May 2008
Balancing the Benefits:
Asthma and Combination Therapy Update
TSANZ Asthma Award
Bangladesh celebrates World Asthma
Day
Making the asthma and allergy
connection at GPCE Sydney
Allergy research
breakthrough
Occupational asthma affects
thousands of Australians
Research Funding Opportunities
The Asthma
Foundation of Queensland PhD Scholarship
Conference Diary
Balancing the Benefits:
Asthma and Combination Therapy Update
Combination therapy in asthma management is the
focus of the NAC's latest program with the Rural
Health Education Foundation, supported by funding
from an unrestricted educational grant from
AstraZeneca.
The NAC has worked with the Rural Health
Education Foundation for many years to develop
medical education programs about asthma. These
engaging panel discussions provide health
professionals with an opportunity to review the
latest health information in their own time while
receiving continuing professional education
recognition.
Program summary
There are more than two million Australians
suffering from asthma. Since 2000 many people living
with asthma have experienced a change in the way
their asthma is managed. Symptom controllers, also
known as long-acting beta2agonists (LABA),
combined with traditional inhaled corticosteroids
are resulting in effective management of asthma
symptoms with lower quantities of medication.
Recent advances in combination therapy medication
are changing the way some of these modern
medications are used. This program outlines the best
practice use of asthma combination therapies,
including the appropriate selection of medications
and different management regimens, in the context of
latest research.
Discussion case studies reinforce learning
outcomes in a clinical setting.
Online now at
http://www.rhef.com.au/programs/810/810.html
Duration: 60 minutes
Learning outcomes
After viewing this program participants will be
able to:
- Improve their ability to identify and assess
people with asthma who may benefit from
combination medication.
- Understand the indications and treatment
regimens of the different combination
medications.
- Identify appropriate review periods, manage
medication regimes and adjust where required for
asthma control.
- Enhance their ability to educate patients
about combination medication dosage, titration
and side effects.
Speakers
- Chair: Dr Norman Swan, Presenter of
the Health Report on ABC Radio National.
- Associate Professor Matthew Peters,
Respiratory Physician, Concord Clinical School,
University of Sydney
- Dr Clive Tucker, General
Practitioner, Purga, QLD
- Mr Stephen Hughes, Community
Pharmacist, Sydney, NSW
- Ms Judi Wicking, Asthma Educator,
Melbourne, VIC and Asthma Education Program
Project Officer, National Asthma Council
Australia
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| Associate Professor Matthew Peters |
Dr Clive Tucker |
Mr Stephen Hughes |
Ms Judi Wicking |
Resources
NAC Asthma Programs with the Rural Health Education
Foundation (http://www.nationalasthma.org.au/html/management/prof_develop/pd001_rhef.asp)
Combination medications, Asthma Management
Handbook 2006
TSANZ Asthma Award
Dr Cristan Herbert from the University of New
South Wales has won the 2008 Thoracic Society of
Australia and New Zealand (TSANZ) and NAC Asthma
Prize.
The TSANZ and NAC Asthma Prize is one of four
annual awards funded by the NAC to encourage
research into asthma. It is given for the best oral
or poster presentation on asthma at the TSANZ Annual
Scientific Meeting.
Dr Herbert’s winning presentation was:
Enhanced expression of cytokines by CD4+ T cells in an acute exacerbation of
chronic asthma. Cristan Herbert, Kim Hoa Scruton, Kenneth Hsu, Jessica S Siegle,
Paul S Foster, Nicodemus Tedla and Rakesh K Kumar.
Resources
NAC Asthma
Research Awards
TSANZ (http://www.thoracic.org.au).
Bangladesh celebrates World
Asthma Day
World Asthma Day was celebrated in Bangladesh
with asthma rallies on behalf of the Bangladesh Lung
Foundation - Primary Care Group (BLF-PCG) and the
International Primary Care Group (IPCRG) Bangladesh
unit.
More than 200 participants attended the rally in
Khulna, including doctors, nurses, pharmacists and
educators (pictured).
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Photo courtesy Dr
Monsur Habib, Chairman BLF-PCG. |
The rallies were supported by a range of
activities around the country, including a poster
promotional campaign in major health institutes and
three television appearances.
