Asthma affects millions worldwide. Long non-coding RNA (lncRNA) are emerging as important factors in the pathophysiology of asthma and respiratory illnesses. LncRNA serve important regulatory roles in numerous pathways, especially gene expression. Nuclear paraspeckle assembly transcript 1 (NEAT1) and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) are two of the most well-studied lncRNA. This review highlights the current evidence of mechanisms involving lncRNA, particularly NEAT1 and MALAT1, in asthma pathophysiology and viral-induced exacerbations, and as novel targets for therapies targeting asthma, asthma-related symptoms and airway remodelling.
BACKGROUND:This paper reports a Phase 1, randomised, placebo-controlled, dose-escalation trial (NCT06037148) with DM-101PX that contains a recombinant hypoallergenic Bet v 1 variant formulated with thermosensitive hydrogel. The objectives of the study included assessment of treatment-related adverse events and the number of participants reaching the maximum dose. In addition, Bet v 1-specific immunoglobulins were analysed to explore the immunological effects of treatment. The trial was funded by Desentum Oy. METHODS:The study included three cohorts differing in starting and maximum dose. Per cohort, subjects were randomised (4:1) to receive 10 weekly subcutaneous injections with DM-101PX or placebo. Main inclusion criteria comprised adult subjects with a birch pollen allergy for ≥ 2 years, positive skin prick test, birch pollen-IgE ≥ 0.7 kU/L and symptoms upon exposure to birch pollen. The randomisation schedule was generated using software. During the trial, the investigator, clinic staff, participants and sponsor remained blinded to the treatment groups. The primary endpoint was the occurrence of treatment emergent adverse events and adverse events of special interest. RESULTS:In each cohort, 10 subjects were randomised and all were used for analysis of safety data. Treatment-related adverse events were reported by 22/24 (91.7%) DM-101PX treated subjects and by 5/6 (83.3%) placebo-treated subjects, which were only of mild or moderate intensity. The DM-101PX and placebo-treated subjects had mainly local injection site reactions, 138/153 (90.2%) and 22/24 (91.2%), respectively. Fifteen systemic allergic reactions were reported by 5/24 (20.8%) DM-101PX-treated subjects, and 2 systemic allergic reactions were reported by 1/6 (16.7%) placebo-treated subject, all of which were of Grade 1. 21/24 (88%) of subjects reached the maximum dose. Treatment with DM-101PX induced pronounced levels of Bet v 1-specific IgG4 and post-treatment sera effectively blocked basophil activation. CONCLUSIONS:This small study demonstrated that DM-101PX was generally well tolerated and induced a strong and functional immune response.
Summary Dupilumab drives coordinated microbiome remodelling with divergent bacterial and fungal responses in children. Skin–gut associations, bridge taxa, and functional recovery converge to implicate gut–skin crosstalk.
Summary Asthma shows distinct sphingolipid signatures in children, strongly modified by body mass index. Understanding sphingolipid alterations may enable biomarker identification and targeted therapies for children with obesity‐associated asthma.
Processionary moths (Thaumetopoea spp.), particularly the oak processionary moth (Thaumetopoea processionea), are an increasingly relevant cause of allergic and toxic disease in Europe, occurring in the context of reported range expansion, changing environmental conditions and persistent contamination with airborne urticating hairs (setae). Clinical manifestations range from toxic-irritant dermatitis and ocular injury to respiratory symptoms, while a subset of exposed individuals develops genuine IgE-mediated disease, including rhinoconjunctivitis, asthma, and rare cases of anaphylaxis. These presentations reflect two mechanistically distinct endotypes: (i) toxin-driven epithelial penetration by the urticating hairs with neuro-inflammatory activation and (ii) allergen-specific sensitisation to defined molecular components such as Tha p 1 and Tha p 2. Accurate endotype differentiation is clinically relevant, as symptom latency, severity, and risk of systemic progression differ substantially. Diagnostic evaluation relies on exposure history and phenotype recognition, complemented in selected cases and experienced centres by skin testing using research-grade extracts and emerging component-resolved approaches. Basophil activation testing may provide additional mechanistic insights in selected cases. Management comprises prompt decontamination, anti-inflammatory therapy, urgent ophthalmologic assessment when eye involvement is suspected, and guideline-based management of anaphylaxis. The environmental persistence of setae and recurrent seasonal exposure highlight the need for improved surveillance, validated molecular diagnostics, and translational research defining immune mechanisms and biomarkers.
Summary Box Upadacitinib 30 mg had the highest stringent short‐term response estimates. Efficacy advantages require balancing against tolerability and certainty limits.
Summary Soluble FGL2 is elevated in eosinophilic nasal polyps and correlates with Th2 inflammation. FGL2 blockade suppresses type 2 cytokines, suggesting a potential involvement in type 2 inflammation.
