Mechanisms and Treatment of Type 2 High and Low Asthma Endotypes

ABSTRACT Asthma is a complex, heterogeneous disease characterised by clinical phenotypes demonstrating distinct and overlapping immunological mechanisms, classified into type‐2 high and type‐2 low asthma endotypes. Both allergic and eosinophilic non‐allergic asthma are driven through an underlying type‐2 high‐endotype, which can be targeted using therapeutic approaches such as allergen‐specific immunotherapy (AIT) for allergic asthma and biologics. AIT demonstrates efficacy for the treatment of allergic asthma. Approved biologics for asthma management include using various interleukin antagonists and anti‐immunoglobulin E, with Tezepelumab offering promising treatments for both type‐2 high and type‐2 low asthma patients. Novel therapeutic candidates, such as Itepekimab and depemokimab, have demonstrated promising results in a Phase 2 clinical trial in moderate‐to‐severe asthma patients.