ORCID

0009-0006-6395-7717 (Mendez)

Document Type

Article

Publication Date

2026

DOI

10.1007/s11882-026-01294-1

Publication Title

Current Allergy and Asthma Reports

Volume

26

Issue

1

Pages

51 (1-16)

Abstract

Purpose of Review

Type 2-low (T2-low) asthma, characterized by low blood and sputum eosinophils and low fractional exhaled nitric oxide (FeNO), remains a major unmet need because of frequent corticosteroid insensitivity and a lack of targeted therapies. This review summarizes recent advances in its epidemiology, multiomics, and therapeutic landscape.

Recent findings

T2-low inflammation is highly prevalent, affecting approximately 14%-39% of adults with current asthma and up to 60% of children. Its pathogenesis reflects complex non-T2 mechanisms, including IL-17 signaling, innate immune activation through IL-1β and IL-33, and neutrophilic inflammation. Heterogeneity is further shaped by systemic factors such as obesity and immunosenescence and by environmental exposures such as ozone. Among available therapies, long-term macrolides and the anti-TSLP biologic tezepelumab have shown significant efficacy in reducing exacerbations, whereas other pathway-specific interventions have yielded inconsistent clinical benefits. Emerging metabolic approaches, including GLP-1 receptor agonists, may offer additional promise.

Summary

Progress in T2-low asthma will require mechanism-based classification and clinically deployable biomarkers to align targeted therapies with specific biological drivers.

Rights

© The Authors 2026

This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original authors and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "No datasets were generated or analyzed during the current study."

Original Publication Citation

Mendez, P., Rosado, A., & Cardet, J. C. (2026). Type 2-low asthma: Epidemiology, multiomics, and emerging therapies. Current Allergy and Asthma Reports, 26(1), Article 51. https://doi.org/10.1007/s11882-026-01294-1

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