Allergy & Immunology

Distinct clusters identify treatable traits across difficult-to-treat and mild asthma

Cluster analysis in two UK cohorts (WATCH-DA n=498; EOSA-MA n=67) identified six difficult-to-treat and two mild asthma clusters, all T2-predominant. Clusters differed by sex, age of onset, BMI, blood eosinophils, spirometry, treatment needs, comorbidity patterns, and quality of life. Some clinically controlled clusters had high comorbidity despite lower airway morbidity, suggesting comorbidity-driven care needs. Recognition of cluster-specific traits supports early personalized management addressing both airway disease and comorbid conditions. 1

Paradoxical Akkermansia enrichment during asthma exacerbations in children

Longitudinal study of 173 children (82 asthma, 91 controls) found lower Akkermansia, Anaerostipes, and Escherichia in asthma versus controls. Escherichia abundance correlated negatively with C-ACT scores and Akkermansia correlated negatively with PEF. Paired analyses showed Akkermansia was paradoxically enriched during exacerbations (LDA=3.66, p=0.023). Authors caution that microbiome–asthma interactions vary by phenotype and therapy, challenging one-size-fits-all probiotic approaches. 2

irAEs predict longer survival in advanced NSCLC; corticosteroids do not erase benefit

Multicenter retrospective cohort of 452 advanced NSCLC patients treated with ICIs found irAEs in 33.4% and grade ≥3 in 8.2%. Patients with irAEs had markedly longer median PFS (23.2 vs 4.2 months) and OS (31.2 vs 7.6 months). Corticosteroid treatment for irAEs (received by 60 patients) did not negate the survival advantage associated with irAEs. Temporary or permanent ICI discontinuation for toxicity was also associated with longer PFS in this cohort. 3