Abstract
Type 2(high) asthma, which accounts for the majority of asthma cases, is driven by Th2 cells that produce cytokines such as IL-4, IL-5, and IL-13. These cytokines promote several features of the disease, including eosinophilia, IgE production, bronchial hyperresponsiveness (BHR), mucus hypersecretion, and susceptibility to exacerbations. In contrast, type 2(low) asthma is characterized by the presence of neutrophils and reduced responsiveness to corticosteroids. In recent years, advances in our understanding of the distinct mechanisms at play in each asthma endotype have paved the way for the development of targeted therapies tailored to specific patient profiles. In this review, we first explore the underlying immunological mechanisms of various asthma endotypes. We also provide an overview of the different types of immunotherapies currently available to asthmatic patients and their clinical efficacy. Finally, we highlight emerging therapeutic strategies that hold promise for improving asthma management in the future.