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Grand RoundsWeekly Evidence Brief

Allergy & Immunology

Edition

30-Second Takeaway

  • TSLPR blockade with verekitug shows strong biomarker suppression and good tolerability, but no clinical outcomes yet.
  • Real-world Korean registry data quantify severe asthma remission rates and highlight practical predictors clinicians can monitor and modify.
  • Microbiota–immune differences between IgE and non-IgE cow’s milk allergy with atopic dermatitis support finer endotyping beyond IgE status.
  • Preclinical work identifies epithelial metabolism, mast cell CysLT2R, IL-33, and nanodecoy vesicles as potential asthma targets.
  • Environmental and pollution-driven networks in pediatric asthma suggest new transcriptomic markers of susceptibility and exacerbation risk.

Week ending December 27, 2025

Asthma and Airway Disease: Emerging Targets, Remission Predictors, and Mechanistic Pathways

TSLPR antibody verekitug achieves full receptor occupancy and biomarker suppression with good safety in asthma

CLINICAL PHARMACOLOGY AND THERAPEUTICSDec 24, 2025

Adults with mild–moderate asthma received subcutaneous verekitug in multiple ascending-dose, placebo-controlled cohorts over 32 weeks. Doses ≥100 mg achieved complete TSLP receptor occupancy by 2 weeks, sustained for up to 24 weeks. Higher doses produced rapid, substantial, and durable reductions in FeNO, blood eosinophils, and IL-5 levels through 24 weeks. Adverse events were mild or moderate, and low-titer anti-drug antibodies had no meaningful impact on pharmacokinetics, pharmacodynamics, or safety. These data support further evaluation of verekitug in severe asthma, CRSwNP, and COPD, while clinical efficacy endpoints remain to be established.

Korean severe asthma registry quantifies remission and identifies practical clinical predictors

RESPIRATORY RESEARCHDec 27, 2025

This nationwide prospective registry followed 405 patients with severe asthma for 12 months to categorize remission status. At 12 months, complete clinical remission occurred in 5.9%, clinical remission in 18.3%, partial remission in 67.9%, and no remission in 7.9%. Higher baseline ACT score independently predicted higher remission category, whereas maintenance oral corticosteroid use markedly reduced remission odds. Baseline chronic cough also negatively predicted remission, and remission groups had better lung function, fewer exacerbations, and lower white blood cell counts. Baseline biologic use was more frequent in higher remission groups, while non-remitters more often received methylxanthines, macrolides, and systemic steroids.

Microbiota and immune signatures distinguish IgE from non-IgE cow’s milk allergy with atopic dermatitis

ISCIENCEDec 24, 2025

Infants with IgE- and non-IgE-mediated cow’s milk allergy plus atopic dermatitis were compared with healthy controls for skin and gut microbiota and immune markers. Skin microbiota in IgE-mediated cow’s milk allergy differed significantly from both healthy controls and non-IgE cow’s milk allergy despite similar dermatitis severity. Non-IgE cow’s milk allergy patients had higher soluble CD14 responses to bacteria than IgE-mediated patients, indicating distinct innate immune activation. They also exhibited more regulatory T cells in blood that preferentially migrated into the intestine compared with IgE-mediated patients. These data support distinct gut–skin axis and immune regulatory programs in IgE versus non-IgE cow’s milk allergy with atopic dermatitis.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Upstream TSLPR inhibition yields deep, sustained type 2 biomarker suppression, positioning it as a potential alternative to current asthma biologics.
  • Severe asthma remission is uncommon but achievable; higher baseline control and lower steroid burden clearly favor better outcomes.
  • Food allergy and asthma research is moving toward multi-omic endotyping, incorporating microbiome, metabolic, and transcriptomic signatures.