{"id":21,"date":"2026-08-23T18:50:03","date_gmt":"2026-08-23T18:50:03","guid":{"rendered":"https:\/\/test.rhino-health.org\/?page_id=21"},"modified":"2026-08-27T13:13:41","modified_gmt":"2026-08-27T13:13:41","slug":"discoveries","status":"publish","type":"page","link":"https:\/\/rhino-health.org\/?page_id=21","title":{"rendered":"Discoveries"},"content":{"rendered":"
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Our Discoveries<\/div>\n

What RHiNO has taught us about lung health after preterm birth<\/h1>\n

\n RHiNO has moved from describing respiratory symptoms and reduced lung function to identifying
\n prematurity-associated lung disease (PLD), distinct physiological phenotypes, treatment responses,
\n mechanisms and lifelong respiratory trajectories.\n <\/p>\n

\n Browse RHiNO publications<\/a>
\n PLD & phenotypes<\/a>\n <\/div>\n<\/p><\/div>\n
\n \"Illustration\n <\/div>\n<\/p><\/div>\n<\/section>\n
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Ten key discoveries<\/div>\n

From long-term lung impairment to a new framework for PLD<\/h2>\n

\n Together, RHiNO studies show that respiratory disease after preterm birth is heterogeneous,
\n biologically complex and potentially modifiable. The findings provide a basis for more precise
\n diagnosis, follow-up and intervention.\n <\/p>\n

\n
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01<\/div>\n

Preterm birth can alter lung health long after infancy<\/h3>\n

\n Children born preterm have an increased risk of respiratory symptoms and lower expiratory airflow
\n at school age. These abnormalities are not confined to children born extremely preterm or those
\n diagnosed with BPD as neonates.\n <\/p>\n

Why it matters:<\/strong> prematurity should be considered a lifelong respiratory exposure, not simply a neonatal event.<\/div>\n<\/article>\n
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02<\/div>\n

BPD does not fully explain later respiratory disease<\/h3>\n

\n Bronchopulmonary dysplasia remains important, but later lung function reflects multiple developmental
\n influences including gestational age, fetal growth and postnatal exposures. Abnormal physiology can
\n occur even in children without neonatal BPD.\n <\/p>\n

Why it matters:<\/strong> later respiratory assessment should be based on current physiology as well as neonatal history.<\/div>\n<\/article>\n
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03<\/div>\n

PLD comprises distinct physiological phenotypes<\/h3>\n

\n RHiNO helped characterise POLD<\/strong>, pPRISm<\/strong> and
\n pDysanapsis<\/strong>, alongside a preterm control pattern. These phenotypes are defined using
\n routinely measured spirometry and show that PLD is not one uniform disease.\n <\/p>\n

Why it matters:<\/strong> different phenotypes may have different mechanisms, prognoses and treatment responses.<\/div>\n<\/article>\n
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04<\/div>\n

Some airflow limitation is reversible<\/h3>\n

\n Bronchodilator testing demonstrates that a substantial proportion of abnormal pre-bronchodilator
\n spirometry can move into the preterm-control range after treatment, but the degree of reversibility
\n differs according to physiological phenotype.\n <\/p>\n

Why it matters:<\/strong> PLD should not automatically be assumed to represent fixed airway disease.<\/div>\n<\/article>\n
\n
05<\/div>\n

Inhaled treatment can improve lung function<\/h3>\n

\n The RHiNO randomised clinical trial showed clinically important improvement in lung function with
\n combined inhaled corticosteroid\/long-acting \u03b22<\/sub>-agonist therapy in selected preterm-born
\n children with reduced lung function.\n <\/p>\n

Why it matters:<\/strong> at least part of prematurity-associated airflow limitation is treatable.<\/div>\n<\/article>\n
\n
06<\/div>\n

Exercise reveals consequences beyond resting spirometry<\/h3>\n

\n Exercise studies show abnormalities in cardiorespiratory performance after preterm birth, including
\n differences in ventilatory and physiological responses that are not fully captured by a resting
\n spirometry measurement.\n <\/p>\n

Why it matters:<\/strong> functional respiratory health is broader than FEV\u2081 alone.<\/div>\n<\/article>\n
\n
07<\/div>\n

Advanced MRI reveals regional lung abnormalities<\/h3>\n

\n Hyperpolarised-gas MRI and complementary physiological techniques can identify regional abnormalities
\n of ventilation and gas exchange in preterm-born children that may be missed by conventional global
\n lung-function measurements.\n <\/p>\n

Why it matters:<\/strong> children with similar spirometry can still have different underlying lung structure and function.<\/div>\n<\/article>\n
\n
08<\/div>\n

The environment can add to developmental lung vulnerability<\/h3>\n

\n RHiNO research into ambient air pollution highlights the importance of potentially modifiable
\n postnatal exposures acting on lungs whose development was already altered by preterm birth.\n <\/p>\n

Why it matters:<\/strong> preserving lung health after discharge may influence future respiratory trajectories.<\/div>\n<\/article>\n
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09<\/div>\n

Biology may connect POLD with later obstructive lung disease<\/h3>\n

\n Metabolomic and mechanistic studies identify disturbances in pathways related to oxidative stress,
\n energy metabolism and airway biology. Some abnormalities seen in POLD resemble those reported in
\n adult COPD.\n <\/p>\n

