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  • Journal article
    Kong E, Cucco A, Custovic A, Fontanella Set al., 2026,

    Machine learning in allergy research: A bibliometric review

    , IMMUNOLOGY LETTERS, Vol: 277, ISSN: 0165-2478
  • Journal article
    Maher T, Jenkins G, Saini G, Johnson S, Chua F, Lukey P, Allen R, Wain L, Fahy W, Molyneaux P, Stewart Iet al., 2026,

    A Prospective Study of Fibrosis in the Lung Endpoints (PROFILE): characteristics of an incident cohort of patients with idiopathic pulmonary fibrosis

    , BMJ Open Respiratory Research, ISSN: 2052-4439

    Background: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disease. The PROFILE study was a prospective, observational cohort study designed to better define the natural history of IPF, understand disease biology and identify biomarkers to support disease management and enhance clinical trial design.Methods: Individuals with an incident diagnosis of IPF were recruited between 2010 and 2017 across two co-ordinating centres in the UK. Demographics, clinical measurements and blood samples were obtained at baseline, and 1, 3, 6, 12, 24, 36 months. Disease progression events were defined as death or relative FVC decline>10% at 12 months. Survival estimates were modelled using cox proportional hazards; longitudinal lung function decline was estimated using mixed effect models, specified with restricted cubic splines, a random intercept for participant and random effect for study visit. All models were adjusted for baseline age, sex and continuous baseline percent predicted forced vital capacity (ppFVC).Results: A total of 632 participants were recruited, 77.1% were male and mean age at enrolment was 70.4 years (SD 8.4). Mean baseline ppFVC was 79.5% (SD 19.2), mean percent predicted DLCO (ppDLCO) was 45.7% (SD 15.1). A total of 304 (48.1%) participants met disease progression criteria at 1 year. Median survival was 3.7 years (95%CI 3.3; 4.0). More severe baseline physiology, 12-month relative lung function decline ≥10%, older age, and short telomeres were independent risk factors for mortality. Twelve-month estimated change in ppFVC was -5.28% (95%CI -6.34; -4.22) with an average FVC decline of 186.9ml (95%CI -225.4.0; -148.5), 12-month estimated change in ppDLCO was -3.35% (95%CI -4.30; -2.40).Conclusion: The PROFILE cohort confirms that untreated, IPF is inexorable progressive and inevitably fatal with a poor median survival from diagnosis.
  • Journal article
    Course CW, Bush A, Kotecha S, 2026,

    Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes.

    , Lancet Respir Med, Vol: 14, Pages: 60-71

    Preterm birth is increasingly recognised as a determinant of chronic respiratory disease across the life course. In this Series on prematurity-associated lung disease (PLD), we introduce the concept of PLD as a unifying framework for the diverse pulmonary consequences of preterm birth. Historically, most attention has focused on extremely preterm infants (<28 weeks of gestation) who develop bronchopulmonary dysplasia (BPD), yet not all infants with BPD have long-term morbidity. Conversely, those born very (28-31 weeks), moderate (32-33 weeks), or late (34-36 weeks) preterm also have increased risk for developing lung disease. Multiple factors beyond BPD-including gestational age and intrauterine growth restriction-contribute to PLD development. Recently described PLD phenotypes include prematurity-associated obstructive lung disease, prematurity-associated preserved ratio impaired spirometry, and prematurity-associated dysanapsis. Each phenotype reflects distinct early-life exposures and mechanisms, with differing implications for prognosis. Defining these phenotypes provides a foundation for personalised monitoring and targeted therapeutic strategies.
  • Journal article
    Custovic D, Custovic A, Gern J, Saglani S, Fontanella Set al., 2026,

    Model-based machine learning to understand the progression of asthma throughout the life course.

    , J Allergy Clin Immunol, Vol: 157, Pages: 59-61
  • Journal article
    Mohammed Abdul Wajid L, Saglani S, Nagakumar P, Heath Get al., 2025,

    Exploring health professional views of management for preschool wheeze: a qualitative study.

