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Ingrid Pat Laing Holt BSc PhD PhD, DSc, FRCPath, FRCPI, FAA Head, Children's Respiratory Science Emeritus Honorary Researcher 6319 1828 Ingrid.laing@
Early childhood wheeze is a major risk factor for asthma. However, not all children who wheeze will develop the disease. The airway epithelium has been shown to be involved in asthma pathogenesis. Despite this, the airway epithelium of children with acute wheeze remains poorly characterized.
Asthma affects > 10% of children in Australia and New Zealand (NZ), with up to 5% of those having severe disease, presenting a management challenge. We aimed to survey tertiary paediatric respiratory services across Australia and NZ using a custom-designed questionnaire, to conduct a cross-sectional observational study of the numbers of children with problematic severe asthma seen, the number treated with biologic therapy, outpatient clinic/multidisciplinary team services available, investigations and tools routinely used and approaches utilised for transition to adult care.
Asthma affects more than 300 million people worldwide and is frequently associated with other medical conditions in adults, including chronic obstructive pulmonary disease, ischaemic heart disease, and stroke. Despite the huge burden, there has been little progress toward prevention and cure, possibly related to a one-size-fits-all approach.
Impaired interferon response and allergic sensitization may contribute to virus-induced wheeze and asthma development in young children. Plasmacytoid dendritic cells play a key role in antiviral immunity as critical producers of type I interferons.
Health outcomes for Australian Aboriginal and Torres Strait peoples are very poor. This is considerably worse in remote regions. The East Pilbara, where the Aboriginal and Torres Strait Islander communities of the Martu and Nyiyaparli people reside, is one such remote region.
Asthma exacerbations in children are associated with respiratory viral infection and atopy, resulting in systemic immune activation and infiltration of immune cells into the airways. The gene networks driving the immune activation and subsequent migration of immune cells into the airways remains incompletely understood. Cellular and molecular profiling of PBMC was employed on paired samples obtained from atopic asthmatic children during acute virus-associated exacerbations and later during convalescence.
The nasal epithelium is the primary point of contact for inhaled respiratory viruses such as rhinovirus, respiratory syncytial virus, influenza, and coronavirus, among others. In order to establish infection, these viruses must engage their respective receptors located on host epithelial cells and begin replication.
Wheezing and asthma exacerbations are leading causes of pediatric hospital admissions. Predicting which children will experience persistent exacerbations remains challenging. Prior research has identified immune endotypes in the nasal epithelium of children with acute asthma and wheezing, characterized by varying balances of interferons and inflammatory markers. Notably, children exhibiting low interferon responses coupled with high inflammation are at an increased risk for recurrent respiratory exacerbations.
Rhinoviruses (RV) are the most common respiratory viruses globally and a major cause of airway symptoms in children and individuals with asthma. Although more than 170 RV types exist across 3 species (RV-A, RV-B, RV-C), type-specific circulation patterns and age-related prevalence remain poorly defined.