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The Children's Respiratory Group

About us

The Children's Respiratory Group,
Clinical and Translational Research Institute,
Newcastle University

The group is embedded within the vibrant academic respiratory medicine grouping in the Translational and Clinical Research Institute, Newcastle University. Clinical members also work in paediatric respiratory medicine at the Great North Children’s Hospital and Freeman Hospital in the Newcastle upon Tyne Hospitals NHS Foundation Trust.
Our programme of research is focused on increasing the understanding of childhood respiratory disease and importantly translating these findings in to the development of new treatments and improved delivery of care for children and young people with lung problems. Current projects span from laboratory-based basic science to major national epidemiological studies.

Our research

Cystic fibrosis

Cystic fibrosis (CF) is the most common genetically-acquired life limiting disorder in the UK, affecting over 10,000 people. The underlying cause of CF is mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which encodes for an apical chloride and bicarbonate transporter expressed by epithelial cells. CF is a multisytem condition, but it is lung disease that is responsible for the vast majority of morbidity and mortality.

CF lung disease is characterised by chronic endobronchial inflammation, infection and retention of airway secretions. Research in our laboratory is focused on understanding the pathogenesis of CF lung disease to inform the development of new treatment strategies. We aim to ask the most clinically meaningful questions possible and our approach to answer these typically involves combining innovative experimental techniques with clinical samples from children and people with CF.

Pleural infection & empyema

Para-pneumonic effusion and empyema are complications of pneumonia in children that are associated with significant morbidity. The incidence of paediatric empyema increased dramatically during the 1990’s and 2000’s. The precise explanation for this remains unclear and substantial gaps remain in our understanding of the pathogenesis of this condition. Childhood empyema is also characterised by a lack of good quality evidence to inform clinical management.
Working with Dr Matt Thomas, current research includes monitoring the changing epidemiology of empyema in children, involving a large prospective national surveillance study (UK-ESPE study). There is long-standing close collaboration with Professor Steve Rushton’s Biological, Clinical and Environmental Modelling Group, School of Biology, Newcastle University. The overarching aim is to advance understanding of the epidemiology and pathogenesis of empyema in children to develop optimal strategies to ultimately aim for prevention but also to treat children with the condition.

Pneumonia

Community-acquired pneumonia (CAP) remains a common childhood condition and is a leading reason for the hospitalisation of children in developed countries. Globally it is responsible for around a million deaths of children each year. Greater understanding of the epidemiology of CAP in children is therefore important to optimise treatment strategies, inform vaccine design and plan future public health policy and research.
The survey’ is a prospective multicentre (9 Hospitals) survey of all children admitted to hospital in the North East of England with CAP over a 12 month period. The study’ is a prospective observational study (GNCH and JCUH, Middlesbrough) investigating the aetiology of CAP in children in the North East of England over an 18 month period. All children admitted are screened for signs and symptoms of CAP and appropriate changes on a chest radiograph. Once a child is enrolled in the study demographic and clinical details are collected, as well as microbiological samples for extended testing.

Airway physiology

Raising airway pressure is one of the most important interventions at the disposal of clinicians treating patients with respiratory failure. Non-invasive ventilatory strategies such as CPAP (Continuous Positive Airway Pressure) or HFNC (High Flow Nasal Cannula) are commonly used in young children, such as premature infants and those with bronchiolitis. Despite widespread usage and rapid adoption of HFNC systems, the mechanisms of action are not well understood with a limited number of studies published in the literature. Preterm infants often receive flow rates of up to 8 litres per minute with no robust data about airway pressures delivered. There is no consistent data to guide what flow should be prescribed and how the relationship between these variables should be adjusted in individual infants or for example about optimal weaning strategies.
Our research aims to study the airway physiology associated with HFNC use in infants (through both direct and indirect measurements) to increase understanding of how HFNC works and to optimise the delivery of this non-invasive ventilation modality. Dr Zheyi Liew, Clinical Research Fellow, works on this collaborative project with Dr Chris O’Brien and Neonatologists Dr Alan Fenton and Dr Sundeep Harigopal from Ward 35, Royal Victoria Infirmary, Newcastle. A pilot study on the feasibility and repeatability of measurement of various aspects of respiratory physiology during HRNC therapy was previously carried out by Dr S. Gopalakaje.

Non tuberculosis mycobacterium

Recently, infection with nontuberculous mycobacteria (NTM) has become a subject of increasing clinical concern in people with CF. NTM are environmental organisms found commonly in soil and water. Two groupings are most frequently isolated from people with CF, Mycobacterium abscessus complex and Mycobacterium avium complex. Infection with M. abscessus specifically has been found to be associated with increased decline in lung function. Treatment of airway infection with NTM requires prolonged courses of multiple antibiotics, often for more than 12 months, and is associated with a significant treatment burden and frequent adverse effects.
We are undertaking research into NTM on two fronts. The first uses a UK CF Registry based approach, allowing us to understand the epidemeology of NTM infection and treatment in the peadiatric CF population. Alongside this we are interested in a translational project investigating the roles of novel antimicrobial compounds in the treatment of NTM, as a way of alleviating the significant treatment burden associated with infection.

Group members

Meet the team

Malcolm Brodlie

Malcolm

Malcolm Brodlie
MRC Clinician Scientist, Clinical Senior Lecturer and Honorary Consultant Paediatric Respiratory Physician

Iram

Iram Haq
NIHR Academic Clinical Lecturer

Aaron Ions Gardner
Post-doctoral Research Associate

View profile

Noreen

Noreen Zainal Abidin
MD Student

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