Abstract

Type 2 inflammation is a central mechanism across pediatric allergic diseases, including atopic dermatitis, food allergy, eosinophilic esophagitis, allergic rhinitis and asthma. Driven by epithelial barrier dysfunction, alarmin release, Th2 and ILC2 activation, and eosinophilic inflammation, type 2 pathways shape early sensitization and chronic disease. This mini-review summarizes current evidence on cellular and molecular mechanisms in childhood, integrating barrier biology, neuroimmune interactions and endotyping, and discusses therapeutic implications of targeted biologics.

References

  1. Shin YH, Hwang J, Kwon R, et al. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy 2023;78:2232-2254. https://doi.org/10.1111/all.15807.
  2. Gorska MM. Update on type 2 immunity. J Allergy Clin Immunol 2025;155:327-335. https://doi.org/10.1016/j.jaci.2024.11.003.
  3. Berni Canani R, Caminati M, Carucci L, et al. Skin, gut, and lung barrier: Physiological interface and target of intervention for preventing and treating allergic diseases. Allergy 2024;79:1485-1500. https://doi.org/10.1111/all.16092
  4. Maspero J, Adir Y, Al-Ahmad M, et al. Type 2 inflammation in asthma and other airway diseases. ERJ Open Res 2022;8:00576-2021. https://doi.org/10.1183/23120541.00576-2021.
  5. Tamari M, Ver Heul AM. Neuroimmune mechanisms of type 2 inflammation in the skin and lung. Allergol Int 2025;74:177-186. https://doi.org/10.1016/j.alit.2025.02.001.
  6. Castagnoli R, De Filippo M, Votto M, et al. An update on biological therapies for pediatric allergic diseases. Minerva Pediatr 2020;72:364-371. https://doi.org/10.23736/S0026-4946.20.05993-9.
  7. Indolfi C, Klain A, Miraglia Del Giudice M, et al. The use of biologic therapies in pediatric severe asthma. Expert Rev Respir Med 2025;19:1209-1219. https://doi.org/10.1080/17476348.2025.2535182.
  8. Licari A, Castagnoli R, Marseglia A, et al. Dupilumab to Treat Type 2 Inflammatory Diseases in Children and Adolescents. Paediatr Drugs 2020;22:295-310. https://doi.org/10.1007/s40272-020-00387-2.

Downloads

pdf
Authors

Simone Foti Randazzese - Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

Riccardo Castagnoli - Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

Amelia Licari - Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

Gian Luigi Marseglia - Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright

Copyright (c) 2026 Italian Journal of Pediatric Allergy and Immunology

How to Cite
Foti Randazzese, S., Castagnoli, R., Licari, A., & Marseglia, G. L. (2026). Type 2 Mechanisms in Pediatric Allergic Diseases. Italian Journal of Pediatric Allergy and Immunology, 39(4). https://doi.org/10.53151/2531-3916/2025-1838
  • Abstract viewed - 18 times
  • pdf downloaded - 11 times