Upper Bedding As A Prevention Measure In Childhood Asthma: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$198,075.00
Summary
Asthma has recently been identified as a National health Priority (1) by the Australian Government in view of the increasing prevalence of asthma and its great importance as a public health problem. The total health system costs of asthma are estimated to be in excess of $600 million (2). Recently, feather pillows have been shown to have more than five times less house dust mite allergen than other pillows. To date, several population-based studies have shown that children using feather upper be ....Asthma has recently been identified as a National health Priority (1) by the Australian Government in view of the increasing prevalence of asthma and its great importance as a public health problem. The total health system costs of asthma are estimated to be in excess of $600 million (2). Recently, feather pillows have been shown to have more than five times less house dust mite allergen than other pillows. To date, several population-based studies have shown that children using feather upper bedding are also reported by their parents to have less severe wheeze. These findings call into question the National Asthma Council recommendation that people with asthma who are allergic to house dust mite should use synthetic quilts rather than feather or down (3). However, concerns remain that these important findings may only have occurred because unmeasured factors, such as the socioeconomic status or child diet may be closely related to feather bedding use, and in themselves, protective against asthma. Alternatively, parents of a child with asthma symptoms may be more likely to have chosen non-feather bedding. The best way to address these concerns is to conduct a randomised controlled trial to evaluate whether the use of new feather upper bedding is associated with reduced asthma severity among house dust mite-sensitised children with severe asthma. This study is underway and has support in 2001-2002 from the Financial Markets Foundation for Children. The research will address the following NHMRC Primary Health Care project grant thematic research areas: Evidence based primary health care practice; Quality of primary care; and Illness prevention and health promotion as a primary health care strategy. (1) National Health Priority Areas: Asthma. http:--www.health.gov.au-hsdd-nhpq-asthma-index.htm (2) NH and MRC Evidence Based Clinical Practice Research Program Workshop - December 16-17, 1999. (3) National Asthma Campaign Asthma Management Handbook 1998Read moreRead less
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
The Effect Of Asthma Control During Pregnancy On Markers Of Airways Inflammation And Lung Function In The Offspring
Funder
National Health and Medical Research Council
Funding Amount
$1,131,043.00
Summary
Asthma is the most common chronic disease complication during pregnancy. By improving asthma management we have reduced asthma exacerbations by 50% during pregnancy and their babies suffered less often from bronchiolitis in the first year of life, which can be a life threatening infection. As bronchiolitis also promotes the development of asthma we want to investigate whether better asthma management in pregnancy leads to less lung inflammation and better lung function in the children.
Environmental Influences On Allergic Airways Disease From Birth To 8yrs: Long-term Outcomes Of A Randomised Trial (CAPS)
Funder
National Health and Medical Research Council
Funding Amount
$530,000.00
Summary
The prevalence of asthma in Australia is among 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, it will not be possible to give confident advice about how to prevent asthma. We are applying to continue follow up of the cohort of the ....The prevalence of asthma in Australia is among 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, it will not be possible to give confident advice about how to prevent asthma. We are applying to continue follow up of the cohort of 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. 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. The interventions are stopped at age 5 years. The continued follow up of the cohort to age 8 will enable us to test conclusively if 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
Early Life Exposures And Chronic Disease: Mechanisms And Preventative Strategies
Funder
National Health and Medical Research Council
Funding Amount
$851,980.00
Summary
The world is facing an epidemic of chronic disease and adverse environmental exposures in early life are partly responsible. One reason why we have not been able to do more to prevent this is the lack of appropriate methods for measuring environmental exposures during pregnancy and infancy. My research will develop and validate methods for measuring exposures early life and the health consequences of these exposures with the aim of developing preventative interventions
Prevention Of Asthma In Young Children Via Immunostimulation
Funder
National Health and Medical Research Council
Funding Amount
$679,683.00
Summary
Persistent asthma is a major problem for Australia yet none of the current therapies do more that control the condition. The long-term solution is to prevent asthma from progressing to the persistent form. The major risk factors are: family history, early allergy and recurrent severe lower respiratory infections (sLRI) in the early life. We will conduct a randomized clinical trial to prevent sLRI using a novel bacterial-derived immunostimulant in infants at high risk of developing asthma.