    , Arch Dis Child

    OBJECTIVE: This study aimed to explore health professionals' perspectives on the management of preschool wheeze, including their views on using tests to guide treatment for children with recurrent wheeze. DESIGN: Purposive and snowball sampling were used in this qualitative study to recruit health professionals with experience of managing children with pre-school wheeze from primary and secondary care settings across England. Semi-structured interviews were conducted via Microsoft Teams. Transcripts were analysed thematically, supported by the use of NVivo software, to identify key themes. RESULTS: 14 health professionals participated: four general practitioners, four general paediatricians, four hospital asthma nurses, one tertiary respiratory paediatrician and one primary care nurse. Participants agreed that preschool wheeze remains a significant disease. Thematic analysis identified four key themes: (1) challenges with diagnostic terminology, where a lack of consistent terminology was considered to impact communication and management; (2) diagnostic uncertainty, where the absence of objective tests for early asthma diagnosis negatively contributed to management plans; (3) current practice of investigating children with preschool wheeze, where participants described a lack of infrastructure and approach to performing tests in primary and secondary care; and (4) treatment considerations in which parents' medication beliefs were thought to influence adherence to prescribed treatments. There were differences in the views regarding the management of preschool wheeze between primary and secondary care professionals. CONCLUSION: Health professionals' views highlight inconsistent use of diagnostic terminology for preschool wheeze, contributing to variation in management. Integrated care pathways and infrastructure are urgently needed to improve outcomes for children with preschool wheeze.
  • Journal article
    Sousa-Pinto B, Louis R, Anto JM, Amaral R, Sa-Sousa A, Czarlewski W, Brussino L, Canonica GW, Chaves Loureiro C, Cruz AA, Gemicioglu B, Haahtela T, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Okamoto Y, Ollert M, Pfaar O, Pham-Thi N, Puggioni F, Regateiro FS, Romantowski J, Sastre J, Scichilone N, Taborda-Barata L, Ventura MT, Agache I, Bedbrook A, Becker S, Bergmann KC, Bosnic-Anticevich S, Bonini M, Boulet L-P, Brusselle G, Buhl R, Cecchi L, Charpin D, de Blay F, Del Giacco S, Ivancevich JC, Jutel M, Klimek L, Kraxner H, Kuna P, Laune D, Makela M, Morais-Almeida M, Nadif R, Niedoszytko M, Papadopoulos NG, Papi A, Patella V, Petre B, Rivero Yeverino D, Robalo Cordeiro C, Roche N, Rouadi PW, Samolinski B, Savoure M, Shamji MH, Sheikh A, Ulrik CS, Usmani OS, Valiulis A, Yorgancioglu A, Zuberbier T, Fonseca JA, Costa EM, Bousquet Jet al., 2025,

    Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study

    , PULMONOLOGY, Vol: 31, ISSN: 2531-0437
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    • Citations: 11
  • Journal article
    Yin X, Meng J, Durham SR, Del Giacco S, Li L, Park H-S, Torres MJ, Li PH, Shamji Met al., 2025,

    East Meets West in Allergic Airway Disease: Insights From the EAACI Hong Kong Allergy School 2025.

    , Allergy
  • Journal article
    Cucco A, Simpson A, Murray C, Roberts GC, Holloway JW, Arshad SH, Custovic A, Fontanella Set al., 2025,

    Clustering lung function and symptom profiles for asthma risk stratification

    , Scientific Reports, ISSN: 2045-2322

    Asthma is a heterogeneous condition often studied through wheeze alone, yet the interplay between lung function and reported symptoms remains underexplored. To capture this heterogeneity, we applied Bayesian Profile Regression to data from school-age children in two prospective birth cohorts, integrating airway hyperresponsiveness, lung function, bronchodilator reversibility, allergic sensitisation, reported symptoms, and physician diagnosis. In the Manchester Allergy and Asthma Study (discovery cohort), five reproducible clusters were identified: HA-LLF (high asthma-low lung function), HA-NLF (high asthma-near-normal lung function), LA-LLF (low asthma-low lung function), LA-NLF (low asthma-normal lung function), and INT-SYM (intermediate asthma with prominent symptoms). The HA-LLF and HA-NLF clusters had very high asthma prevalence (80–100%), but differed markedly in lung function, airway responsiveness, bronchodilator reversibility, sensitisation, and symptom burden. The LA-HLF and LA-NLF clusters with low asthma prevalence (<5%) displayed contrasting lung function profiles, while INT-SYM (~50% asthma prevalence) was largely defined by prominent symptoms such as chest tightness and shortness of breath. These subtypes were replicated in an independent cohort, Isle of Wight. Our findings demonstrate that integrating physiological, immunological, and symptom-based measures yields clinically meaningful asthma subtypes beyond wheeze-based definitions and may support more precise disease classification.
  • Journal article
    Perikleous A, Lewis G, Bowen S-J, Pavord ID, Fleming L, Bush A, Griffiths Cet al., 2025,

