Chronic Obstructive Pulmonary Disease (COPD)

Immune Activation in Subjects with COPD
(Professor Peter Gibson)

The University of Newcastle is investigating innate immune activation in subjects with COPD and matched controls. Data analysis is complete and further flow cytometry experiments to confirm TLR2 expression in airway cells are close to completion. Further studies in this area are currently being planned, including a project relating to the characterisation of Airway Inflammation in the elderly, and a randomised controlled trial of guidelines management versus non-invasive inflammatory marker.

COPD Secondary Prevention
(Dr Claudia Dobler, Professor Guy Marks, Professor Peter Gibson)

Some people who quit smoking continue to progress to develop symptomatic COPD despite having quit. There is some evidence that this is attributable to persisting inflammation and that anti-oxidant and anti-inflammatory therapies may ameliorate this progression. We are planning a randomised controlled trial to test the effect of two interventions which may have a beneficial effect among relatively young, symptomatic ex-smokers with evidence of systemic inflammation: anti-oxidant vitamin supplements and treatment with statins. At present we are using CCRE seed funding to conduct a pilot study to assess feasibility and to collect preliminary data.

Overlap Syndrome (Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea)
(Dr Keith Wong / Dr Roo Killick / Brian Jackson)

CCRE has provided seed funding for a pilot study, a randomised controlled trial in Overlap Syndrome (coincidence of COPD and OSA), to characterise markers of systemic inflammation in patients with Overlap Syndrome. The protocol was developed, and ethics approval has been obtained for two collaborating sites of Royal Prince Alfred Hospital and John Hunter Hospital. The study is now open for recruitment.

CCRE seed funding also supports a project examining the effects of continuous positive airway pressure treatment on pulmonary function, markers of systemic inflammation, and respiratory-related quality of life, in patients with combined chronic obstructive pulmonary disease and obstructive sleep apnea in a parallel group randomised trial is in the recruitment phase. This project is being run in collaboration between Woolcock Institute of Medical Research and the Hunter Research Institute at John Hunter Hospital, Newcastle. This study has the potential to impact greatly on clinical practice, as there is an estimated half a million Australians with moderately advanced chronic obstructive pulmonary disease, and it is estimated that up to 20% of these may have co-existing obstructive sleep apnea. Both of these conditions are associated with significant cardiovascular morbidity and mortality, and obviously providing thorough research to generate good clinical practice guidelines would be of particular benefit to national health outcomes in this clinical area.