A Christmas and New Year message to our supporters

Dearest supporter

As we find ourselves at the close of another year, we want to send our warmest wishes to you and your families.

It is astonishing how far we have come since 2011 – from a small seed of an idea to a charity that has helped shape national and international work in pulmonary fibrosis (PF), interstitial lung disease (ILD), infection and respiratory imaging. None of this would have been possible without your generosity, your belief in what we are trying to achieve and your steadfast support. Thank you.

Key research achievements in 2025

• Early detection of ILD and PF – This year has seen a remarkable breadth of progress in our research, both in the laboratory and in clinical practice. One of the themes running through 2025 has been the importance of recognising lung disease early, well before symptoms emerge. A major study we published this autumn looked at interstitial lung abnormalities seen in lung cancer screening programmes (1). These subtle changes on CT scans are increasingly common, and until now we have struggled to understand which ones matter. Our work showed that certain patterns signal a higher risk of developing clinically important ILD, while others are more benign. This gives us, for the first time, a clearer way of identifying who needs monitoring and who might benefit from early referral – a significant step toward detecting pulmonary fibrosis at the very beginning of its journey.
• Understanding the role of the immune system in idiopathic pulmonary fibrosis (IPF) – Another highlight of the year was our work on the immune system, and in particular how neutrophils behave in IPF (2). These cells, often thought of as simple foot soldiers of the immune response, appear to be markedly different in IPF compared with healthy individuals. Their altered behaviour may be doing more than signalling inflammation; they may be directly contributing to the pattern of scarring we see in the lungs. This line of research, building on several years of work at UCL, continues to transform our understanding of why fibrosis develops and how we might interrupt the process.
• Advances in imaging in ILD – Our imaging programme has also moved forward in important ways. This year, we published evidence that FDG PET/CT predicts survival in systemic sclerosis–associated ILD, reinforcing PET as a valuable tool across the wider ILD spectrum (3). This sits alongside our ongoing work with new tracers such as PSMA and markers of B-cell activity, which offer us the tantalising possibility of tracking inflammatory and fibrotic changes before they manifest clinically. These discoveries strengthen our belief that imaging will play a central role in how we diagnose, monitor and treat ILD in the coming years.
• Pleuroparenchymal fibroelastosis (PPFE) – We have also been continuing work on a rare fibrotic lung condition, called PPFE. This can develop in some people after intensive treatments such as bone-marrow or lung transplantation, often years after recovery from cancer or other serious illness, though it can also occur later in life. The condition causes gradually increasing breathlessness and has characteristic changes on chest imaging. At present, the underlying causes are not fully understood and there are no proven disease-modifying treatments, so care is individualised and cautious, particularly as weight loss and frailty can be important features. Related work from UCL has also shown that people with IPF who have features of PPFE on imaging tend to do less well overall, highlighting the importance of recognising these patterns. We are particularly interested in earlier identification using imaging, and developing novel treatments for this devastating disease. We hope this will become an increasing focus of our work over the next few years.
• Post-COVID lung disease and the microbiome – We were delighted to publish work comparing the respiratory microbiome in patients with post-COVID residual lung abnormalities to those with IPF (4). Despite some superficial similarities on imaging, the microbiomes were entirely different, with the post-COVID group more closely resembling healthy individuals. This provides reassurance to many people still recovering from COVID that what they are experiencing is not the same as PF and helps clinicians make clearer decisions about prognosis and treatment.
• Bronchiectasis treatments and personalised care – Beyond ILD, this has also been a significant year for our work on lung infection and bronchiectasis, another area of our focus. In 2025, our team contributed to an important clinical study evaluating whether nebulised hypertonic saline or carbocisteine could reduce infective exacerbations in bronchiectasis (5). While neither treatment significantly lowered flare-up rates overall, many patients still felt better, and certain subgroups may benefit in ways we are only beginning to understand. These findings reinforce our commitment to tailoring treatments to the individual rather than relying on a one-size-fits-all approach.
• Longterm antibiotic use in bronchiectasis – We contributed to a major study showing that far more people with bronchiectasis could benefit from long-term azithromycin prophylaxis than previously recognised (6). Current guidelines limit macrolide prophylaxis to patients with frequent exacerbations, but the new evidence demonstrates that those with significant daily symptoms, especially sputum production, also experience meaningful benefit. This aligns strongly with our real-world clinical practice, where we often see symptomatic patients gaining better quality of life and improved stability when supported early with macrolides.
• Mental health and bronchiectasis – We were also involved in research showing that anxiety and depression are common in people with bronchiectasis, and that those experiencing poorer mental health had more frequent exacerbations (7). This finding underscores something we see every day in all our clinics, bronchiectasis and ILD: supporting emotional wellbeing is not an optional extra – it is a core part of good respiratory care.
• Global research into tuberculosis – Looking beyond ILD and bronchiectasis, we contributed to a major global review of lung function in people who had previously been treated for pulmonary tuberculosis (8,9). The findings showed just how common long-term impairment is, especially in low- and middle-income countries, where the burden of TB remains high. Although this is not classical ILD, the overlap in physiology and long-term scarring means that insights from TB lung disease continue to inform our broader understanding of fibrosis and post-infectious damage.

