research

respiratory diseases

summary

The group is active in several areas of research relating to common chronic childhood respiratory conditions such as asthma, cystic fibrosis, allergy and tuberculosis. The group is recognized internationally for its research into methods for early detection of lung disease and holds several grants in this area. The group is also responsible for a large long-standing epidemiology asthma project which is a unique resource, respected internationally for the insight provided by the study into the development and evolution of childhood asthma. The cystic fibrosis clinic at the Royal Children's Hospital Melbourne is one of the largest specialist centres in the world and the group is running numerous clinical research projects with the aim of improving and extending the quality of life of children diagnosed with CF.

group leader(s)

Professor Colin Robertson
Department of Respiratory Medicine
Murdoch Childrens Research Institute
Royal Children's Hospital
Flemington Road
Parkville Victoria 3052

T  +61 3 9345 5818
T  +61 3 9345 5844
E colin.robertson@rch.org.au

current research projects

Project 1 - Early Detection And Evaluation Of Lung Disease In Infants And Pre-School Children

The intent of this research program is to identify the most informative investigations for early detection of lung disease and to monitor the progress of disease or its response to treatment in its earliest stages.

Early detection of lung disease in cystic fibrosis

There is emerging evidence that even asymptomatic infants with cystic fibrosis (CF), detected by newborn screening, have signs of early lung disease. However, the nature of this early lung disease, whether it begins antenatally or shortly after delivery, its rate of progression, its reversibility, and its potential for modification by medical intervention are all important questions that remain unanswered. We are conducting a comprehensive study developing a detailed evaluation of children with cystic fibrosis. 

Forced oscillation to detect impaired pulmonary function in children with repaired tracheo-oesophageal fistula.

Using  specialised tests (the forced oscillation technique) to measure the lung function of children with repaired  tracheo-oesophageal fistula. Children born with a connection between their oesophagus and the trachea frequently have respiratory symptoms during the early childhood years but it has not been possible to measure their lung function until recently. In this study we aim to determine lung function and its progress in pre-school children born with this condition.

Evaluation of airway function in pre-school children with a history of wheezing

The aim of the study is to develop techniques which provide objective markers of lung function and bronchodilator responsiveness in pre-school children with wheezing and to use these to inform treatment decisions for childhood asthma.

Multicentre study of the role of broncho-alveolar lavage (BAL) in infants and young children with CF

The study aims to evaluate the role of BAL compared with more routine methods for identifying infections in the respiratory tract of those with CF

Project 2 - Clinical Research In Cystic Fibrosis

  • The production of normal values for sweat test results across age groups.
  • Community screening for CF
  • Assessment of Pseudomonas eradication
  • Skin complications of CF
  • Sonographic assessment of the Vas Deferens in CF
  • Review of clinical scoring systems in CF
  • Cilial function in CF
  • Evaluation of CT and its role in determining suitability for lung transplantation
  • Investigation of the utility of MRI scanning in CF
  • MMIM linking of Victorian databases for chronic diseases
  • Low frequency sound waves in detecting lung hyperinflation and parenchymal destruction in patients with cystic fibrosis: Initial proof of concept.
  • Prevalence of behavioural problems in CF kids

Project 3 - Epidemiology Studies Of Asthma

ISAAC - The internal study of asthma and allergy in childhood

This is a worldwide study to examine the prevalence of asthma throughout the world and to monitor the changes over time

Exercise induced dyspnoea in asthma

There are several studies examining the mechanisms of exercise-induced dyspnoea in children with asthma which has a major implication for treatment.

Melbourne Epidemiological Study of Children with Asthma

A cohort of children recruited at the age of 7 years and followed through to adulthood.  This group will turn 50 in the 2006 when they will have their next follow-up providing a unique opportunity to investigate  factors linking chronic asthma in childhood to the development of chronic obstructive pulmonary disease in adults

Long-term follow-up of asthma ICU admissions

Project 4 - Clinical Outcome Studies

The department has a well-established record of clinical outcome studies, which have influenced management nationally and internationally.  Recent examples include:

The development of prediction equations using ulnar length to predict lung function and weight where standing height cannot be measured.
The development of a device to improve cough efficiency in those with tracheomalacia.
Outcome of congenital cystic adenomatoid malformation of the lung diagnosed antenatally.
Evaluation of new diagnostic tests for tuberculosis including QuantiFERON Gold and Elispot.
Evaluation of mandibular distraction in the management of Pierre Robin syndrome.

