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Conjoint Professor Peter Gibson

Conjoint Professor

School of Medicine and Public Health

Joining forces to ease the wheeze

Australia's two million sufferers of airway disease can breathe easier thanks to the work of the University's groundbreaking respiratory researchers.

Conjoint Professor Peter GibsonFrom the bench to the bedside, the University of Newcastle's Centre for Asthma and Respiratory Diseases is leading the way in the understanding, management and treatment of chronic airway conditions.

Centre co-directors Professor Paul Foster and Professor Peter Gibson lead highly talented teams of scientists and doctors who integrate the latest advances in laboratory technology and methodology with innovative, patient-focused research.

The work of the centre is internationally recognised, having contributed significantly to advancing both medical practice and policy through its discoveries.

Its studies are regularly published in the most prestigious journals and it is a major training hub for respiratory medicine and immunology, attracting gifted PhD students and postdoctoral researchers from around the world to work and study in Newcastle.

Foster and Gibson's teams work under the umbrella of the Hunter Medical Research Institute, a partnership between the University of Newcastle and Hunter New England Health. They also collaborate with research groups in Sydney, Newcastle, Melbourne and Perth as part of the Cooperative Research Centre for Asthma and Airways, a $55 million government-backed program.

Gibson is working at the clinical interface, using his role as a respiratory physician at the John Hunter Hospital in Newcastle to inform his research into treatments and management strategies for asthma and airway disease.

Foster, the University's Chair in Immunology, investigates the molecular and cellular mechanisms of disease in the laboratory. Both have a keen interest in unravelling the critical role of inflammation in asthma and other respiratory conditions.

"We are constantly on the lookout for better treatments but with a disease like asthma, management is also important," Gibson says.

"For some people, just understanding what is happening to them is enough to make a big difference to their condition and quality of life."

Gibson's clinically based team is involved in research projects with significant implications for future treatment and management of airway disease (see below).

Novel discoveries have also been made by the centre's laboratory-based researchers.  These discoveries have enhanced the understanding of processes associated with the development and progression of respiratory diseases.

Centre scientists study the cellular and molecular functions of the diseases on animal models then collaborate with the clinical researchers to validate their findings using human tissue.

Foster says the centre is at the forefront of interpreting how inflammation, which underpins airway disease, occurs and of developing new anti-inflammatory treatments.

A major breakthrough was their research into how microRNA molecules, which regulate protein production in human cells, can cause inflammation in the body that can manifest as asthma. Working out how to control that inflammatory response has provided scientists with a therapeutic target, which could lead to new treatments.

"Steroids are the conventional treatment, but they can have side effects and while they dampen response, they do not cure the disease," Foster explains.

"Also, not everyone is responsive to steroids and within that non-responsive group there is a lot of morbidity."

Foster says his team has made a significant contribution to the understanding of the mechanisms of steroid-resistant inflammatory pathways that may be relevant to asthma, bringing them closer to the goal of developing alternative treatments. Other critical areas of laboratory research focus on allergies, viruses and infection as triggers for asthma.

While the two arms of research within the centre are undertaken by different teams, Foster says it is the critical mass that contributes to its overall success.

"What we have is diversity and common interest," he says. "There are similar centres of excellence around the world but they primarily do either clinical-based research or basic immunology. The way the two are integrated here is what makes us unique and underpins our success."

"People are willing to collaborate," Gibson agrees, "and it is only by linking patient-focused research with laboratory discoveries and evidence-based medicine that we are able to get these broad insights into disease."

Leading the way

Professor Peter Gibson's clinical research team is leading three groundbreaking projects that could revolutionise the treatment of asthma.

These specific projects involve better management of asthma in pregnancy, the development of a blood test to diagnose the disease and the treatment of non-eosinophilic asthma with macrolide antibiotics.

The team's study into asthma in pregnancy was prompted by the reluctance of women to use treatments during gestation, even though severe asthmatic episodes can be harmful to both mother and child.

As part of this project, researchers measured nitric oxide, which is produced by inflamed airways, in the pregnant patient's exhaled breath. They were then able to adjust the amount of medication according to the severity of the inflammation.

In many cases this reduced the amount of steroid that needed to be administered, which made women more likely to take their medication as they were less apprehensive about the treatment and its effects on their unborn child.

Another benefit was that the frequency of asthma exacerbations, or episodes, decreased because the condition was being better managed.

In another study, published this year in the American Journal of Respiratory and Critical Care Medicine, the team used the emerging scientific field of proteomics (the study of proteins) to identify four blood-based biomarkers that when analysed together can distinguish between asthma and chronic obstructive pulmonary disease.

The two diseases share common symptoms, so are difficult to distinguish, but require different therapeutic approaches.

This finding could lead to the development of the first blood test for asthma, which would be a major diagnostic breakthrough.