    Acceptability and feasibility of biomarkers of airway eosinophilic inflammation for the management of preschool wheeze: a qualitative study

    , ARCHIVES OF DISEASE IN CHILDHOOD, ISSN: 0003-9888
  • Journal article
    Bush A, 2025,

    Preschool wheeze endotypes and their association with asthma attacks and ICS response

    , ERJ Open Research, ISSN: 2312-0541

    Background: Eosinophilic airway inflammation predicts asthma attacks and inhaled corticosteroid (ICS) response in adults; similar mechanisms may apply to preschool wheeze. This study assessed whether blood eosinophil count (BEC) alone or combined with allergic sensitisation and fractional exhaled nitric oxide (FeNO) was associated with future wheeze attacks. Methods: Ninety-five preschool children (aged 12-59 months) with clinician-confirmed wheeze were recruited from primary and secondary care. At baseline, finger-prick BEC, skin-prick testing for allergic sensitisation and offline FeNO were performed. Children were followed for eight-to-nine months. The primary outcome was the number of acute wheeze attacks diagnosed during unscheduled visits to an emergency department or general practitioner, documented by parental reports, medical records, or oral corticosteroid prescriptions. Exploratory analyses examined ICS association with wheeze attack odds across different biomarker subgroups. Results: Children with BEC had higher wheeze attack odds over nine months [N=60, Odds ratio (OR):4.27, 95%CI:1.7–11.38]. Odds were greatest in those with BEC and FeNO ppb (N=12, OR:60.74, 95%CI:2.98–1238.9). ICS prescription was associated with reduced three-month wheeze attack odds among children with elevated BEC (N=21, OR:0.11, 95% CI:0.02–0.49) or allergic sensitisation (N=19, OR:0.11, 95%CI:0.01–0.65), with further reduction when both were combined (N=10, OR:0.06, 95%CI:0.002–0.59). Conclusion: Elevated BEC may identify preschool children at increased wheeze attack odds, particularly when combined with FeNO. ICS treatment was associated with odd reduction in children with elevated BEC or allergic sensitisation. These findings provide rationale for future randomised controlled trials comparing biomarker-guided and symptom-based treatment strategies.
  • Journal article
    Vassilopoulou E, Tsabouri S, Arasi S, Comotti A, Milani GP, Ryczaj K, Agostoni C, Pagkalos I, Vlieg-boerstra B, Caballero-lopez CG, Feketea G, Nowak-wegrzyn A, Halken S, Beken B, Alvaro-lozano M, Padua I, Giovannini M, Du Toit G, Alvarez-perea A, Canani RB, Peroni D, Perez-gordo M, Shamji MH, Klimek L, Agache I, Berghea EC, Roth-walter F, Ozdemir C, Smith P, Mahony LO, Meyer RW, Venter Cet al., 2025,

    Healthcare Professional Survey on Complementary Feeding and Allergy Prevention in High- Versus Low-Risk Infants: An EAACI Task Force Report

    , ALLERGY, ISSN: 0105-4538
  • Journal article
    Antao J, Rodrigues G, Zounemat-Kermani N, Montuschi P, Deng Q, Franssen FME, Andersson LI, Adcock IM, Dahlen S-E, Wagers SS, Spruit MA, Marques Aet al., 2025,

    Proteomic and Transcriptomic Signatures of Poor Asthma Symptom Control in the U-BIOPRED Cohort

    , ALLERGY, ISSN: 0105-4538
  • Journal article
    Shamji MH, Boyle RJ, 2025,

    Prize Winning Abstracts From the BSACI 2025 Meeting

    , CLINICAL AND EXPERIMENTAL ALLERGY, ISSN: 0954-7894
  • Journal article
    Shamji MH, Boyle RJ, 2025,

    Mechanisms and Epidemiology of Drug Hypersensitivity: From Neutrophil Activation to ER Stress and Global Anaphylaxis Patterns

