Our new look

The National Asthma Council Australia has launched a brand new logo to take it forward well into the next decade.

This is only the third image upgrade for the National Asthma Council Australia since it was established, originally as the ‘National Asthma Campaign', 21 years ago.

Contents this month Our new look Inhaler misuse warning Handy resource links for NAC website Assisting in asthma Vitamin D may halt lung function decline Why eczema often leads to asthma Research Funding Opportunities Conference Diary 2009

The new logo uses two blue tones to emphasise the name of the organisation, reinforcing the NAC's role as Australia's national peak asthma body, and it features a stylised cloud graphic to convey the important concept of breathing fresh air.

It is a clean, modern image for the Council that works equally well on traditional mediums, such as printed brochures, and with the latest electronic and on-line formats.

Many NAC resources have already been updated to feature the new logo, including the revamped website which was launched last month. Other popular publications, such as the Asthma Management Handbook, will be re-branded when a reprint is necessitated.

So, next time you're looking for the most up to date asthma management information and advice, just look for the clouds!

Inhaler misuse warning

World Asthma Day is the first Tuesday in May each year and the National Asthma Council Australia (NAC) marked the occasion by reminding the two million Australians who suffer from asthma to brush up their inhaler technique. This follows reports that up to 90 per cent of patients who use inhalers do not use their inhalers (puffers) correctly.  

According to the NAC, inhaler misuse results in poor medication delivery, which in turn can lead to reduced quality of life, more frequent and longer hospital stays and poor control of the symptoms of asthma, wheeze, cough and breathlessness.

Whilst inhaler misuse is rife amongst all age groups, it is particularly concerning amongst older Australians, who are most at risk of dying from chronic respiratory conditions like asthma.

Handy resource links for NAC website

There are two handy resource pages on the National Asthma Council website that may assist you with better accessing the wide range of asthma information available. 

For health professionals

Shortcuts to the top asthma management resource tools from the National Asthma Council Australia for GPs and Health Professionals are available at Asthma Management Tools.

Resources include:

• Asthma Management Handbook
• Spirometry Handbook
• Spirometry Users` and Buyers` Guide
• Asthma Action Plans and more

For students

Shortcuts to information about adherence, evidence-based review, asthma information papers and other key data about asthma are available from the Student Resources page.

Resources include:

• Asthma Adherence - A Guide for Health Professionals
• 1999 Evidence-Based Review of the Australian Six Step Asthma Management Plan
• Asthma information papers for Health Professionals: Series 1-8
• Managing your Asthma chart
• Asthma: Basic facts and more       

 Assisting in asthma 

New Information Service for Asthma Patients from Asthma Foundation NSW#

We all know that poor asthma management leads to compromised quality of life and increased risk of exacerbation.  People who understand their own asthma and have the right information to deal with changes in their condition are less likely to experience symptoms and utilise healthcare urgently, and are more likely to enjoy a full and active life.

We also know that many people with asthma are keen to receive detailed information about the condition and its management, and that this is a critical element in empowering individuals to effectively manage chronic conditions such as asthma. 

Asthma Foundation NSW have launched a comprehensive information service - Asthma Assist, which is based on the insight that asthma information is highly sought after, but not always easy to find.  Offering people a comprehensive information service which includes subscription to a regular e-newsletter, an asthma information pack, and access to the Asthma Information Line and website of the Foundation, has been shown to appeal to consumers.  

GPs are a critical source for asthma information 

GPs are in contact with patients at the time of diagnosis, when their asthma is most problematic, or when it is under review.  During consultations with GPs, the patient has a strong focus on their asthma, and is most receptive to suggestions as to where they can obtain further information about asthma and its management.

Medication + Education = Good Asthma Management

Asthma Foundation NSW ran a pilot campaign promoting Asthma Assist to over 2000 GPs across metropolitan NSW during May. GPs received a special pack including a sample of the Asthma Control Packs freely available to their patients who join the Asthma Assist service and fliers that could be distributed to patients. explaining the Asthma Assist Service and how to join.  An evaluation of this pilot will shortly be undertaken.

Do you refer your patients to the Asthma Foundations for information?

