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The prevalence of asthma is increasing, especially among children. For those with severe disease, frequent flare-ups, hospitalisations and side effects of treatment can make quality of life poor.1 Dr Erol Gaillard, of the University of Leicester, is investigating a possible link between severe asthma and the presence of fungi in children’s airways (small tubes that carry air into the lungs). His findings could lead to a clinical trial of anti-fungal treatment, with the aim of improving the lives of children with severe asthma.
What is the problem and who does it affect?
Around 1.1 million children in the UK have asthma.2 Around 1 in 20 of those children has severe asthma, which remains difficult to control despite large doses of medicines.3,4
“Severe asthma can be really quite disabling for the child and can disrupt family life considerably,” explains Dr Gaillard. “Children can suffer symptoms on a daily basis, which disturbs their sleep and limits their activity. They may be unable to take part in PE lessons, or go on school trips, and have frequent flare-ups. It’s common for children to be admitted to hospital three or four times a year for several days at a time. The children can miss significant amounts of school. Sadly, the severity and unpredictability of asthma attacks can cause lots of anxiety.”
Treatment options for severe asthma are limited. Children often need high doses of medicines called corticosteroids, which are linked to problematic side effects.
“Unfortunately, we don’t know much about why a child’s asthma might become severe,” says Dr Gaillard. “Medication works for the majority of children with asthma, keeping their symptoms under control, but children with severe asthma don’t respond so well to medication and we don’t know why.”
What is the project trying to achieve?
“We are trying to find out why some children’s asthma becomes severe,” explains Dr Gaillard. “We think that children with severe asthma might be more likely than other children to have fungi growing in their airways and to be allergic to fungi. We are testing whether or not that’s true. Does the presence of fungi make the children’s asthma worse and stop them from responding to treatment? We are trying to find out.”
Around 40 children with severe asthma, 60 children with mild-to-moderate disease and 40 children with no history of asthma are joining the study.
“If we find that there is a link between severe asthma and fungi in the airways, then the next step would be to investigate whether anti-fungal treatment makes children’s lives better,” explains Dr Gaillard. “We would also investigate what sorts of disease processes are triggered by the fungi, which could eventually lead to totally new treatments.”
What are the researchers’ credentials?
Dr Gaillard is using cutting-edge research techniques that will be central to the success of this study. He is supported by colleagues from the University of Leicester who are world experts in the role fungi play in diseases of the airways, including asthma.
- Global Initiative for Asthma. Pocket guide for asthma management and prevention. Updated December 2011. http://www.ginasthma.org/guidelines-pocket-guide-for-asthma-management.html Website accessed 3 October 2012.
- Asthma UK. Asthma and your child. http://www.asthma.org.uk/about-asthma/my-child-has-asthma/asthma-your-ch... Website accessed 12 September 2012
- Asthma UK. What is severe asthma? http://www.asthma.org.uk/about-asthma/what-is-severe-asthma/ Website accessed 12 September 2012
- Lang A et al. Severe asthma in childhood: assessed in 10 year olds in a birth cohort study. Allergy 2008; 63: 1054-60.
|Project Leader||Dr Erol A Gaillard PhD MRCPCH|
|Project Team||Professor Andrew J Wardlaw FRCP PhDDr Catherine H Pashley PhDDr HC Pandya MBCHB MRCP MD|
|Project Location||Department of Paediatrics, Leicester Royal Infirmary and Department of Infection, Immunity and Inflammation, University of Leicester|
|Project Location Other||Department of Respiratory Medicine, Institute for Lung Health, Glenfield Hospital, Leicester|
|Project duration||2 years|
|Date awarded||26 July 2012|
|Project start date||1 March 2013|
|Project end date||31 March 2017|