National Clinical Centre Of Research Excellence In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$2,597,952.00
Summary
Severe Asthma remains a large burden for the Australian community. It does not respond to current management approaches. We will develop and implement a targetted therapy approach to severe asthma that will involve assessment of needs of people with severe asthma, community burden form severe asthma, biomarkers and linked treatment strategies, as well as knowledge transfer tools and training of the health and medical workforce.
Targeting Neutrophil Extracellular Traps To Reduce Inflammation In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$585,240.00
Summary
People with severe asthma, a chronic disease of the lungs, often have many inflammatory cells in the airways called neutrophils. Neutrophils release a meshwork of fibers in a web like trap called NETs, which are made of the cells DNA and other proteins that fight infection. These NETs can promote inflammation in the persons airways. Current asthma treatments have no effect on NETs. This project will measure NETs in the airways and test a new treatment to reduce NETs, and relieve asthma symptoms.
The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue ....The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue the Childhood Asthma Prevention Study (CAPS) which has been underway since mid-1997. CAPS is a randomised controlled trial in which 616 infants at high risk of developing asthma because of a family history have been enrolled. The interventions include allergen reduction and dietary supplementation with omega-3 fatty acids. The interventions are designed to have maximum effect but be simple to implement by parents. Several measures of compliance are being collected and regular contact is maintained though telephone calls and frequent home visits. Objective and subjective measurements of exposures, atopy, diet and asthmatic symptoms are being collected at 3 month intervals and at medical assessments when the children are 18 months, 3 and 5 years old. It is essential that we continue the study until all children are aged 5 and we will be able to test conclusively whether the interventions have had a positive effect. If so, CAPS will form the basis for a nationwide public health campaign which will have the potential to reduce the incidence of childhood asthma in Australia.Read moreRead less
Understanding How Azithromycin Prevents Exacerbations In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$697,273.00
Summary
In some people with severe asthma, conventional inhaler treatments are not able to control the disease so there is a need for new treatment options. We have recently completed a large clinical trial which showed that very low doses of a common antibiotic help prevent asthma attacks in this situation. However, not much is known about how the antibiotic is working. This study will help us understand how the antibiotic is working and which people respond best.
Exploring The Role Of Respiratory Virus Infections In Childhood Asthma Exacerbations
Funder
National Health and Medical Research Council
Funding Amount
$596,649.00
Summary
The PEAK study will explore the reasons children get worse asthma symptoms when they get colds. These reasons examined include the asthma medications taken (or not taken), allergies and exposure to allergens and the type of virus involved. The study follows the children over the whole school term and uses a new way to sample virus by collecting it in the breath, this is more comfortable than old methods and can be done at home.
Sex-related Changes In Asthma During The Transition Through Puberty In The CAPS Birth Cohort
Funder
National Health and Medical Research Council
Funding Amount
$831,581.00
Summary
Early adolescence is a critical period in the life of people with asthma. Some children grow out of their asthma and others acquire the disease for the first time. There are important sex differences in the pattern of change. We believe these changes are related to the passage through puberty. This study will examine changes in the features of asthma and allergy during this period and their relation to early life and current environmental exposures.
While many cases of asthma are mild, severe cases require extensive health care resources and are virtually unresponsive to conventional treatment. This project will investigate whether specific compounds released from the airway are able to cause lung damage and airway abnormalities similar to that in severe asthma. We will investigate whether these changes are responsive to conventional therapy and investigate a potential treatment for regaining this responsiveness in severe asthma.
Exploration Of Exposures Associated With Bedding That Are Risks For Childhood Allergy And Asthma Symptoms
Funder
National Health and Medical Research Council
Funding Amount
$263,500.00
Summary
Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. Howe ....Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. However, three recent major trials using encasings and a meta-analysis of earlier trials all fail to show a clinical benefit. One of the applicants (ET) recently showed, using expertise in measuring personal exposure, that these encasings, as used, fail to significantly reduce aeroallergen exposure. By contrast, 3 recent Australian studies, involving the applicants, AK, ALP and NG showed that feather bedding compared to synthetic bedding, was strongly protective for asthma - the opposite of public advice. The suggested mechanisms involve reduced exposure to mite allergens, or altered exposure to bacterial endotoxin, but persuasive experimental support is lacking. We also propose a novel hypothesis that feather exposure may induce allergic 'tolerance'. Currently there is a lack of certainty about valid approaches to prevent asthma, and the Global Initiative for Asthma has described the need to understand mechanisms and improve interventions as urgent. This project is an ideal opportunity to combine the expertise of the CIA (ET) in measuring airborne exposures (mite, endotoxin, proteins) with that of the others who have expertise in children's asthma, and who are already involved in two large clinical trails involving different bedding and allergen avoidance. Our measurements of these bedding exposures and their clinical outcomes will provide, for the first time, a quantitative basis to refine public health allergen-based interventions to prevent and manage asthma.Read moreRead less
Galectin-3 And Phagocyte Function In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$698,084.00
Summary
Asthma, a major chronic inflammatory disease affects more than 2 million Australians. Neutrophilic severe asthma is not responsive to current therapies. We have recently made a significant advance in understanding neutrophilic asthma, reporting low levels of a protein called galectin-3 (gal-3). In this project we will explore the role of gal-3 its effect on the resolution of inflammation. This study will result significantly advance the knowledge of the mechanisms of neutrophilic severe asthma.