Biological Therapies for Asthma: Targeting Type 1 and Type 2 Inflammation

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1806

Special Issue Editors


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Guest Editor
Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
Interests: asthma; airway inflammation; physiology; cardiometabolic disease; molecular biology

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Guest Editor
College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
Interests: asthma; airway inflammation; pulmonary pharmacology

Special Issue Information

Dear Colleagues,

Asthma is a complex and varied disease driven by different types of inflammation, mainly type 1 and type 2. While type 1 inflammation, often associated with non-allergic asthma, remains less understood and harder to treat, recent advances are starting to shed light on its mechanisms and potential treatment targets. On the other hand, type 2 inflammation is linked to allergic asthma and driven by cytokines like IL-4, IL-5, and IL-13. Type 2 inflammation has been the focus of many effective biological therapies now available in clinical practice.

This Special Issue invites contributions that explore the role of biological therapies in targeting both the  type 1 and type 2 inflammation in asthma. We aim to cover the following topics:

  • The biological mechanisms driving type 1 and type 2 inflammation and how they shape asthma subtypes.
  • New and existing biological treatments for both types of inflammation, including their clinical benefits and limitations.
  • Biomarkers that help identify type 1 and type 2 inflammation and predict responses to treatment.
  • Comparative studies on outcomes, effectiveness, and challenges in treating these two types of inflammation.
  • Personalized treatment approaches based on inflammatory patterns of asthma.

By bringing together insights from researchers and clinicians, this Special Issue aims to advance our understanding of how biologicals can be used to address the different inflammatory processes in asthma, paving the way for more personalized and effective treatments.

Dr. Mohammad Irshad Reza
Dr. Nilesh Sudhakar Ambhore
Guest Editors

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Keywords

  • asthma endotypes
  • type 1 inflammation
  • type 2 inflammation
  • biological therapies for asthma
  • non-type 2 asthma
  • cytokine pathways in asthma
  • precision medicine in asthma
  • inflammatory biomarkers in asthma
  • Th1/Th2 immune responses

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Published Papers (1 paper)

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Review

32 pages, 652 KiB  
Review
Inflammation in Asthma: Mechanistic Insights and the Role of Biologics in Therapeutic Frontiers
by Mohammad Irshad Reza and Nilesh S. Ambhore
Biomedicines 2025, 13(6), 1342; https://doi.org/10.3390/biomedicines13061342 - 30 May 2025
Viewed by 1536
Abstract
Asthma is a chronic and multifaceted respiratory condition that affects over 300 million individuals across the globe. It is characterized by persistent inflammation of the airways, which leads to episodes of wheezing, breathlessness, chest tightness, and coughing. The most prevalent form of asthma [...] Read more.
Asthma is a chronic and multifaceted respiratory condition that affects over 300 million individuals across the globe. It is characterized by persistent inflammation of the airways, which leads to episodes of wheezing, breathlessness, chest tightness, and coughing. The most prevalent form of asthma is classified as Type 2 or T2-high asthma. In this variant, the immune response is heavily driven by eosinophils, mast cells, and T-helper 2 (Th2) cells. These components release a cascade of cytokines, including interleukin-4 (IL-4), interleukin-5 (IL-5), and interleukin-13 (IL-13). This release promotes several processes: the production of immunoglobulin E (IgE), which is integral to allergic responses; the recruitment of eosinophils—white blood cells that contribute to inflammation and tissue damage. Conversely, non-Type 2 or T2-low asthma is typically associated with a different inflammatory profile characterized by neutrophilic inflammation. This type of asthma is driven by T-helper 1 (Th1) and T-helper 17 (Th17) immune responses, which are often present in older adults, smokers, and those suffering from more severe manifestations of the disease. Among asthmatic patients, approximately 80–85% of cases are classified as T2-high asthma, while only 15–20% are T2-low asthma. Treatment of asthma focuses heavily on controlling inflammation. Inhaled corticosteroids remain the cornerstone therapy for managing T2-high asthma. For more severe or treatment-resistant cases, biologic therapies targeting specific inflammatory pathways, such as anti-IgE (omalizumab), anti-IL-5 (mepolizumab, benralizumab), and anti-IL-4/IL-13 (dupilumab), have shown great promise. For T2-low asthma, macrolide antibiotics like azithromycin and other novel therapies are being explored. This article reviews the safety, efficacy, and indications of the currently approved biologics and discusses potential novel biologics for asthma. Full article
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