The Role Of Pulmonary Macrophages In The Pathogenesis Of An Acute Exacerbation Of Chronic Asthma
Funder
National Health and Medical Research Council
Funding Amount
$495,710.00
Summary
We will examine the role of lung defence cells, known as macrophages, in triggering the inflammation of acute severe asthma. The experimental work will use unique mouse models of mild chronic asthma and of an acute exacerbation of the illness, which have been developed in our laboratories. We will study the mechanisms of activation of the asthmatic response and assess whether treatment with drugs that suppress the function of macrophages can help to control steroid-resistant exacerbations.
The Pathogenesis Of Distinct Endophenotypes Of Asthma Is Underpinned By The Collaborative Activation Of Specific PRRs.
Funder
National Health and Medical Research Council
Funding Amount
$678,754.00
Summary
Asthma is a chronic airway disease caused by inflammation. Although asthmatics can be sub-typed based on the type of inflammatory cells present in the lungs, medication specific for the treatment of these sub-types is not yet available. In this grant we will investigate the immune processes that orchestrate the development of the distinct inflammatory sub-types of asthma. This information will help us develop new therapies that will be tailored to target the appropriate type of inflammation.
Macrophages, Sugars And Innate Immunity In Chronic Lung Inflammation
Funder
National Health and Medical Research Council
Funding Amount
$413,150.00
Summary
This project is about a new idea to treat severe asthma, chronic obstructive lung disease (COPD) and sudden worsening of these diseases (exacerbations). Asthma and COPD are very common. Asthma afflicts approximately 10 % of all Australians and kills approximately 700 annually. COPD will be the third most common cause of death worldwide by 2010 (WHO) and costs more that $ AUS 10 Billion annually. The highest risk of death and greatest costs are associated with severe asthma and exacerbations. Our ....This project is about a new idea to treat severe asthma, chronic obstructive lung disease (COPD) and sudden worsening of these diseases (exacerbations). Asthma and COPD are very common. Asthma afflicts approximately 10 % of all Australians and kills approximately 700 annually. COPD will be the third most common cause of death worldwide by 2010 (WHO) and costs more that $ AUS 10 Billion annually. The highest risk of death and greatest costs are associated with severe asthma and exacerbations. Our idea, which is based on extensive animal data, is that these diseases can be treated by blocking the activity of proteins that allow a cell called the lung macrophage to grow, become activated, proliferate and survive. These proteins are called CSF-1 and GM-CSF and they belong to a larger class of proteins called colony stimulating factors (CSFs) Macrophages are important because they can rapidly respond to bacteria, viruses and fungi that can infect the lungs of asthma and COPD patients. Infections cause exacerbations. Normally, macrophages release a number of molecules called mediators that rouse a strong defensive reaction- a process called innate immunity. For example macrophages signal for a cell type called the neutrophil, which is a very efficient bacteria killer, to flood into the lung. However, these same cells can cause serious lung damage if the response is too strong or persistent. Macrophages and neutrophils need CSFs to work properly so blocking CSFs prevents lung damage. Although we now already know that blocking CSFs can prevent and reverse lung inflammation we still need to know a great deal more in order to know if this approach will be useful to treat people in the future. Our project is therefore all about understanding the fine detail of how CSFs can damage the lung. The importance of the project is that our work may lead to entirely new, and much more effective, treatments for people suffering from asthma and COPD.Read moreRead less
Innate Immune Factors Regulate Steroid-resistant Airways Hyperreactivity And Asthma
Funder
National Health and Medical Research Council
Funding Amount
$524,456.00
Summary
Infection induced asthma is often difficult to manage because of lack of efficacy of steroid treatment. The innate immune system plays an important role in inflammation associated with infection. I have shown that two innate immune factors, IFN-gamma and lipopolysaccharide (LPS), induce airways hyperreactivity that is resistant to steroid therapy in a mouse model. Identification of how this pathway works may help in the treatment of infection induced steroid-resistant difficult to manage asthma.