Resources
Bangladesh Lung Foundation (www.lungbd.org)
WAD on Global Initiative for Asthma (GINA)
(http://www.ginasthma.com/WADIndex.asp)
Making the asthma and allergy
connection at GPCE Sydney
' Asthma
and Allergy: what’s the connection?' was one of the
most popular sessions at General Practitioners’
Conference and Exhibition (GPCE) Sydney on 25 May.
The 1-hour seminar was hosted by the NAC with
support from Schering Plough.
Professor Connie Katelaris, allergist and
immunologist, and Associate Professor Ian Charlton,
GP, presented a dynamic session covering
differential diagnosis and practical strategies for
management of concurrent asthma and allergy.
There is a strong association between asthma and
allergy. Allergic individuals are over three times
more likely to develop asthma while 60-80% of asthma
patients have coexisting allergic rhinitis or
sinusitis.
Resources
Allergic rhinitis and your asthma: What you should
know
Allergic rhinitis and the patient with Asthma: A
guide for health professionals
Asthma information brochures for patients
Asthma information papers for Health Professionals
Allergy research breakthrough
 In
a world first scientists have identified how a gene
associated with allergic diseases such as asthma and
eczema works, providing new hope for potential drug
treatments.
The University of Sydney's Dr Graham Jones led a
group based at the Westmead Millennium Institute
(Institute of Immunology and Allergy) which
investigated the 'PHF11' gene and its role in the
immune system (and therefore allergies). They
focussed on two types of T-cells known as Th1 and
Th2.
"One of the hallmarks of allergy is an imbalance
between these two types of T-cells: we know many
children and adults with allergies have an
oversupply of the Th2 version of T-cells compared to
the Th1 version," said Dr Jones.
"Our breakthrough is finding that the PHF11 gene
encodes a protein whose function is to turn on other
T-cell genes and, more importantly, that its effect
is more pronounced in Th1 than Th2 cells.
"In a nice tie-in with our earlier genetic
studies, we have also found that genetic variants in
the PHF11 gene that are associated with childhood
eczema lead to lower levels of PHF11 gene activity.
This could lead to problems with Th1 T-cells.
"Although there is much work ahead of us, our
results suggest that problems with the Th1 subset
could contribute to the Th1/Th2 T-cell balance. This
idea has been around for some time now, but it is
very satisfying to uncover new evidence for it using
our genetic and functional approach," stated Dr
Jones.
"Most people with asthma or eczema are atopic -
meaning they have a genetic tendency for the
disorders," said Professor Tony Cunningham, Westmead
Millennium Institute Director. "So this is an
important step forward in this field of genetic
research."
"While in its early stages the research does have
the potential to guide the development of new drugs
and topical therapies for the treatment of allergies
like asthma and eczema."
It is well known that allergy has a strong
genetic basis: in other words, if parents have
an allergy then in many cases so to do their
children. Although genetic studies can show what
genes play a role in allergic diseases such as
asthma and eczema, understanding how these genes
contribute to the development of allergic
disease often lags behind.
This new work is particularly exciting as it
builds upon genetic studies to show for the
first time how a gene called PHF11 is involved
in allergic disorders such as asthma and eczema,
said Dr Jones.
Reference
Clarke E, Rahman N, Page N, Rolph MS, Stewart GJ, Jones GJ. Functional
characterization of the atopy-associated gene PHF11. The Journal of
Allergy and Clinical Immunology - May 2008 (Vol. 121, Issue 5, Pages
1148-1154.e3, DOI: 10.1016/j.jaci.2008.02.028)
Occupational asthma affects
thousands of Australians
Exposure to agents such as wood dust, paint
fumes, solvents, latex and baking flour triggers
from 1,000 to 3,000 new cases of asthma every year
in susceptible workers in Australia, according to a
report from the Australian Institute of Health and
Welfare (AIHW).
There are between 300 and 400 potential causal
agents of occupational asthma. Among the most common
causes of occupational asthma in Australia are wood
dust from trees such as the Western red cedar,
isocyanates (the raw materials used in polyurethane
products), paint fumes, solvents, latex, and flour.
The report, Occupational Asthma in Australia,
shows that anywhere from 9 to 15% of adult-onset
asthma cases can be attributed to exposure to causal
agents at work.