Programs like Asthma Assist play an important role in assisting your patients to better understand and manage their asthma through the provision of evidence based and user friendly information and advice to answer any questions that might arise in between GP visits.  Many patients don't always ask all their questions during a consult with their GP.

Asthma Assist is for anyone with an interest in asthma.  You can join online www.asthmansw.org.au 
The Asthma Foundations have a wide range of information resources that are freely available to the community, to help them better understand and manage their illness.

# Article provided by Asthma Foundation NSW  

 Vitamin D may halt lung function decline in asthma and COPD

American Thoracic Society Meeting San Diego, USA  

Vitamin D may slow the progressive decline in the ability to breathe that can occur in people with asthma as a result of human airway smooth muscle (HASM) proliferation, according to researchers at the University of Pennsylvania.

The group found that calcitriol, a form of vitamin D synthesized within the body, reduced growth-factor-induced HASM proliferation in cells isolated from both persons with asthma and from persons without the disease. The proliferation is a part of process called airway remodeling, which occurs in many people with asthma, and leads to reduced lung function over time.

The researchers believe that by slowing airway remodeling, they can prevent or forestall the irreversible decline in breathing that leaves many asthmatics even more vulnerable when they suffer an asthma attack.

"Calcitriol has recently earned prominence for its anti-inflammatory effects," said Gautam Damera, PhD, who presented the research at the American Thoracic Society's 105th International Conference in San Diego on Wednesday, May 20. "But our study is the first to reveal the potent role of calcitriol in inhibiting ASM proliferation."

The experiments were conducted with cells from 12 subjects, and the researchers compared calcitriol with dexmethasone, a corticosteroid prescribed widely for the treatment of asthma. Although, dexmethasone is also a powerful anti-inflammatory agent, the researchers found that it had little effect on HASM growth.

Dr Damera and his colleagues found calcitriol inhibits HASM in a dose-dependent manner, with a maximum inhibitory effect of 60 percent ± 3 percent at 100nM.

As part of the University of Pennsylvania's Airway Biology Initiative, the researchers are planning a randomized control trial of calcitriol in patients with severe asthma and expect to have data from the trial in about a year's time.

With its anti-inflammatory qualities and its ability to inhibit smooth muscle proliferation, Dr. Damera said, calcitriol may become an important new therapy, used alone or in combination with already prescribed steroids, for treating steroid-resistant asthma.

Dr Damera and his colleagues have also conducted experiments to determine the mechanism by which calcitriol retards HASM proliferation. They believe the vitamin works by inhibiting activation of distinct set of proteins responsible for cell-cycle progression.

The investigators have also conducted experiments to determine whether calcitriol, which is currently used to treat psoriasis, could be an effective therapy for COPD. Although preliminary, their data shows that calcitriol appears to reduce pro-inflammatory cytokine secretions in COPD. As with asthma, the researchers believe, calcitriol may also have the added benefit of slowing, if not stopping, the progression of airway remodeling. Others in the field believe calcitriol may also have the potential to inhibit the development and growth of several types of cancer.

Why eczema often leads to asthma

Many young children who get a severe skin rash develop asthma months or years later. Doctors call the progression from eczema, or atopic dermatitis, to breathing problems the atopic march.

Now scientists at Washington University School of Medicine in St. Louis have uncovered what might be the key to atopic march. They've shown that a substance secreted by damaged skin circulates through the body and triggers asthmatic symptoms in allergen-exposed laboratory mice.

The findings, published May 19, 2009, in Public Library of Science Biology, suggest that early treatment of skin rash and inhibition of the trigger substance might block asthma development in young patients with eczema.

Fifty percent to 70 percent of children with severe atopic dermatitis go on to develop asthma, studies show. By comparison, the rate of asthma incidence among the general population is only about 9 percent in children and 7 percent in adults. Seventeen percent of U.S. children suffer from atopic dermatitis, although not all cases are considered severe.

"Over the years, the clinical community has struggled to explain atopic march," says study author Raphael Kopan, professor of developmental biology and of dermatology. "So when we found that the skin of mice with an eczema-like condition produced a substance previously implicated in asthma, we decided to investigate further. We found that the mice also suffered from asthma-like responses to inhaled allergens, implicating the substance, called TSLP, as the link between eczema and asthma."

