The Risks Of Thin Basement Membrane Nephropathy (TBMN)
Funder
National Health and Medical Research Council
Funding Amount
$253,500.00
Summary
Our aims are to save the $10 million spent on inappropriate investigations in TBMN each year by the Australian community; to identify and treat individuals with TBMN at risk of renal impairment in order to delay the onset of kidney failure; to understand the underlying disease mechanisms in order to develop specific treatments; and to contribute to the development of a diagnostic assay for TBMN that flags mutations associated with renal impairment and includes a screening test for modifying gene ....Our aims are to save the $10 million spent on inappropriate investigations in TBMN each year by the Australian community; to identify and treat individuals with TBMN at risk of renal impairment in order to delay the onset of kidney failure; to understand the underlying disease mechanisms in order to develop specific treatments; and to contribute to the development of a diagnostic assay for TBMN that flags mutations associated with renal impairment and includes a screening test for modifying genes. The proposed project will change the practice of clinicians by providing evidence for our clinical definition of TBMN and reduce the need for renal biopsies and other investigations thus saving the Australian community up to $10 million annually. demonstrate that a peripheral retinopathy distinguishes between TBMN and X-linked Alport syndrome. This will be a major advance in the diagnosis of Alport syndrome too. determine how often individuals with persistent haematuria who have proteinuria >500 mg-day or renal impairment actually have TBMN. identify the genetic risk factors for renal impairment in TBMN in both the genes directly responsible for TBMN as well as in the modifying genes. determine the mechanisms by which genetic mutations and modifying genes in TBMN cause disease and predispose to renal impairment. Understanding these mechanisms is the first step in the development of specific treatments.Read moreRead less
ProbioticTreatment Of Diarrhoeal Disease And Malnutrition In Top End Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$332,036.00
Summary
Aboriginal children in the Top End of Australia have high rates of hospital admission for diarrhoea and malnutrition. We have discovered that underlying small intestinal damage in these children is an important contributor to the high complication rates and longer lengths of stay in hospital compared to non-Aboriginal children. This research proposes to continue our work on small intestinal damage by using two non-invasive tests of gut function, namely a sugar absorption test and novel breath te ....Aboriginal children in the Top End of Australia have high rates of hospital admission for diarrhoea and malnutrition. We have discovered that underlying small intestinal damage in these children is an important contributor to the high complication rates and longer lengths of stay in hospital compared to non-Aboriginal children. This research proposes to continue our work on small intestinal damage by using two non-invasive tests of gut function, namely a sugar absorption test and novel breath test. The sugar permeability test involves the children drinking a solution of the two sugars lactulose and rhamnose, and measuring their absorption into the blood 90 minutes later using a sophisticated measuring instrument called HPLC, which can measure minuscule amounts of sugars and is set up at Royal Darwin Hospital. The breath test involves children drinking another sugar solution with a special non-radioactive marker called a stable isotope of carbon, and measuring changes in the amount of this marker in carbon dioxide from the breath at timed periods after drinking the sugar solution. The breath is analysed in Adelaide using another sophisticated instrument. These tests are being used to measure abnormal sugar absorption due to intestinal damage, which is particularly common in Aboriginal children during the weaning period of 4-18 months. Our hypothesis is that treatment with 'healthy germs' (probiotics) like those in certain yoghourts will colonise the gut, stimulate immunity and reduce the presence of 'nasty germs' (pathogenic bacteria) in the intestines of Aboriginal children which contribute to the need for their hospitalisation with diarrhoea and malnutrition. If this hypothesis is correct, then this research will provide the best kind of evidence for reducing the need for hospital treatment by treating all cases of diarrhoea with these probiotics and possibly even decreasing the gut damage of children in the weaning period by including probiotics in their dietsRead moreRead less
Evaluation Of A Rapid Behavioural Treatment For Sleep Onset Insomnia
Funder
National Health and Medical Research Council
Funding Amount
$268,500.00
Summary
Chronic insomnia is a prevalent health problem that affects 5-10% of the population. It is associated with significant physical and mental health problems as well as lowered quality of life. By far the most common treatment for insomnia continues to be sleeping tablets despite the problems of drug dependence, daytime impairment and long term loss of effect. It is also despite the evidence that behavioural therapies are more effective in the long term. In clinical experiments stimulus control the ....Chronic insomnia is a prevalent health problem that affects 5-10% of the population. It is associated with significant physical and mental health problems as well as lowered quality of life. By far the most common treatment for insomnia continues to be sleeping tablets despite the problems of drug dependence, daytime impairment and long term loss of effect. It is also despite the evidence that behavioural therapies are more effective in the long term. In clinical experiments stimulus control therapy (SCT) is consistently the most effective of the behavioural therapies. However, SCT is difficult to carry out over the 4-6 week period necessary for effective treatment. If the treatment process could be shortened, it may increase the number of successful treatments. We have developed a laboratory procedure which includes the effective elements of SCT. These elements include sleep restriction and the experience of one rapid sleep onset each night. Our procedure involves some sleep deprivation and the experience of many (over 40) rapid sleep onsets over just one day. Therefore, it condenses 40 nights of the re-training benefits of SCT into just one day. A preliminary study has shown this procedure to be as effective as normal SCT. However, with no follow-up therapy to the procedure the initial gains tended to diminish with time. Our proposal is to test and extend the possible benefits of this new treatment procedure. We will compare it with the standard SCT as well as combine it with SCT. We feel that the greatest benefit may be to use the laboratory procedure as a kick start to SCT, which will by-pass the most difficult first 2--3 weeks of SCT. This will greatly reduce the time as well as absolutely improve the outcome. In further studies the laboratory procedure may be transferred to the patient s home, thereby further increasing its effectiveness. We feel the proposal will lead to a significant improvement in the non-drug treatment of insomnia.Read moreRead less
Cytokines In Milk Modulate The Development Of Immune Responses In The Infant
Funder
National Health and Medical Research Council
Funding Amount
$188,912.00
Summary
There is substantial epidemiological evidence that formula fed infants are more susceptible than breast fed infants to auto-immune diseases later in life. However direct evidence is lacking and the mechanism is not understood. We aim to provide direct experimental evidence to test the hypothesis that maternal milk regulates infant immune responses by providing the factors that modulates antigen presentation and priming in the neonatal gut. The significance of the study lies in the absence of the ....There is substantial epidemiological evidence that formula fed infants are more susceptible than breast fed infants to auto-immune diseases later in life. However direct evidence is lacking and the mechanism is not understood. We aim to provide direct experimental evidence to test the hypothesis that maternal milk regulates infant immune responses by providing the factors that modulates antigen presentation and priming in the neonatal gut. The significance of the study lies in the absence of these regulatory factors in infant formula. The results will allow more fully informed decisions regarding breast feeding, and may lead to the development of infant formula that modulate immune responses in a manner analogous to natural maternal milk.Read moreRead less