family’s medical history. When multiple people in a family have the same – or different – inflammatory conditions, it could be a sign of type 2 inflammation.”
Shreaya has seen the genetic connection of type 2 inflammation in real life with her own family.
“My grandmother and I both have asthma,” she noted. “A lot of people in my family have environmental allergies, and my dad is also allergic to shellfish. Without knowing about type 2 inflammation, I never would have guessed that all of our conditions could be related.”
Chronic Conditions and Their Impact on Day-to-Day Life
Type 2 inflammation can be chronic, meaning it always exists in the body, even when symptoms aren’t felt or seen.1 When symptoms are present, they can be a burden on day-to-day life. Unmanaged conditions may make it difficult to go to work or school, share meals with friends, enjoy social activities, and fulfill daily responsibilities.3,4,5
Living with eczema, asthma, and food allergies since early childhood, Shreaya knows first-hand how type 2 inflammation can impact all stages of life.
“Dealing with these challenges can be hard at any age, but especially during childhood,” she said. “When I was 6 years old, I wanted to play on a soccer team but quit due to my asthma and allergies. I didn’t play outdoor sports because being outside really triggered my symptoms. In the cafeteria during lunch time, I had to sit at a specific table for kids with food allergies. My conditions made me feel isolated from my friends.”
As a young adult, Shreaya faced additional challenges at college. The dust and mold in her old dorm room caused flare-ups. Frequent colds and sickness that circulated among her nine other roommates sometimes triggered her symptoms.
Major life changes can also affect condition management.
“Sometimes it feels like managing my conditions can take over my entire world,” said Raelle. “I’ve moved to different states multiple times in search of a climate with better air quality that won’t trigger my symptoms. Moving can also mean finding a new job. Sometimes people without type 2 inflammation might not realize how every aspect of your daily life can be affected by your disease.”
Advocating for Yourself When You Have a Chronic Condition
Even though allergic diseases and other conditions caused in part by type 2 inflammation can create challenges, you can find a treatment plan that could work for you. It’s important to work with your doctors and care team to create the right plan to manage your symptoms and treat your conditions. Dr. Mahr advocates for having a care team made up of health care specialists who understand that different parts of the body can impact one another.
“I recommend patients be treated by a team of physicians and specialists who can work together to treat them holistically,” he explained. “It’s common for a primary care doctor, dermatologist or skin specialist, and/or an allergist to all work together on one care plan. Depending on the patient, they may also work with a gastroenterologist (GI) or an ear, nose, and throat (ENT) doctor. For patients with more than one condition, sometimes treating one can affect the others as well, so it’s important for an entire care team to be involved in treatment decisions and consider the big picture.”
Raelle recommends people also take an active role on their own care team. “I keep a log of my symptoms with photos, descriptions, and dates,” she said. “That way, I can show my doctors how bad my flare-ups were, even if they’re already over by the time I get to my appointment. Proactively participating in my own treatment plan was empowering. It gave me a sense of control and helped build a relationship with my care team.”
People with type 2 inflammation can also turn to organizations like the Asthma and Allergy Foundation of America (AAFA) for resources, information, support, and community.
“There is an enormous community of people living with different allergic and inflammatory conditions,” said Kathy Przywara, Vice President of Community at AAFA. “Connecting with other people who have similar or shared experiences can help you feel like you’re not alone. Anyone living with a type 2 inflammatory condition – or who has a friend or family member living with one – can find information, care resources, and other types of support through the AAFA.”
Explore more about type 2 inflammation.
The health information contained herein is provided for general educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. 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. Each patient’s story reflects the real-life experiences of individuals diagnosed with their respective diseases. Individual experiences may vary. The medical professional and patients included in this blog were compensated by Sanofi and Regeneron for their participation.
AAFA medical review: Content summarized from Type 2 Inflammation which was reviewed March 2023 by John James, MD
US.IMM.23.09.0003 | 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 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
3 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
4 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 2014 Aug 1;71(2):327-49. https://doi.org/10.1016/j.jaad.2014.03.030
5 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
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