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Primary prevention of asthma

We may not be able to cure asthma within the next few years, but our researchers are working on ways to prevent people from developing asthma in the first place.

Research in this area includes: studying children at an increased risk of developing asthma (such as babies born prematurely) to understand what increases this risk, and develop interventions to stop that from happening; identifying children at risk of developing asthma, and understanding what is different about their lungs - with a view to changing these differences to prevent asthma from developing; potential advantages of certain vitamins during pregnancy, such as vitamin D, as a way to reduce the risk of children developing asthma; understanding the best way to expose children to substances to avoid the development of food allergies, which are a common cause of asthma attacks; and other research in this area.

 

See the Centre structure for the full list of researchers that support each research theme.

 

Pre-term birth, respiratory infection and lung function as predictors of asthma

Greenough and Johnston will investigate roles of viruses and genetic pre-disposition influences on prematurely born children’s respiratory health and asthma risk. Greenough will pursue her studies of ventilation strategies in pre-term infants, including longitudinal studies and assessment of young adults, to understand what triggers the excess of asthma in this population. She will also investigate the pulmonary complications of sickle cell disease (SCD) to identify the importance of co-existing asthma to increasing morbidity and mortality, and in particular investigating reducing asthma-related pulmonary morbidity and mortality in SCD.

 

Pre-school wheeze:

Bush, Custovic, Saglani and Lloyd will focus on pre-school wheezers to investigate the usefulness of “biomarkers in infancy” in predicting asthma risk. Lloyd with Saglani and Bush will focus on the molecular mechanisms underlying pre-school wheeze, studying airway macrophages and epithelial cells from patients with severe asthma and determining how these characteristics are changed by the local environmental cytokine milieu, together with the role of early life infection and how this affects development of allergic responses. They will investigate manipulation of the developing immune system in early life by using agents designed to skew the microbiome.

 

Vitamin D

Pregnancy and early life represent a critical time window for development of the immune system; data from the VDAART-Ancillary studies suggest that vitamin D sufficiency throughout pregnancy enhances “fitness” of the immune response to microbial challenge, whilst preserving immunoregulatory mechanisms. Hawrylowicz will study neonatal-specific effector and regulatory pathways, their regulation by vitamin D, and how they predict respiratory outcomes. The longer-term goal is to perform the first UK-based clinical trial of vitamin D supplementation in pregnancy to assess the impact on respiratory and immune outcomes in the neonate and infant in the first years of life, a critical period in determining asthma onset.

 

Allergen exposure

Lack will study the persistence, and immunological basis, of oral tolerance induction to peanut in the ongoing LEAP-ON trial; and the impact of peanut protein in dust as an objective marker of compliance in that study. Santos, with Gould, Lack and Sutton will study biomarkers and mechanisms of food allergy and oral tolerance in IgE-sensitised children, aimed at improving the diagnosis of peanut allergy using the basophil activation test and understanding the mechanisms driving the absence of clinical allergy in children with positive allergy tests to peanut.