Outcome Of Childhood Asthma In Adult Life And The Interaction With COPD
Funder
National Health and Medical Research Council
Funding Amount
$503,549.00
Summary
The Melbourne Study of Childhood Asthma (MESCA) is the longest, most comprehensive follow-up study of childhood asthma. The members were recruited in 1964 at the age of 7 and they have been reviewed at ages 10, 14, 21, 28, 35 and 42 years of age with a retention rate of 87% of survivors at the most recent follow-up. To date, the MESCA study has provided comprehensive data on the outcome of childhood asthma through to their adult years and has been particularly influential in establishing approac ....The Melbourne Study of Childhood Asthma (MESCA) is the longest, most comprehensive follow-up study of childhood asthma. The members were recruited in 1964 at the age of 7 and they have been reviewed at ages 10, 14, 21, 28, 35 and 42 years of age with a retention rate of 87% of survivors at the most recent follow-up. To date, the MESCA study has provided comprehensive data on the outcome of childhood asthma through to their adult years and has been particularly influential in establishing approaches to treatment of paediatric asthma nationally and internationally. The results of the study have been published widely over the years and cited extensively. The members of this cohort turn 50 in 2007 and will be invited to participate in a further review to reassess their clinical outcome to examine the relationship between long standing asthma and the development of COPD. Those members of the cohort who have had asthma persisting through their adult years have a degree of fixed obstruction on their tests of lung function and are potentially at risk of developing COPD. Some are at increased risk as approximately 30% of the members are regular smokers. In this review, at age 59 years, there is an excellent opportunity to examine the interaction of asthma and COPD and to compare the inflammatory processes between those who have continuing asthma, those whose asthma has resolved and in each group examine the effect of smoking. We will also look at a numbers of genetic markers associated with COPD to identify those who are more susceptible to the development of COPD. A second area of interest is the components of the immune system that influence asthma.. In an earlier study we identified one component of the immune system, known as the T cell system, that had returned to normal in those whose asthma had resolved. In this review, we plan to examine the T cell system in detail to understand what mechanisms may be responsible for resolution of childhood asthma.Read moreRead less
Vitamin D And Risk Of Cancer And Mortality In The Melbourne Collaborative Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$519,829.00
Summary
Overseas studies indicate that vitamin D might protect against certain cancers and other diseases such as heart disease and diabetes. Vitamin D is made when skin is exposed to sunlight. Because sunlight is stronger in Australia than in most of the USA and Europe, where most studies were conducted, the results of those studies might not be relevant to Australia. In this study, we will see if vitamin D is important for cancer and mortality in Australia.
The Effects Of Inherent Inaccuracies In DXA In Vivo BMD Measurements On Osteopenic/Osteoporotic Diagnostics/Prognositics
Funder
National Health and Medical Research Council
Funding Amount
$411,980.00
Summary
Osteoporosis (porous bone) and consequent associated bone fractures of mainly post-menopausal women and the elderly of both genders constitutes a significant, widespread and rapidly growing public health problem. It is already a major health-cost burden in Australia and worldwide and is set to increase dramatically over the next few decades as the proportion of the population at or above the osteoporosis-prone age increases sharply. Current diagnostic evaluations of osteoporosis, bone mineral st ....Osteoporosis (porous bone) and consequent associated bone fractures of mainly post-menopausal women and the elderly of both genders constitutes a significant, widespread and rapidly growing public health problem. It is already a major health-cost burden in Australia and worldwide and is set to increase dramatically over the next few decades as the proportion of the population at or above the osteoporosis-prone age increases sharply. Current diagnostic evaluations of osteoporosis, bone mineral status of the skeleton, mechanical integrity of bone, and bone fracture risk are mainly based on X-ray absorption measurements of a given individual's bone mineral density (BMD) using Dual-energy X-ray Absorptiometric (DXA) bone densitometer instrumentation. New drugs to retard, ameliorate, or reverse the low bone mineral density condition of osteoporosis are now becoming available, but cannot be prescribed unless sufficiently low BMD is demonstrated for a given patient. The efficacy of these drugs is usually held to be greatest at the earliest stage of osteoporosis (osteopenia) and their effectiveness evaluated on the basis of DXA-measured bone mineral density. The Chief Investigator of this project has already shown by published quantitative analysis and simulation studies that such BMD measurements are inherently inaccurate; that errors of 20% and greater can readily pertain, particularly for those patients at the early stages of osteoporosis and those at or above the osteoporosis-prone age -- the very individuals for whom bone mineral density values are often of paramount interest and concern. These systematic DXA inaccuracies can be large enough to either mask the presence of osteoporosis or lead to false diagnoses and patient monitoring results. The present project, for the first time anywhere, is desiged to quantitatively establish the extent of these inaccuracies using actual DXA densitometers utilizing sophisitcated and precise methods.Read moreRead less
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