Respiratory Diseases

The Respiratory Diseases group have undertaken several areas of research that relate to common chronic childhood respiratory conditions such as asthma, cystic fibrosis, long-term effects of prematurity, allergy and tuberculosis. They also responsible for a large long-standing epidemiology asthma project (MESCA), a unique resource well respected internationally for the insight provided by the study into the development and evolution of childhood asthma.

Their main research focus is in the assessment, treatment and prevention of cystic fibrosis lung disease in young children. We believe that by preventing lung disease early in life, individuals with cystic fibrosis will live longer fulfilling lives. The Early Surveillance Program (AREST CF) is a collaboration of specialist pediatric fibrosis centers in Perth and Melbourne, in conjunction with teams across North America and Rotterdam, who work together to improve the respiratory health and outcomes of children with cystic fibrosis. AREST CF is internationally recognised for its world leading research in this area.

Group Leaders: 
Group Members: 
Dr Jo Harrison
Role: 
Honorary Fellow Manager
Dr Mandie Griffiths
Role: 
Honorary Fellow
Dr Ranjana Warrier
Role: 
PhD Student
Dr Liam Welsh
Role: 
Senior Scientist
Dr Anne-Marie Adams
Role: 
Research Scientist
Courtney Munro
Role: 
Research Associate
Cindy Branch-Smith
Role: 
Research Associate (off-campus)
Louise King
Role: 
Respiratory Medicine Research Coordinator
Julie Smith
Role: 
Research Officer- Clinical Trials Coordinator
Rosemary Alysandratos
Role: 
Research Scientist
Billy Skoric
Role: 
Billy Skoric, Respiratory Scientist/Research Coordinator
Nadeene Clarke
Role: 
Research Scientist/Research Coordinator
Dr Karla Logie
Role: 
Respiratory Scientist/Research Assistant
Jo Kappers
Role: 
Research Nurse
Denisia Galadis
Role: 
Research Nurse
Dr Katherine Frayman
Role: 
Clinical Research Fellow
Dr Jane Sheehan
Role: 
Research Officer
Amanda Mukushi
Role: 
Research Nurse
Paul Griffin
Role: 
Scientist
Mary Roberts
Role: 
Research Assistant/Sleep Technologist
Dr Shivanthan Shanthikumar
Role: 
Respiratory Medicine Fellow
Dr Ajay Kevat
Role: 
Cystic Fibrosis Fellow
Natalie Zajakovski
Role: 
Respiratory Scientist/Research Coordinator

The AREST-CF study has identified risk factors for the early development of bronchiectasis in CF and described the prevalence of structural, infection and inflammation findings in the lungs of infants with CF. These findings show the importance of early surveillance for these problems and led to personalised medicine in order to  better target treatments in early life across all specialist centres within Australia caring for children with CF. Our research into early lung function in CF and standardisation of infant lung function (ILF) testing has led to the introduction of ILF testing into clinical practice for CF in many European and US CF centres.

MESCA – Melbourne Epidemiological Study of Childhood Asthma (1964-current).
The longest, most comprehensive follow-up study of childhood asthma. The study’s data on the outcome of childhood asthma through to adult years has been influential in establishing approaches to treatment of paediatric asthma nationally and internationally. 401 children (7 year old) were randomly selected from a survey of 30,000 and stratified by frequency of wheezing (including a control group). In 1967, 83 children with more severe asthma were recruited at age 10 from the same age cohort. Participants have been reviewed at ages 10, 14, 21, 28, 35, 42 and 50 years of age. A 59 year old follow-up is soon to take place.

Molecular epidemiology of severe Respiratory Syncytial Virus Infections In Children Under 2 Years of Age in Australia.
This multi-centre study will specifically investigate the molecular characteristics of RSV associated with severe lower respiratory tract infection. The primary objective of this study is to describe the molecular epidemiology of severe, compared to non-severe RSV lower respiratory tract infections. Some secondary objectives aim to identify clinical risk factors and predictors of severe RSV disease, evaluate the presence of specific genotypes and their relationship to increased disease severity and determine geographical spread of RSV genotypes across Australia.

Population-based carrier screening for cystic fibrosis (2005 onwards).
A collaboration with Genetic Health Services Victoria. Many aspects of carrier screening for CF have been explored including patient attitudes, physician attitudes, CF patient attitudes, health economics and cost-effectiveness (in collaboration with the Centre for Health Economics Research and Evaluation, Sydney) and ethical considerations. A National (Human Genetics Society of Australasia) and International (European CF Society) policy has been developed. Ongoing research includes attitudes of women in public obstetric clinics, women who have declined carrier screening and a detailed analysis of carrier couple identified by screening. It is intended that State and National policy on CF carrier screening will be addressed through this research.

Clinical trials
Numerous sponsored studies are carried out within the department of Respiratory Medicine.  The majority focus on cystic fibrosis lung disease with inhaled and oral therapies. Some of which aim to prevent radiologically-defined bronchiectasis, others focus on specific CFTR (Cystic Fibrosis Transmembrane conductance Regulator) gating mutations to name a few. Besides cystic fibrosis, other clinical trials that are undertaken include persistent asthma, severe uncontrolled refractory asthma and RSV infection in preterm infants.