Immune-mediated diseases (IMIDs) are an increasing medical burden in industrialized countries worldwide. IMIDs are characterized by an enormous heterogeneity with regard to disease outcome and response to targeted therapies, which currently cannot be adequately anticipated to tailor individual patient management. Hence, mechanistic understanding of this heterogeneity and biomarkers predictive for disease control and therapy response over time are important prerequisites of a future precision medicine in IMIDs. ImmUniverse has been formed as a European transdisciplinary consortium to tackle these unmet needs and to understand the role of the crosstalk between tissue microenvironment and immune cells in disease progression and response to therapy of two different IMIDs: ulcerative colitis and atopic dermatitis. Following this unique cross-disease approach ImmUniverse will fill the gap and the limitations of current studies, which do not systematically compare the complex interactions between recirculating immune cells and the respective tissue microenvironment. The consortium will combine analysis of tissue-derived signatures with “circulating signatures” detectable in liquid biopsies, employing state-of-the-art profiling technologies corresponding to multi-Omics datasets. The project will also bring diagnostics in IMID to a new level by implementing disruptive non-invasive liquid-biopsy methodology in combination with novel, validated circulating biomarker assays which are expected to improve diagnosis, inform early in the clinical course on disease severity and progression and enable treatment response monitoring. The identified signature will be validated to monitor state/progression and response to therapy in prospective observational cohorts. Realization of these objectives will result in improvement of patient management, lead to increased patient well-being and will significantly reduce the socioeconomic burden of these diseases.

The asthma pandemic imposes a huge burden on patients and health systems in both developed and developing countries. Notwithstanding major efforts in untangling its pathophysiology, we are not even close to reaching a cure. Despite available treatments, symptom control is generally suboptimal and hospitalisations and deaths remain at unacceptably high levels. This calls for disruptive innovation towards a long-term treatment strategy. Asthma is an inflammatory condition associated with immune deviations, most often atopic allergy. However, a key characteristic of asthma that remains relatively unexplored is susceptibility to infection. Most acute asthma attacks follow upper respiratory infections; infections are also associated with asthma initiation and persistence. Recent studies reveal that the respiratory microbiome is characteristically imbalanced (dysbiotic) in asthma. Our own data indicate that a feature of dysbiosis in asthma is reduced abundance of bacteriophages (phages). These bacterial viruses infect and are able to naturally control bacterial populations. Phage therapy has been grossly neglected in the western world and is currently just appearing as a novel tool against infection. However, it has never been used for rebalancing dysbiosis in humans. We propose that reinstating eubiosis within the asthmatic airway through phage therapy is feasible and will be able to control the immune dysregulation and clinical presentation of the disease. To achieve this, we must be able to predict the effects of adding phage mixtures to the complex ecology of the airways and design appropriate interventions. In CURE, we will develop a predictive model using information from virus-bacterial interactions, host responses and clinical disease expression, validated and fine-tuned using an in-vitro host-microbe-phage interface system. The project will develop phage preparations as candidates for clinical testing in asthma

myAirCoach aims to develop a holistic mHealth personalised asthma monitoring system empowering patients to manage their own health by providing user friendly tools to increase the awareness of their clinical state and effectiveness of medical treatment. This will be achieved through a multi-disciplinary approach aiming at the development of an ergonomic, compact and efficient sensor-based inhaler that will be in continuous communication with a mobile device. This sensing infrastructure will have the capability of automated monitoring of several clinical, behavioural and environmental factors in realistic conditions. A pipeline of advanced analysis, processing and computational modelling techniques, dealing with raw measurements, extracted features, indicators, and personal profile data representation will ensure clinical state awareness and a timely optimal treatment. Besides, a "personal mHealth guidance system" will empower patients to customize their treatment towards personalised preset goals and guidelines, either automatically or driven by healthcare professional in a telemedicine manner. In this context, myAirCoach will give to clinicians early indications of increasing symptoms or exacerbations, while making an important contribution in successfully self-management of asthma. The myAirCoach framework will be quantified and evaluated in two test campaigns with carefully designed cohorts of patients in three testing sites. Besides the obvious necessity of the test campaigns to ground the myAirCoach patient models and framework with data, the objective formal validation of the results is expected to lead to increased confidence in the myAirCoach approach and in ICT decision support and self-management systems in general. The impact of such a holistic and innovative approach is huge and the foundations laid here are expected to result in a widespread adoption of sensor-based self-management systems not only in asthma, but also in other respiratory diseases.