Doctors and scientists had come up with theories to explain why a skin rash is sometimes associated with asthma. Do some people have an immune system disorder that causes an overreaction to allergens that contact the skin and lung airways? Or is it the opposite - do they have defective skin and airways that trigger an excessive immune response?

Kopan's findings suggest the problem starts with damaged or defective skin. The researchers found that cells in damaged skin can secrete TSLP (thymic stromal lymphopoietin), a compound capable of eliciting a powerful immune response. And because the skin is so effective in secreting TSLP into the blood system, the substance travels throughout the body. When it reaches the lungs, it triggers the hypersensitivity characteristic of asthma.

Led by doctoral student Shadmehr (Shawn) Demehri, the researchers studied mice that had been engineered with a genetic defect in patches of their skin. In the affected areas, the typically ordered layers of skin cells were disrupted, creating a condition similar to eczema. These patches were thickened and inflamed. The defective skin secreted TSLP as part of an alarm system alerting the body that its protective barrier function has failed - the substance activates an immune response that fights invaders.

Operating on the assumption that other barrier organs such as the lung will understand this alarm, the researchers tested what happened when the mice with skin defects inhaled an allergen. They found that their lungs reacted strongly - their breathing became labored and their lung tissue took on the traits that mark asthma in humans: mucous secretion, airway muscle contraction, invasion by white blood cells and conversion of lung cells from one type to another. Additional experiments showed that mice that had normal skin but were engineered to overproduce TSLP also developed the asthma-like symptoms.

"We are excited because we've narrowed down the problem of atopic march to one molecule," Kopan says. "We've shown that skin can act as a signaling organ and drive allergic inflammation in the lung by releasing TSLP. Now it will be important to address how to prevent defective skin from producing TSLP. If that can be done, the link between eczema and asthma could be broken."

TSLP is also produced in lungs of asthma patients, and Kopan says that research in the skin could eventually lead to ways to interfere with TSLP made in the lungs and thereby ease asthma development even in cases that aren't linked to eczema.

"This research is a great example of the value of basic research approaches in uncovering the root causes of disease," says Richard Anderson, MD, PhD, of the National Institutes of Health's National Institute of General Medical Sciences, which partially supported the work. "If these mechanisms operate the same way in humans, we could be on our way toward developing new strategies for preventing or treating asthma."

Reference

Demehri et al. Skin-derived TSLP triggers progression from epidermal-barrier defects to asthma. PLoS Biology, 2009; 7 (5): e1000067 DOI: 10.1371/journal.pbio.1000067   

Research Funding Opportunities

The National Asthma Council Australia would be pleased to list funding opportunities that may be available for asthma research. Submit brief details for consideration by email to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Conference Diary

Submit brief conference/meeting details to the National Asthma Council Australia for possible posting in our Conference Diary by email to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

2009
	IPCRG International Scientific Conference 5 June 2009, Stansted Airport, UK http://www.theipcrg.org/sci_conf_2009/programme.php
	49th Annual Meeting of the JRS 12-14 June 2009 Tokyo, Japan http://www.jrs.or.jp/
	First World Conference of COPD Patients  14 June 2009  Rome, Italy http://www.internationalcopd.org/Conference/
	ERS Annual Congress 12-16 September 2009 Vienna, Austria http://www.ersnet.org/
	Inspiration for Life Asthma and Respiratory Educators Association 2009 Conference 15 and 16 Octyober, 2009 Sebel, Albert Park, Melbourne Victoria Australia http://www.aareaconference.com/
	Annual International Scientific Assembly of the American College of Chest Physicians 31 October - 5 November 2009 San Diego, United States http://www.chestnet.org/CHEST/
	American College of Allergy, Asthma & Immunology 6-11 November 2009 Miami Beach, United States http://www.acaai.org/
	Melbourne GPCE 13-15 November 2009 Melbourne Exhibition Centre, Southbank http://www.gpce.com.au/
	14th Congress of the APSR   14-18 November 2009 Seoul www.apsresp.org/congress/2009.php
2010
	8th Asia Pacific Congress of Allergy, Asthma and Clinical Immunology (APCAACI 2010)  7-10 November 2010  Suntec Singapore International Convention & Exhibition Centre  http://www.apcaaci2010.org/  This e-mail address is being protected from spam bots, you need JavaScript enabled to view it