Patterns of airway infection and inflammation in children
Do patterns of airway infection and inflammation distinguish pathophysiological phenotypes in children with wheeze and asthma?
Imperial College London
Duration of Study in the UK
1 years, 10 months, 28 days
Can the pattern of infection and inflammation in the lungs of children with respiratory symptoms be used to help decide their treatment?
Up to one third of children aged under 5 years develop wheezing and breathlessness but there are few effective treatments. Asthma treatments are commonly used but it is very difficult to know which children will benefit. In some preschool children the pattern of inflammation in the breathing tubes (airways) is similar to that in older children with asthma; however in others respiratory infections (viral and bacterial) cause symptoms and inflammation in the airways may be very different. Despite the differences in the causes of symptoms, the clinical presentations are similar and treatment choice is based upon best guess.
School aged children with asthma also have airway inflammation and there is increasing evidence that treatment based on these inflammatory patterns may be beneficial. Samples obtained at bronchoscopy (a camera passed into the airways under general anaesthetic) provide an accurate picture of airway inflammation, however this is invasive, and provides only a snapshot at a single moment in time. Less invasive methods allow us to monitor airway inflammation and infection over time in the clinical setting enabling assessment of treatment response and disease progression. However, we have yet to determine the optimal non-invasive methods to use.
The purpose of this study is to make use of samples collected as part of the clinical assessment and collect additional research samples (including sputum, nasal fluid and blood) to define the non-invasive assessment of airway inflammation and infection in pre-school children with recurrent wheeze and school aged children with asthma and compare these measures to children with other respiratory symptoms (recurrent chest infections or prolonged cough). In a sub-group of children undergoing a clinically indicated bronchoscopy the non-invasive measures will be compared to bronchoscopic samples.
London - Hampstead Research Ethics Committee
Date of REC Opinion
10 Dec 2015
Further Information Favourable Opinion