ORCID Profile
0000-0003-2467-8708
Current Organisations
University of Sydney
,
Western Sydney Local Health District
,
Children's Hospital at Westmead
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Publisher: Wiley
Date: 23-10-2017
DOI: 10.1111/PCMR.12620
Abstract: A SNP within intron4 of the interferon regulatory factor4 (IRF4) gene, rs12203592*C/T, has been independently associated with pigmentation and age-specific effects on naevus count in European-derived populations. We have characterized the cis-regulatory activity of this intronic region and using human foreskin-derived melanoblast strains, we have explored the correlation between IRF4 rs12203592 homozygous C/C and T/T genotypes with TYR enzyme activity, supporting its association with pigmentation traits. Further, higher IRF4 protein levels directed by the rs12203592*C allele were associated with increased basal proliferation but decreased cell viability following UVR, an etiological factor in melanoma development. Since UVR, and accompanying IFNγ-mediated inflammatory response, is associated with melanomagenesis, we evaluated its effects in the context of IRF4 status. Manipulation of IRF4 levels followed by IFNγ treatment revealed a subset of chemokines and immuno-evasive molecules that are sensitive to IRF4 expression level and genotype including CTLA4 and PD-L1.
Publisher: Wiley
Date: 09-12-2020
DOI: 10.1111/JPC.15290
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-054510
Abstract: To present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation. Prospective, multicentre cohort study. Eight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network—Paediatric Active Enhanced Disease (PAEDS). All children aged years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020. Laboratory-confirmed SARS-CoV-2 infection. Incidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic. Among 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1–12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4 KD-TS, n=1) (median 7.9 years (IQR 7.8–9.8)). Most children with COVID-19 (n=278 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%) cardiac and respiratory comorbidities were most common (n=32/72 %). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5 1.3%), all were hospitalised and three (3/5 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic. Most children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.
Publisher: Wiley
Date: 31-07-2020
DOI: 10.1111/JPC.15049
Publisher: Wiley
Date: 29-01-2020
DOI: 10.1111/JPC.14797
Publisher: Wiley
Date: 04-09-2023
DOI: 10.1111/JPC.16484
Publisher: Wiley
Date: 30-10-2021
DOI: 10.1111/JPC.15816
Abstract: The incidence of Kawasaki disease (KD) is reported to be increasing in some populations. We sought to describe long‐term trends in the incidence and epidemiology of KD in Australia over 25 years. Two nationally complete administrative datasets relevant to KD in Australia were analysed and compared. The Australian Red Cross Lifeblood Supply Tracking Analysis Reporting System (STARS) recorded all doses of immunoglobulin (IVIG) approved in Australia between January 2007 and June 2016. The Australian Institute of Health and Welfare National Hospital Morbidity Database (NHMD) records all episodes of care in hospitals across Australia. Data relevant to KD were extracted an analysed, with comparisons made for the period of data overlap. During the period of data overlap (2007–2015) the IVIG treatment rate in the 0‐ to 4‐year age group (calculated from STARS) was 14.31 per 100 000 person‐years (95% confidence interval 13.67–14.97). The hospitalisation rate in the same age group (calculated from the NHMD) was 14.99 per 100 000 person‐years (95% confidence interval 14.33–15.66). Hospitalisation rates rose at an average rate of 3.54% annually over the 25 years to 2017 in the 0‐ to 4‐year age group, almost exclusively in the 1‐ to 4‐year age group. There is evidence of increasing KD diagnosis in Australia. Similar trends have also been reported in Asia but not in North America or Europe. Increasing diagnosis may reflect a true increase in disease incidence, increasing recognition or overdiagnosis. Further research is needed to determine the cause for these trends.
Location: Australia
No related grants have been discovered for Ryan Lucas.