RHiNO is a research programme investigating why some children born preterm develop breathing problems, how their lungs change as they grow, and how prematurity-associated lung disease can be recognised, treated and followed through later life.
The original RHiNO study recruited and assessed children between 2016 and 2019. From 1,122 returned questionnaires, 767 children underwent RHiNO assessments: 565 born preterm and 202 term-born controls, aged 7–12 years. A subgroup underwent advanced lung MRI, and children with reduced lung function participated in detailed physiological studies and a randomised inhaler trial.
RHiNO and the research that preceded it have shown that respiratory consequences of preterm birth can persist through childhood and potentially across the life course. The programme has progressed from describing respiratory symptoms and reduced lung function to understanding distinct physiological patterns, mechanisms and treatment responses.
A neonatal diagnosis of bronchopulmonary dysplasia is important, but it does not fully describe respiratory disease later in life. RHiNO research helped develop the concept of prematurity-associated lung disease (PLD) as a broader framework for respiratory impairment after preterm birth.
Explore PLD →RHiNO has helped characterise POLD, pPRISm and pDysanapsis. These patterns can be identified using routine spirometry and provide a basis for studying differences in mechanisms, prognosis and treatment.
Explore PLD & phenotypes →The RHiNO randomised clinical trial showed that combined inhaled corticosteroid/long-acting β2-agonist treatment produced a clinically important improvement in lung function in selected preterm-born children with reduced lung function.
Read about RHiNO discoveries →
The programme is no longer asking only whether lung function is abnormal. It is asking which physiological phenotype an individual has, why it developed, whether it changes with growth, and whether its trajectory can be modified.
Different patterns of abnormal lung function exist after preterm birth.
Some airflow limitation is reversible and can respond to inhaled therapy.
MRI, respiratory mechanics and molecular studies reveal abnormalities beyond standard spirometry.
Postnatal exposures and subsequent lung growth may influence lifelong respiratory outcomes.
In January 2026, The Lancet Respiratory Medicine published a three-paper Series addressing PLD and its phenotypes, lifelong lung-function trajectories, and management from infancy through adulthood.
Large studies establish persistent respiratory effects of preterm birth.
Detailed childhood respiratory assessment starts.
Original study visits finish and analysis accelerates.
RHiNO inhaler trial is published.
PLD phenotypes, MRI, pollution, metabolomics and mechanistic work expand.
Phenotypes, trajectories and management are synthesised across the life course.
RHiNO studies how phenotypes and lung function evolve towards adulthood.
Every RHiNO discovery has depended on children and families giving their time for questionnaires, breathing tests, hospital assessments, exercise studies, treatment research and specialist imaging.
To all our participants and families: thank you.
Recruitment to the original RHiNO study is complete, but the information and samples contributed by participants continue to generate new knowledge.
Participants & familiesAzithromycin Therapy for Chronic Lung Disease of Prematurity
Visit AZTEC ↗Preventing respiratory infections after discharge
Visit BALLOON ↗Respiratory Health Outcomes in Neonates
Explore RHiNO →