Adolescent Assessment Of The Perth Infant Respiratory Cohort
Funder
National Health and Medical Research Council
Funding Amount
$412,327.00
Summary
In spite of extensive research over several years, we still don t know why some people get asthma while others do not or at what age the disease begins. We also don t know why in some people, asthma resolves during the teenage years while in other people the disease persists through adolescence. The Perth respiratory cohort has been studied on repeated occasions (at recruitment prior to birth, 1, 6 and 12 months, 6 and 11 years of age) and is unique in having measured airway responsiveness (AR) ....In spite of extensive research over several years, we still don t know why some people get asthma while others do not or at what age the disease begins. We also don t know why in some people, asthma resolves during the teenage years while in other people the disease persists through adolescence. The Perth respiratory cohort has been studied on repeated occasions (at recruitment prior to birth, 1, 6 and 12 months, 6 and 11 years of age) and is unique in having measured airway responsiveness (AR) soon after birth and at each subsequent assessment. Our previous data have established the importance of an individual s airway status in infancy in determining respiratory health in mid-childhood. Since the last assessment at 11 years, most children in this cohort will have passed through puberty. Lung growth will have been maximal, but there will be differences in the rate of growth between boys and girls. Body size will also have increased during this period and the body mass index may start to exert a major influence on measured respiratory function and the development or persistence of asthma. The aim of this research (assessing the Perth respiratory cohort at 16 years of age) is to look at the effect of gender, puberty and obesity on the previously identified early life risk factors to see how they determine respiratory health in 16 year olds. We expect that airway status in early life will continue to predict respiratory health at 16 years of age and that respiratory health will be modified by gender, puberty and the development of obesity. In addition we expect that genetic variations will show age-specificity in their associations with disease outcomes ie. particular variations will be associated with disease at different ages. This study will answer fundamental questions on airway function and physiology through childhood and adolescence.Read moreRead less
A Multi-centre, Randomised, Controlled Trial Of BAL Directed Therapy In Young Children With Cystic Fibrosis.
Funder
National Health and Medical Research Council
Funding Amount
$571,750.00
Summary
The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated ....The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated with a decline in pulmonary function and an increase in morbidity and mortality. Many CF centres internationally now treat young children with CF using aggressive antibiotic protocols in an attempt to eradicate infection. Most centres use oropharyngeal specimens to diagnose LRTI with a sensitivity of around 45% and specificity of around 90%. Thus many children miss out on treatment or are exposed unnecessarily to antibiotics. The use of antibiotics themselves may increase the risk of infection with resistant organisms thus complicating the design of drug trials in young children as monitoring for the emergence of resistant new organisms requires BAL. It is thus of key importance that the safety and value of FB and BAL is examined and long term outcomes are obtained. The financial costs of managing patients with CF in Australia may be estimated at more than $85 million-annum. Early intervention strategies may reduce health costs because of improved morbidity or may increase costs due to the intervention. This will be the first time an economic evaluation of early management and the cost effectiveness of an intervention in children with CF has been undertaken which will enable responsible health care planning for this important group of patients. This trial provides a unique opportunity to study the relationship between LRTI and inflammation and long term outcomes such as lung function and radiological scores and will provide key evidence for designing future trials.Read moreRead less