In people with chronic lung conditions such as asthma, cystic fibrosis or bronchiectasis, the common airborne mould Aspergillus fumigatus (AF) can cause a severe hypersensitivity reaction of the lungs. This disease is called allergic bronchopulmonary aspergillosis (ABPA). ABPA affects around 8% of patients with asthma and 15% of people with cystic fibrosis. If not properly recognized and treated, ABPA can lead to permanent damage to the airways, thus resulting in deterioration of the performance of the lungs. AF is ubiquitous and we all inhale countless spores every day. Nevertheless, most people do not develop illnesses because their immune system is strong enough to withstand the effect. The airways of people who are adversely affected are more vulnerable to repeated inhalation of AF. Such people easily get sensitized and produce antibodies directed to AF. Progression from sensitization to ABPA may be a slow process. When ABPA is suspected as a cause of airway exacerbation, the presence of such antibodies is important for diagnosis. Many teams are working to characterise how the immune system responds to AF and this research can lead to improved diagnosis and treatment of ABPA. However, there are currently no recommendations for clinical practice. We plan to establish an EAACI Task Force which would review and analyse currently available evidence in order to provide a position paper with evidence-based recommendations on the diagnosis and treatment of ABPA.

Antibiotics are one of the most frequently prescribed medicines; therefore antimicrobial resistance is on a steep rise posing a threat for human health. This has led to several antibiotic stewardship programmes, but these are mainly aimed at hospitalised patients. Patients with allergic diseases, such as asthma and eczema, are at increased risk for infections and subsequent antibiotic use, both in the outpatient- and inpatient clinic. There is however controversy whether antibiotics will do benefit (or even harm) in patients with acute allergic disease exacerbations. Moreover, antibiotic use at a very young age is associated with the development of allergic diseases. Within this EAACI task force, consisting of diverse clinicians and basic scientists, we aim to summarize all current knowledge of the effects of antibiotics on the development and treatment of allergic diseases (asthma, eczema). With this knowledge, we will be able to write position papers and guidelines to promote rational antibiotic use. We will also identify gaps of knowledge with respect to antibiotic stewardship in allergic diseases to direct new research areas.

The prevalence of allergic diseases is increasing worldwide. In Europe alone, ~150 million citizens suffer from chronic allergic diseases, and it is estimated that, by 2025, more than 50% of Europeans will suffer allergy (Source: EAACI advocacy manifesto). This enormous disease burden has a negative impact at the health, social and economic level, remedy of which requires action by policy makers, lay public, clinicians and researchers worldwide. Activities to solve the allergy-epidemic require funding by public agencies. In thatregard, it is becoming more important that clinicians and scientist translate their findings into lay languagefor information of the general public, politicians, policy makers and potential donors. Moreover, adequate education of patients plays an important role in everyday clinical work to ensure full success of medical treatment. Due to the increasing need for common scientific understanding, some excellent public outreach activities have been published in the field of allergy by the EAACI. In an additional effort to maximize the accessibility and visibility of the knowledge generated by EAACI, this TF focuses on EAACI position papers,which are documents supported by a line-up of experts and cover clinically relevant issues and novel ideas in the field. Improving the accessibility of such types of documents would have a remarkable impact in combating the allergy-epidemic.

Asthma is a heterogeneous disease with various phenotypes. Currently, patients with asthma can be classified based on their inflammatory cell profile such as eosinophilic, neutrophilic, or mixed granulocytic or by atopic status and time of disease onset. Additionally, some asthmatics are triggered by viral infections whereas some are not. These factors make it clear that asthma characteristics and treatment responses are different in distinct individuals and, most likely, involve diverse biological processes, so called endotypes. A better description of these endo/phenotypes may guide personalized treatment approaches in the future.

Both genetic and epigenetic alterations contribute to altered immune responses in the airways of asthmatics. Gene regulatory microRNAs (miRNAs) have recently emerged as a research field with critical roles in the regulation of many biological processes. These noncoding RNA molecules (17-27 nucleotides) can, by their ability to bind specific messenger (m)RNAs, repress translation or promote mRNA degradation of their target genes. In addition to fine-tuning the expression of target genes, miRNAs have been shown to be of crucial importance in inflammatory processes, where they take part in the regulation of both adaptive and innate immune responses as well as tissue homeostasis. Evolutionarily, miRNAs are highly conserved, which facilitates translational research. In addition, miRNAs have been found to be extremely stable in serum. These features make miRNAs potential novel biomarkers for chronic and heterogeneous diseases like asthma. Furthermore, disease-associated miRNAs may also be targets for treatment, as well as predicting treatment responses in asthmatics.

The overall aim: The TF aims to describe current knowledge of miRNA involvement in asthma related pathogenic processes and to critically evaluate the role of microRNAs as potential biomarkers and therapeutics in allergy and asthma.