'As many as 3,000 new cases of occupational
asthma occur each year in Australia,' said Dr
Kuldeep Bhatia, Head of the AIHW's Asthma, Arthritis
and Environmental Health Unit.
Occupations with the greatest risk for
occupational asthma include farming, painting,
cleaning, baking, animal handling and chemical work.
Other at-risk occupations include nursing,
welding, food processing, dentistry, timber and
forestry industries, and industries that produce
metals, plastics, electronics, rubber and textiles.
Although not curable, occupational asthma is
largely preventable through actions that avoid or
reduce exposure to workplace sensitisers and
irritants.
'Unfortunately people with occupational asthma
often have to change jobs or careers to relieve
their symptoms, hence work disruption and economic
hardship can result,' Dr Bhatia said.
Asthma is a chronic inflammatory disease of the
airways that affects more than 2 million Australians
across all age groups. Asthma can develop any time
in life but current estimates are that 50-60% of all
cases develop in adulthood.
Exposure to causal agents, tobacco smoking,
previous allergic sensitisation, and genetic
disposition are all thought to affect individual
susceptibility to asthma.
Resources
Occupational Asthma in Australia (http://www.aihw.gov.au/publications/index.cfm/title/10328)
Occupational asthma, Asthma Management Handbook
2006.
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
editor@nationalasthma.com.au. |
The Asthma Foundation of Queensland
PhD Scholarship
for Eligible Medical, Scientific, Nursing & Pharmacy
Graduates and equivalently qualified Allied Health
Practitioners Commencing 2009
Applications are invited for the Asthma
Foundation of Queensland PhD Scholarship open to
eligible medical, scientific, nursing and pharmacy
graduates and equivalently qualified allied health
practitioners (eg psychologists, physiotherapists,
asthma educators, etc) who plan to commence a PhD in
2009. The scholarship will provide financial support
for a graduate looking to build a career in research
relevant to asthma.
The research must be undertaken in Queensland.
The scholarship is open to Australian citizens or
permanent residents intending to nurture a career in
Queensland, and will be for a period of up to three
years, with the stipend and allowances based upon
NHMRC rates. Further information and application
forms are available for downloading at the
foundation’s website at
www.asthmaqld.org.au or from:
The Managing Director
The Asthma Foundation of Queensland
PO Box 394
Fortitude Valley Qld 4006
Email: info@asthmaqld.org.au
Ph:
(07) 3252 7677 or 1800 645 130 Fx: 07 3257 1080
Applications close on 30 June 2008
Conference Diary
Submit brief conference/meeting details to the National Asthma Council Australia for possible posting in our Conference Diary by email to
editor@nationalasthma.com.au.
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The 4th IPCRG World Conference:
Building bridges among diversity
28 - 31 May, 2008
Seville, Spain
http://ipcrg-seville2008.unicongress.com/ |
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XXVII
Congress of the European Academy of Allergology and
Clinical Immunology
7-11 June 2008
Barcelona, Spain
http://www.eaaci2008.com |
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48th Annual Meeting of the Japanese Respiratory Society
15-17 June 2008
Kobe, Japan
http://www.jrs.or.jp/english/information/meeting48.html
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2nd
Australian Lung Cancer Conference
21–24 August 2008
Holiday Inn – Surfers Paradise
Queensland
http://www.alcc.net.au/ |
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WONCA
2008 Asia Pacific Regional Conference
1–5 October 2008.
Melbourne, Australia
http://www.wonca2008.com |
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ERS Annual Congress
4-8 October 2008
Berlin, Germany
http://www.ersnet.org/
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Advancing Asthma Where?
Australian Asthma Conference
20 - 21 October 2008
Australian Technology Park
Sydney, Australia
http://www.asthmaconference2008.com/ |
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CHEST, Annual International Scientific Assembly of the American College of Chest Physicians
25-30 October 2008
Philadelphias United States
http://www.chestnet.org/CHEST/
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American College of Allergy, Asthma & Immunology
7-12 November 2008
Seattle, United States
http://www.acaai.org/
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13th APSR Congress
19-22 November 2008
Bangkok, Thailand
http://www.apsr2008.org
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Annual Meeting of Taiwan Society of Pulmonary and Critical Care Medicine
6-7 December 2008
Taipei, Taiwan
spccm@mars.seed.net.tw
http://www.tspccm.org.tw/
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