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Rationale To examine the potential of TLR9 (Toll-like receptor 9) activation to modulate the type 2 immune response in asthma.Objectives To evaluate efficacy and safety of AZD1419, an inhaled TLR9 agonist, in a phase 2a, randomized, double-blind trial.Methods Adult patients with asthma with a history of elevated eosinophils (250 cells/μl) were randomized 11 to receive 13 once-weekly doses of inhaled AZD1419 (1, 4, or 8 mg; n = 4 or placebo (n = 41). Inhaled corticosteroids and long-acting β2-agonist were tapered down and then dis