Challenges associated with type 2 inflammatory diseases in general medical practice

The article considers the mechanism of type 2 inflammation, describes the main cytokines mediating severe eosinophilic diseases, and presents the frequency of detection of comorbid type 2 inflammation related diseases: bronchial asthma (BA), allergic rhinitis (AR), chronic polyposis rhinosinusitis (CPRS), atopic dermatitis (AD) and eosinophilic esophagitis (EoE). We have described symptoms, diagnostic methods with an emphasis on the correctness of histological verification of eosinophilia in biopsies of the esophageal mucosa, modern treatment algorithms, including non-drug dietary recommendations and pharmacotherapy using proton pump inhibitors (PPIs) and topical glucocorticosteroids (GCS) in detail. Particular attention is paid to the modern method of treating type 2 inflammatory diseases - immunobiological therapy with genetic engineering drugs. We have shown the advantages of dupilumab, which inhibits the key type 2 inflammatory cytokines IL-4 and IL-13, and has the widest indications for use.