Vaccination, infection prevention and national guidelines

• RSV vaccination and national policy – Our wider infection and vaccination work also reached an important milestone this year. Professor Brown, as part of the UK Joint Committee on Vaccination and Immunisation (JCVI), has helped guide national vaccine strategy. A new vaccine against Respiratory Syncytial Virus (RSV), a major trigger of exacerbations in people with chronic lung disease, was introduced for 75–79-year-olds in 2024. Early data show a substantial reduction in RSV-related hospital admissions in this group, confirming the vaccine’s effectiveness. We hope to see this protection extended in future years to people under 75 who live with chronic respiratory conditions.
• Changes to pneumococcal vaccination – The JCVI has also recommended an important change in pneumococcal vaccination. From 2026, older adults and those with chronic diseases will receive the newer PCV20 vaccine instead of PPV23, offering broader and more durable protection against the most common cause of bacterial pneumonia. This has the potential to reduce pneumonia-related illness significantly in our community.
• Aspergillus national guidelines – Finally, we were delighted that Professor Brown served as co-chair for the new national guidelines on treating chronic lung disease caused by Aspergillus fumigatus, including ABPA. The guidelines, published in May 2025, provide clear and practical recommendations for diagnosing and managing chronic aspergillosis. We hope they will help standardise and improve patient care across the UK for years to come.

Looking ahead to 2026

• Transplantation and advanced care – As we look to the future, two themes are particularly important. The first is transplantation. For some people with PF, transplant remains the only possibility of cure. We are developing work that looks at how best to support patients before and after transplantation, how to preserve strength and how to understand the immune processes that influence outcomes.
• Improving tolerability of antifibrotic treatments – Our second area of focus is the tolerability of current antifibrotic medications. While these treatments remain the cornerstone of PF management, many patients struggle with side effects, limiting their benefit. We urgently need better drugs – but also better ways of delivering them, including nebulised or inhaled approaches that might reduce side effects while maintaining effectiveness. Improving tolerability and expanding options will be central to our research aims in 2026.

Supporting patients, families and the community

Improving access to patient information – Alongside our research, we have been working hard to make information more accessible to patients and families. We have just launched a comprehensive series of new videos about pulmonary fibrosis – covering what PF is, how it is diagnosed, who is at risk, what symptoms to expect, how it is monitored, what treatments exist, how lifestyle changes help, and what support is available. These videos have been designed with clarity and compassion, and we hope they will serve as trusted resources for anyone facing a new diagnosis or trying to understand the condition better.

We also continue to expand the information available on our website, including new patient-friendly articles on emerging treatments, research studies and clinical trials.

Community engagement – It has been a particular joy this year to meet many of you again in person. The UCLH Celebrating Research Open Day in July was a wonderful showcase of progress, and our regular ILD Patient Support Groups have been full of warmth, conversation and shared experience. The singing sessions held were especially uplifting. Patients told us that singing brought them improved mood, greater energy and moments of easier breathing, and we hope to build this into a more structured programme next year. We were also delighted to launch our new Patient and Public Involvement Advisory Group which will help ensure that patients remain at the centre of everything we do. #Breathtember 2025 brought another burst of creativity and generosity, and our Christmas Concert on 11 December 2025 was a beautiful way to begin the festive season.

Funding research and innovation

Breathing Matters remains a small, efficient charity, with at least 90% of funds each year directed to research. Your donations not only fund equipment and studies, but also the scientists, clinicians and fellows who drive our progress forward.