    , CLINICAL AND EXPERIMENTAL ALLERGY, ISSN: 0954-7894
  • Journal article
    Arigliani M, Venditto L, Irving S, Gardner L, Carr SB, Hogg C, Bush Aet al., 2025,

    Multiple Breath Washout in Primary Ciliary Dyskinesia: Potential for Lung Disease Monitoring

    , PEDIATRIC PULMONOLOGY, Vol: 60, ISSN: 8755-6863
  • Journal article
    Sousa-Pinto B, Bousquet J, Vieira RJ, Schünemann HJ, Zuberbier T, Bognanni A, Togias A, Samolinski B, Valiulis A, Williams S, Bedbrook A, Czarlewski W, Torres MJ, Shamji MH, Morais-Almeida M, Canonica GW, Vecillas LDL, Dykewicz MS, Jacomelli C, Klimek L, Leemann L, Lourenço O, Palamarchuk Y, Papadopoulos NG, Pereira AM, Savouré M, Toppila-Salmi SK, Ventura MT, Yepes-Nuñez JJ, Cruz AA, Ciprandi G, Gemicioglu B, Giovannini M, Gradauskiene B, Jartti T, Jeseňák M, Kuna P, Kvedariene V, Larenas-Linnemann DE, Latiff AH, Mohammad Y, Ohta K, Mahesh PA, Pali-Schöll I, Pfaar O, Regateiro FS, Roche N, Taborda-Barata L, Ulrik CS, Rostan MV, Viegi G, Zhang L, Haahtela T, Cherrez-Ojeda I, Carlos Ivancevich J, Khaltaev N, Yorgancioglu A, Abdullah B, Al-Ahmad M, Al-Nesf MA, Amaral R, Asllani J, Bergmann K-C, Bernstein JA, Blaiss MS, Braido F, Camargos P, Carreiro-Martins P, Casale T, Cecchi L, Fiocchi A, Giuliano AFM, Christoff G, Cirule I, de Sousa JC, Costa EM, Del Giacco S, Devillier P, Dokic D, Hossny E, Iinuma T, Irani C, Ispayeva Z, Julge K, Kaidashev I, Bennoor KS, Kraxner H, Kull I, Kulus M, Kupczyk M, Kurchenko A, La Grutta S, Miculinic N, Tuyet LLT, Makris M, Milenkovic B, Lee SM, Montefort S, Moreira A, Mullol J, Nadif R, Nakonechna A, Neffen HE, Niedoszytko M, Nyembue D, O'Hehir RE, Ogulur I, Okamoto Y, Olze H, Palomares O, Panzner P, Patella V, Pawankar R, Pitsios C, Popov TA, Puggioni F, Quirce S, Ramonaité A, Recto M, Repka-Ramirez MS, Roberts G, Robles-Velasco K, Rottem M, Salapatas M, Sastre J, Scichilone N, Sisul J-C, Solé D, Soto-Martinez ME, Sova M, Tantilipikorn P, Todo-Bom A, Tsaryk V, Tsiligianni I, Urrutia-Pereira M, Valovirta E, Vasankari T, Wallace D, Wang DY, Worm M, Yusuf OM, Zidarn M, Gil-Mata S, Marques-Cruz M, Mahboub B, Ansotegui IJ, Romano A, Aberer W, Artesani MC, Azzolini E, Barreto B, Bartra J, Becker S, Beghe B, Boner A, Borowiack E, Bouchard J, Bourgoin-Heck M, Brussino L, Buhl R, Castillo-Vizuete JA, Charpin D, Chavannes NH, Chełmińska M, Chenet al., 2025,

    Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part I-Guidelines on Intranasal Treatments.

    , Allergy

    BACKGROUND: Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024-2025). This manuscript presents the ARIA 2024-2025 recommendations for intranasal treatments, one of the mainstays for AR management. METHODS: The ARIA 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgments and recommendations, including systematic reviews, evaluation of mHealth and pharmacovigilance data, as well as a survey of experts on costs. RESULTS: Eleven guideline questions concerning intranasal treatments for AR were prioritized, leading to recommendations. Overall, these questions concern the choice between different classes of intranasal medications-most notably, intranasal corticosteroids (INCS), antihistamines (INAH), fixed combinations of INAH+INCS and decongestants-or between different individual medications within each class. Four questions had not been evaluated in previous ARIA guidelines, while for the other three there was a change in the strength or directionality of recommendations. Overall, recommendations point to the suggested use of INAH+INCS over INAH or INCS and INCS over INAH. CONCLUSION: This ARIA 2024-2025 article supports patients, their caregivers, and healthcare professionals in choosing an intranasal treatment. However, decisions on AR treatment should consider the clinical variability of the disease, patients' values, and the affordability of medications.
  • Journal article
    Lee CT, Ghandi SA, Elmrayed S, Barnes H, Lorenzetti D, Salibury ML, Stewart ID, Barber C, Peters CE, Feary J, Johannson KAet al., 2025,

