R Djukanovic NIHR EME: BEyond Allergic Th2 Difficult to treat Severe Asthma (BEAT-Severe Asthma)

Research interests

• Professor Djukanovic has a lifelong interest in asthma, especially its severe forms. where his focus is on: 1) underlying pathobiological mechanisms of asthma, 2) stratification of asthma into clinical phenotypes and mechanism-based endotypes, 3) unmet needs of severe asthma management. He also has an interest in the mechanisms and treatments of severe viral infections of the lung.
• Underlying mechanisms of asthma: Professor Djukanovic has conducted pioneer studies into the pathology of asthma, applying research bronchoscopy  (with endobronchial biopsy and bronchoalveolar lavage) and sputum induction. He led the initial task forces which defined the use of these two techniques, thereby paving the way for standardised research approches that enabled in-depth descriptions of the roles of various inflammatory cells and their mediators. He developed an explant model, consisting of bronchial biopsies placed into tissue culture, that could be stimulated ex vivo with relevant triggers, applying as needed, novel agents not yet approved for in vivo use in humans volunteers. 
• Stratification of asthma into clinical phenotypes and mechanism-based endotypes: Professor Djukanovic led the discovery of biomarkers using omics technology (transcriptomics, proteomics, lipidomics, breathomics). After the first ever study of transcriptomics biomarkers in the epithelium of patients with Chronic Obstructive Pulmonary Disease (COPD), together with a colleague from Amsterdam and two colleagues from Imperial College, London, he created a large (€27 milllion) programme for severe asthma (U-BIOPRED), funded by the EU Innovative Medicines Initiative. This has resulted in more than 100 publications, providing insight into novel phenotypes and endotypes of asthma.