PATH-2 TASK FORCE. A Multidisciplinary Approach for Type 2 Allergic Diseases: What Do Biologics Teach Us?

Maniscalco M, Detoraki A, Sarnelli G, Nolano M, De Paulis A, Spadaro G, Cantone E;  J Pers Med. 2023 Jun 1;13(6):941. doi: 10.3390/jpm13060941.

Open AccessEditorial

Patients with atopic/allergic disorders, including atopic dermatitis (AD), allergic rhino-conjunctivitis (AR), chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP), bronchial asthma, food allergy, and eosinophilic esophagitis (EoE), often share a common genetic background, a type Th2 polarized immune response, and several environmental factors.

Th2 immunity has evolved to ensure the integrity of the epithelial barrier and to protect against helminths.

Although the pathways underlying Th2-driven inflammation can differ and are related to age and ethnicity, they can share some common mediators [1]. The alarmins, namely, thymic stromal lymphopoietin (TSLP), interleukin (IL)-25 and IL-33, are released from injured epidermal and epithelial cells and play pivotal roles in Th2 cell development. Other cytokines, including IL-4, IL-5, IL-9, IL-13, and IL-31, are also relevant in orchestrating a Th2-type immune response [3]. Naïve CD4+ T cells differentiate into Th2 cells under the influence of IL-4, which also stimulates isotype class switching of B-cells in order to produce immunoglobulin E (IgE). The additional signaling provided by IL-5 and IL-9 leads to eosinophil and mast cell recruitment to the inflammatory site...

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