The Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) ERS Clinical Research Collaboration: a new dawn in asthma research

The past 30 years have seen major advances in the understanding of asthma mechanisms and the clinical introduction of effective medicines based on these pathways. The first major step-change occurred in the 1980s with the development of bronchial challenge as a research tool to dissect the airways inflammatory responses [1, 2]. The advent of bronchoscopy and sputum induction in the early 1990s, to study asthma pathology in vivo, enabled the description of characteristic features of airways inflammation and remodelling [3–6], while epidemiological and challenge studies showed viruses to be the main cause of asthma exacerbations [7, 8]. One of the greatest discoveries was the central role of Type-2 cytokines driven by the interleukin (IL)-4/IL-13 and IL-5 pathways, for which simple biomarkers, like sputum eosinophils and exhaled nitric oxide, were discovered [9, 10]. However, it was not until early 2000s that the basic science translated into fundamentally novel treatments, beginning the “era of biological treatments” with the anti-IgE antibody, omalizumab [11]. It took almost 15 years for the next biologics to arrive, targeting the pro-eosinophilic cytokine IL-5, showing how difficult drug development can be [12, 13]. SHARP (Severe Heterogeneous Asthma Research collaboration, Patient-centred) is set up to harmonise severe asthma management across Europe and unravel the heterogeneity of severe asthma in a patient-centred way http://ow.ly/s1x730mwLpk