    Inhalational exposures associated with risk of interstitial lung disease: a systematic review and meta-analysis

    , Thorax, Vol: 80, Pages: 918-926, ISSN: 0040-6376

    Rationale: Inhalational exposures are associated with risk of developing interstitial lung disease (ILD), yet the relationship between specific exposures and ILD is poorly characterized. Objective: Identify inhalational exposures associated with ILD and estimate the effects of exposures on ILD risk.Methods: MEDLINE and EMBASE databases were searched from 1990 until 2022 to identify inhalational exposures associated with ILD diagnosis. ILDs where causality is well-established (hypersensitivity pneumonitis, pneumoconiosis) and sarcoidosis were excluded. Two independent reviewers screened abstracts with full-text review and data extraction of eligible studies. Where possible, data were pooled and multi-level meta-analysis was specified using a random effects model. Sources of heterogeneity and risk of bias were assessed. Main Results: Ninety-six studies were included in the systematic review, representing 40,819,116 subjects (295,167 had ILD, 40,523,949 controls). For the meta-analysis, fifty-four studies were included (40,490,793 subjects: 273,899 ILD, 40,216,894 controls). Exposures associated with significantly increased ILD risk included smoking (OR 1.69, 95% CI 1.47-1.94), organic exposures (OR 1.56, 95% CI 1.12-2.16), metals (OR 1.52, 95% CI 1.07-2.16), dust (OR 1.45, 95% CI 1.20-1.76), and asbestos (OR 1.53, 95% CI 1.08-2.15). Silica and fumes had positive associations with ILD that trended toward significance. Conclusions: This systematic review and multilevel meta-analysis is the first to comprehensively assess the effect of inhalational exposures on overall risk of ILD, with multiple putative exposures identified. Future work should investigate novel occupational exposures associated with ILD, characterize the gene-environment interaction, and develop preventative strategies.
  • Journal article
    Piciucchi S, Adegunsoye A, Travis WD, Nicholson AG, Wells AU, Cooper WA, Khor YH, Wijsenbeek MS, Sharma A, Hariri LP, Antoniou K, Borie R, Fabre A, Inoue Y, Johannson KA, Johkoh T, Kawano-Dourado L, Kazerooni E, Maher TM, Molyneaux PL, Protti R, Ravaglia C, Renzoni EA, Saito-Koyama R, Sverzellati N, Walsh SLF, Wolters PJ, Yang S-R, Ryerson CJet al., 2025,

    Reply: The rationale for distinguishing RB-ILD and AMP

    , EUROPEAN RESPIRATORY JOURNAL, Vol: 66, ISSN: 0903-1936
  • Journal article
    Ryerson CJ, Adegunsoye A, Piciucchi S, Hariri LP, Khor YH, Wijsenbeek MS, Wells AU, Sharma A, Cooper WA, Antoniou K, Borie R, Fabre A, Inoue Y, Johannson KA, Johkoh T, Kawano-Dourado L, Kazerooni E, Maher TM, Molyneaux PL, Protti R, Ravaglia C, Renzoni EA, Saito-Koyama R, Sverzellati N, Walsh SLF, Wolters PJ, Yang S-R, Travis WD, Nicholson AGet al., 2025,

    Reply: Bronchiolocentric interstitial pneumonia is a morphological term used for lung biopsy and chest imaging pattern and is not a substitute for hypersensitivity pneumonitis

    , EUROPEAN RESPIRATORY JOURNAL, Vol: 66, ISSN: 0903-1936
  • Journal article
    Adams KE, Patel N, Hatcher VR, Bigas P, Golden DBK, Turner PJet al., 2025,

    Deprescribing Self-Administered Epinephrine: Why, Who, and When?

    , JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 13, Pages: 3201-3208, ISSN: 2213-2198

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