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The prevalence of asthma varies substantially across the European Union. It is estimated that the number of people aged 45 years and under with asthma in Europe is over 30 million. Asthma is one of the most common chronic long-term health conditions in Europe.
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International guidelines describe asthma as a chronic airway disease characterised by airway hyper-reactivity (AHR) caused by a range of processes including airway inflammation, bronchoconstriction of airway smooth muscle (ASM), airway infections, allergic responses, exposure to pollutants, exercise, stress, and nervous provocation. This coordinated agenda for asthma research and innovation will be used to address this major health and societal challenge and will be the foundation on which future European Union, national and international research funding programmes can transform asthma outcomes throughout Europe. The partnership has produced an evidence- and consensus-based list of the research priorities needed to reduce asthma deaths and hospitalisations. The EARIP project was established in 2013 to harmonise efforts to reduce mortality and morbidity from asthma by agreeing the most important research priorities in Europe. This manuscript describes a state-of-the-art view of the mechanisms involved in asthma onset, asthma progression and asthma exacerbations and is an outcome of the European Asthma Research and Innovation Partnership (EARIP: Readers are also referred to companion EARIP reports including a report describing the vision and call to action resulting from the EARIP project, to explore pathways for optimising asthma research in Europe, a report on national and regional asthma programmes in Europe and an editorial on building the case for more investment in asthma research in Europe. This report aims to identify the mechanistic areas in which investment is required to bring about significant improvements in asthma outcomes. The European Asthma Research and Innovation Partnership (EARIP) is an FP7-funded programme which has taken a co-ordinated and integrated approach to analysing the future of asthma research and development. Preventing, treating and ultimately curing asthma requires co-ordinated research and innovation across Europe. Therapeutic advances have been slow despite greater understanding of basic mechanisms and the lack of satisfactory preventative and disease modifying management for asthma constitutes a significant unmet clinical need. There is a wide spectrum of disease severity and control. It affects many millions of Europeans throughout their education and working lives and puts a heavy cost on European productivity.
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Asthma is a heterogeneous, complex disease with clinical phenotypes that incorporate persistent symptoms and acute exacerbations.
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