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Patterns of airway infection and inflammation in children

  • Research type

    Research Study

  • Full title

    Do patterns of airway infection and inflammation distinguish pathophysiological phenotypes in children with wheeze and asthma?

  • IRAS ID

    187435

  • Contact name

    Sejal Saglani

  • Contact email

    s.saglani@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    1 years, 10 months, 28 days

  • Research summary

    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.

  • REC name

    London - Hampstead Research Ethics Committee

  • REC reference

    15/LO/1885

  • Date of REC Opinion

    10 Dec 2015

  • REC opinion

    Further Information Favourable Opinion