Project 5 - Clinical Trials

Randomised controlled trial of inhaled mannitol in CF
Randomised controlled trial of daily versus intermittent  use of montelukast for episodic wheezing in Children
Randomised controlled trial of parent-initiated corticosteroids for childhood asthma
Immune tolerance network study of immunoprophylaxis of allergic disease

team members

  • Rosemary Alysandratos - Research Assistant
  • Nadeene Clarke - Research Assistant
  • Anne-Marie Gibson - Research Assistant
  • Jo Harrison - HONORARY FELLOW
  • Emily Hart - HONORARY FELLOW
  • Johanna Kappers - Research Assistant
  • Adrian Lowe - NHMRC Postdoctoral Fellow
  • John Massie - HONORARY RESEARCH FELLOW
  • Mahjabeen Mazhar - VISITOR & VOLUNTEERS
  • Mary Roberts - Research Assistant
  • Phil Robinson - Site Investigator
  • Billy Skoric - Research Assistant
  • Julie Smith - Research Officer
  • John Wong - PhD Student (UoM Paeds)

publications

  • Bjorksten B., Ait-Khaled N., Asher MI., Clayton TO., Robertson C. Global analysis of breast feeding and risk of symptoms of asthma, rhinoconjunctivitis and eczema in 6-7 year old children: ISAAC Phase Three. ALLERGOLOGIA ET IMMUNOPATHOLOGIA 39 (6) : 318 - 325(2011) PubMed
  • Chisti MJ., Duke T., Robertson CF., Ahmed T., Faruque ASG., Bardhan PK., La Vincente S., Salam MA. Co-morbidity: exploring the clinical overlap between pneumonia and diarrhoea in a hospital in Dhaka, Bangladesh. ANNALS OF TROPICAL PAEDIATRICS 31 (4) : 311 - 319(2011) PubMed
  • Ferreira MAR., Matheson MC., Duffy DL., Marks GB., Hui J., Le Souef P., Danoy P., Baltic S., Nyholt DR., Jenkins M., Hayden C., Willemsen G., Ang W., Kuokkanen M., Beilby J., Cheah F., De Geus EJC., Ramasamy A., Vedantam S., Salomaa V., Madden PA., Heath AC., Hopper JL., Visscher PM., Musk B., Leeder SR., Jarvelin M-R., Pennell C., Boomsma DI., Hirschhorn JN., Walters H., Martin NG., James A., Jones G., Abramson MJ., Robertson CF., Dharmage SC., Brown MA., Montgomery GW., Thompson PJ. Identification of IL6R and chromosome 11q13.5 as risk loci for asthma. LANCET 378 (9795) : 1006 - 1014(2011)
  • Gangell C., Gard S., Douglas T., Park J., De Klerk N., Keil T., Brennan S., Ranganathan S., Robins-Browne R., Sly PD. Inflammatory responses to individual microorganisms in the lungs of children with cystic fibrosis. Clinical Infectious Diseases 53 (5) : 425 - 432(2011) PubMed
  • Garratt LW., Wright AK., Ranganathan SC., Grigg J., Sly PD., on behalf of AREST CF. Small macrophages are present in early childhood respiratory disease. Journal of cystic fibrosis (2011)
  • Hall GL., Logie KM., Parsons F., Schulzke S., Nolan G., Murray C., Ranganathan S., Robinson P., Sly PD., Stick SM. Air trapping on chest computerized tomography is associated with worse ventilation distribution in infants with cystic fibrosis diagnosed following newborn screening. PLOS ONE (2011) PubMed
  • Koplin JJ., Tang ML., Martin PE., Osborne NJ., Lowe AJ., Ponsonby AL., Robinson MN., Tey D., Thiele L., Hill DJ., Gurrin LC., Wake M., Dharmage SC., Allen KJ., HealthNuts investigators. Predetermined challenge eligibility and cessation criteria for oral food challenges in the HealthNuts population-based study of infants. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY (2011) PubMed
  • Lodge CJ., Lowe AJ., Gurrin LC., Hill DJ., Hosking CS., Khalafzai RU., Hopper JL., Matheson MC., Abramson MJ., Allen KJ., Dharmage SC. House dust mite sensitization in toddlers predicts current wheeze at age 12 years. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 128 (4) : 782 - 788(2011) PubMed