How you can get involved

There are lots of ways you can be part of our story:

• Christmas donation – You can donate and support our research in many ways. Visit out donation page to see how you can donate and make a gift directly.
• Stay up to date – Sign up to our website for the latest news on research and events.
• Spread the word – Follow us on our socials [Facebook, X, LinkedIn, Instagram, You-Tube) – help share our mission by liking and resharing our posts.  
• Fundraise – Take part in popular UK events or explore other national and international opportunities on our fundraising page. Our partnerships with Run for Charity and Global Adventure Challenges continue to grow, offering opportunities for those who want to take on something extraordinary in 2026.
• Regular giving – Regular contributions provide steady support, helping us plan and deliver research more effectively. Read our handy guide.
• Leave a legacy – Consider leaving a legacy gift, or a living legacy so you can see the impact of your support.
• Shop online – Browse our online shop for unique merchandise, personalised gifts and events-wear to help spread awareness.
• Charity cards – We have cards and ecards for Christmas and other occasions. Explore the collection here!

Every action, big or small, brings us closer to a world where people with pulmonary fibrosis, ILD and lung infections can live longer, healthier lives.

Thank you

As 2025 comes to a close and we approach our 15th anniversary, we want to give a special THANK YOU to all our amazing supporters for your incredible support – your generosity is the heartbeat and the breath(!) of Breathing Matters. Whether you have donated, left us a gift in your will or a living legacy, taken part in our events or organised your own, purchased items from our merchandise or card collection, or helped spread the word about Breathing Matters through word of mouth or via our socials, your generosity and commitment make our work possible. We extend a special thank you to everyone who joined as new regular givers this year, as well as those who have supported us faithfully over many years through regular giving.

Thank you for believing in us – you have all helped us continue our research.

Remembering loved ones

As always, we pause during this season to remember those we have lost to pulmonary fibrosis, bronchiectasis, pneumonia, COVID and other interstitial lung diseases and lung infections. For anyone facing a first Christmas without someone dear, please know that our thoughts are with you. Your loved ones remain at the heart of our work, their memories inspiring us to push forward.

We wish you a Christmas filled with peace, comfort, love and connection, and a New Year that brings good health and renewed joy.

With heartfelt thanks and warmest wishes
The Breathing Matters Team

 

 

 

Referenced published articles:

1. Differentiating clinically important interstitial lung abnormalities in lung cancer screening 11 Sep 2025BMJ OPEN RESPIRATORY RESEARCH12(1):11 pages, BMJ PUBLISHING GROUP Co-authors: Selvarajah B, Bhamani A, Azimbagirad M…28 more.

2. Neutrophils in idiopathic pulmonary fibrosis patients are phenotypically distinct to controls 3 Jul 2025ERJ Open Research 00424-2025 European Respiratory Society (ERS) Co-authors: Chong DLW, Sahota J, Dennery EK…5 more.

3. [18F]FDG PET/CT Predicts Patient Survival in Patients with Systemic Sclerosis-Associated Interstitial Lung Disease. 29 May 2025J Nucl Medjnumed.125.269497 Society of Nuclear Medicine, Co-authors: Lilburn DML, Garthwaite HS, Ganeshan B…11 more.

4. The respiratory microbiome in patients with post-COVID-19 residual lung abnormalities resembles that of healthy individuals and is distinct from idiopathic pulmonary fibrosis. 1 May 2025ERJ OPEN RESEARCH11(3):12 pages EUROPEAN RESPIRATORY SOC JOURNALS LTD, Co-authors: Smith DJF, Teng NMY, Denneny EK…23 more

5. Hypertonic Saline or Carbocisteine in Bronchiectasis. N Engl J Med 2025 Oct 23;393(16):1565-1577, Bradley et al.

6. Symptoms, risk of future exacerbations, and response to long-term macrolide treatment in bronchiectasis: an observational study. The Lancet Respriatory, Volume 13, Issue 10 p911-920 October 2025, Sibila et al.

7. Anxiety, depression, physical disease parameters and health-related quality of life in the BronchUK national bronchiectasis cohort. ERJ Open Res 2025 May 27;11(3):00348-2024, De Soysa et al.

8. Post-pulmonary tuberculosis lung function: a systematic review and meta-analysis Jun 2025The Lancet Global Health13(6):e1020-e1029Elsevier BV, Co-authors: Ratnakumar S, Hayward SE, Denneny EK…9 more.

9. Post-pulmonary tuberculosis lung function: a systematic review and meta-analysis Jun 2025 The Lancet Global Health 13(6):e1020-e1029 (10 pages) ELSEVIER SCI LTD, Co-authors: Ratnakumar S, Hayward SE, Denneny EK…9 more.