Why it matters:<\/strong> childhood PLD may provide early clues to later chronic respiratory risk.<\/div>\n<\/article>\n
\n
10<\/div>\n

Lung health is a trajectory, not a single measurement<\/h3>\n

\n RHiNO is increasingly studying how PLD phenotypes and lung function change through adolescence
\n and towards adulthood. Some physiological patterns appear more stable than others, while some
\n individuals transition between phenotypes as their lungs grow.\n <\/p>\n

Why it matters:<\/strong> the long-term goal is to identify adverse trajectories early enough to modify them.<\/div>\n<\/article><\/div>\n<\/p><\/div>\n<\/section>\n
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The PLD framework<\/div>\n

One of RHiNO’s most important contributions is recognising heterogeneity<\/h2>\n

\n The concept of prematurity-associated lung disease moves beyond a single neonatal label and asks
\n what physiological pattern an individual has later in life.\n <\/p>\n

\n \"Illustrated
\n PTc, POLD, pPRISm and pDysanapsis<\/strong> provide a clinically accessible framework
\n for studying mechanisms, reversibility, prognosis and treatment.
\n <\/figcaption><\/figure>\n
\n Explore PLD & phenotypes<\/a>\n <\/div>\n<\/p><\/div>\n<\/section>\n
\n
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Featured science<\/div>\n

The 2026 Lancet Respiratory Medicine PLD Series<\/h2>\n

\n In January 2026, a three-paper Series brought together the emerging PLD framework across the life course:
\n its phenotypes, respiratory trajectories and management from infancy to adulthood.\n <\/p>\n

\n
\n 01<\/span><\/p>\n

PLD and its phenotypes<\/h3>\n

Defining the physiological framework and moving beyond BPD alone.<\/p>\n<\/article>\n

\n 02<\/span><\/p>\n

Lifelong lung-function trajectories<\/h3>\n

Understanding how respiratory impairment evolves from childhood into adult life.<\/p>\n<\/article>\n

\n 03<\/span><\/p>\n

Management across the life course<\/h3>\n

Bringing together assessment, treatment and prevention from infancy through adulthood.<\/p>\n<\/article><\/div>\n

\n Explore the PLD Series<\/a>
\n Browse all publications<\/a>\n <\/div>\n<\/p><\/div>\n<\/section>\n
\n
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From discovery to impact<\/div>\n

What these findings could change<\/h2>\n
\n
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Better recognition<\/h3>\n

Identify physiological abnormality rather than relying on symptoms or neonatal history alone.<\/p>\n<\/article>\n

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More targeted treatment<\/h3>\n

Match therapy more closely to reversibility and physiological phenotype.<\/p>\n<\/article>\n

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More personalised follow-up<\/h3>\n

Focus surveillance on children and young adults whose lung-function trajectories appear most vulnerable.<\/p>\n<\/article>\n

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Healthier lifelong trajectories<\/h3>\n

Ultimately test whether earlier intervention can preserve lung growth and reduce later chronic respiratory disease.<\/p>\n<\/article><\/div>\n<\/p><\/div>\n<\/section>\n

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\n \"Illustration\n <\/div>\n
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Where RHiNO is going next<\/div>\n

From childhood phenotype to adult respiratory health<\/h2>\n

\n The next phase of RHiNO is increasingly longitudinal. Current analyses ask how stable PLD phenotypes are,
\n which abnormalities respond to bronchodilator treatment, how genetic susceptibility influences PLD,
\n and whether childhood physiological patterns predict later respiratory health.\n <\/p>\n

\n RHiNO is increasingly asking not only whether lung function is abnormal, but which phenotype an
\n individual has, why it developed, whether it changes with growth, and whether its trajectory can be modified.\n <\/p><\/blockquote>\n

\n The RHiNO Study<\/a>
\n Research & publications<\/a>\n <\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n
\n
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Explore RHiNO in more detail<\/div>\n
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PLD & Phenotypes<\/h3>\n

PTc, POLD, pPRISm and pDysanapsis.<\/p>\n

Explore \u2192<\/a><\/article>\n

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The RHiNO Study<\/h3>\n

Recruitment, assessments, timeline and follow-up.<\/p>\n

Explore \u2192<\/a><\/article>\n

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Publications<\/h3>\n

The complete thematic RHiNO research library.<\/p>\n

Browse \u2192<\/a><\/article>\n

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Participants & Families<\/h3>\n

The people whose participation made the discoveries possible.<\/p>\n

Explore \u2192<\/a><\/article>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Our Discoveries What RHiNO has taught us about lung health after preterm birth RHiNO has moved from describing respiratory symptoms and reduced lung function to identifying prematurity-associated lung disease (PLD), distinct physiological phenotypes, treatment responses, mechanisms and lifelong respiratory trajectories. Browse RHiNO publications PLD & phenotypes Ten key discoveries From long-term lung impairment to a […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-21","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/pages\/21","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rhino-health.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21"}],"version-history":[{"count":2,"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/pages\/21\/revisions"}],"predecessor-version":[{"id":41,"href":"https:\/\/rhino-health.org\/index.php?rest_route=\/wp\/v2\/pages\/21\/revisions\/41"}],"wp:attachment":[{"href":"https:\/\/rhino-health.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}