  • Lowe A., Brback L., Ekeus C., Hjern A., Forsberg B. Maternal obesity during pregnancy as a risk for early-life asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 128 (5) : 1107 - 1109(2011) PubMed
  • Lowe AJ., Hosking CS., Bennett CM., Allen KJ., Axelrad C., Carlin JB., Abramson MJ., Dharmage SC., Hill DJ. Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high-risk children: A randomized controlled trial. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 128 (2) : 360 - 365(2011) PubMed
  • Martin PE., Matheson MC., Gurrin L., Burgess JA., Osborne N., Lowe AJ., Morrison S., Meszaros D., Giles GG., Abramson MJ., Walters EH., Allen KJ., Dharmage SC. Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: A prospective cohort study over 4 decades. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 127 (6) : 1473 (2011) PubMed
  • McClaren BJ., Metcalfe SA., Amor DJ., Aitken M., Massie J. A case for cystic fibrosis carrier testing in the general population. MEDICAL JOURNAL OF AUSTRALIA 194 (4) : 208 - 209(2011) PubMed
  • Mott LS., Park J., Murray CP., Gangell CL., de Klerk NH., Robinson PJ., Robertson CF., Ranganathan SC., Sly PD., Stick SM., on behalf of AREST CF. Progression of early structural lung disease in young children with cystic fibrosis assessed using CT. THORAX (2011)
  • Osborne NJ., Koplin JJ., Martin PE., Gurrin LC., Lowe AJ., Matheson MC., Ponsonby AL., Wake M., Tang MLK., Dharmage SC., Allen KJ. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 127 (3) : 668 (2011) PubMed
  • Pillarisetti N., Williamson E., Linnane B., Skoric B., Robertson CF., Robinson P., Massie J., Hall GL., Sly P., Stick S., Ranganathan S. Infection, Inflammation, and Lung Function Decline in Infants with Cystic Fibrosis. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 184 (1) : 75 - 81(2011) PubMed
  • Ranganathan SC., Davis SD., Rosenfeld M. Monitoring of structure and function in early cystic fibrosis lung disease. Pediatric, Allergy, Immunology, and Pulmonology 24 (3) : 133 - 137(2011)
  • Ranganathan SC., Parsons F., Gangell C., Brennan S., Stick SM., Sly PD. Evolution of pulmonary inflammation and nutritional status in infants and young children with cystic fibrosis. THORAX 66 (5) : 408 - 413(2011) PubMed
  • Triasih R., Duke T., Robertson CF. Outcomes following admission to intensive care for asthma. ARCHIVES OF DISEASE IN CHILDHOOD 96 (8) : 729 (2011) PubMed
  • Valovirta E., Boza ML., Robertson CF., Verbruggen N., Smugar SS., Nelsen LM., Knorr BA., Reiss TF., Philip G., Gurner DM. Intermittent or daily montelukast versus placebo for episodic asthma in children. ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 106 (6) : 518 - 526(2011) PubMed
  • Van Asperen PP., Mellis CM., Sly PD., Robertson CF. Evidence-based asthma management in children - what's new?. MEDICAL JOURNAL OF AUSTRALIA 194 (8) : 383 - 384(2011) PubMed
  • Wainwright CE., Vidmar S., Armstrong DS., Byrnes CA., Carlin JB., Cheney J., Cooper PJ., Grimwood K., Moodie M., Robertson CF., Tiddens HA. Effect of Bronchoalveolar Lavage-Directed Therapy on Pseudomonas aeruginosa Infection and Structural Lung Injury in Children With Cystic Fibrosis A Randomized Trial. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 306 (2) : 163 - 171(2011) PubMed