The third project is the AMAZES study (Asthma and Macrolides: Azithromycin Efficacy and Safety). It will trial an alternative treatment, known as a macrolide antibiotic, for asthma that is not responsive to conventional steroid medication.

Steroids treat a particular cell, called an eosinophil, which is thought to provoke inflammation when present in increased levels. But research has established that up to half of adults with asthma symptoms have normal levels of eosinophils and respond poorly to conventional treatment.

The five-year, $2.9 million study is trialling the antibiotic on approximately 400 asthmatics in four cities and is the biggest study into non-eosinophilic asthma in the world.  It is funded by the National Health and Medical Research Council.

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Peter Gibson

Joining forces to ease the wheeze

The School of Medicine and Public Health is a multi-disciplinary team of researchers, many of whom are recognised as world-leaders in their field.

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Career Summary

Biography

Peter Gibson works as a doctor who cares for people with respiratory diseases and as a clinical scientist investigating the mechanisms and treatment of asthma, Chronic Obstructive Pulmonary Disease (COPD), cough, and other airway disorders.

He is a concept leader who has developed innovative approaches around inflammatory subtypes of asthma and cough; airway biomarkers; neurogenic mechanisms, laryngeal dysfunction and related treatments for refractory cough; multidimensional assessment and management of complex airway disorders such as severe asthma, airways diseases in the elderly, and asthma in pregnant women.

Peter's research metrics record a H index of 62 (Scopus 2015), 450 published articles, competitive research funding success, and effective mentorship of clinical researchers.  His peers have awarded Peter several research medals and elected him as the president of the Thoracic Society of Australia and New Zealand (2015-6).

His research, clinical practice, and participation in guideline panels serve to bring research developments into focus as effective health care interventions that improve the health of people suffering from breathing disorders.

Research Expertise
Inflammation and immunological mechanism of airway diseases such as asthma, COPD, and cough. Clinical assessment and treatment of airway diseases. Practice guidelines and policy of respiratory diseases.



Qualifications

  • Bachelor of Medicine & Surgery, University of New South Wales

Keywords

  • Asthma
  • COPD
  • Cough

Fields of Research

Code Description Percentage
110299 Cardiorespiratory Medicine and Haematology not elsewhere classified 80
110799 Immunology not elsewhere classified 20

Professional Experience

Academic appointment

Dates Title Organisation / Department
1/01/2019 - 31/12/2023 Fellow NHMRC NHMRC (National Health & Medical Research Council)
1/01/2015 - 31/12/2018 Fellow NHMRC NHMRC (National Health & Medical Research Council)
1/01/2009 - 1/12/2013 Fellow NHMRC

NHMRC - Practitioner Fellowships (Formerly Practioner Fellowships Scheme)

National Health & Medical Research Council
1/01/2004 - 1/12/2008 Fellowship

NHMRC - Practitioner Fellowships (Formerly Practioner Fellowships Scheme)

National Health & Medical Research Council
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Book (4 outputs)

Year Citation Altmetrics Link
2005 Gibson P, Abramson M, Wood-Baker R, Volmink J, Hensley M, Costabel U, Evidence-Based Respiratory Medicine, BMJ Books/Blackwell Pub, Malden, Mass., 608 (2005)
2005 Gibson PG, Monitoring Asthma, Taylor & Francis, Boca Raton, 576 (2005)
2005 Gibson P, Abramson M, Wood-Baker R, Volmink J, Hensley M, Costabel U, Evidence-Based Respiratory Medicine, BMJ Books/Blackwell Pub, Malden, Mass., 608 (2005)
2005 Gibson PG, Monitoring Asthma, Taylor & Francis, Boca Raton, 576 (2005)
Show 1 more book

Chapter (21 outputs)

Year Citation Altmetrics Link
2014 McDonald VM, Gibson PG, 'Asthma education', Clinical Asthma: Theory and Practice 127-137 (2014)

© 2014 by Taylor & Francis Group, LLC. We have presented Lucy, a 42-year-old female with asthma, who was recently admitted to hospital with an acute exacerbation of her asth... [more]

© 2014 by Taylor & Francis Group, LLC. We have presented Lucy, a 42-year-old female with asthma, who was recently admitted to hospital with an acute exacerbation of her asthma. Currently, she has ongoing poor symptom control despite being prescribed a combination high-dose ICS/LABA. An assessment of her asthma management skills and knowledge indicates that there are a number of areas that require addressing. Asthma education will be integral to Lucy¿s management of her asthma.

DOI 10.1201/b16468
Co-authors Vanessa Mcdonald
2014 McDonald VM, Gibson PG, 'Asthma Education', Clinical Asthma, CRC Press, Bosa Roca/US 127-137 (2014) [B2]
DOI 10.1201/b16468-18
Co-authors Vanessa Mcdonald
2013 Scott H, Wood LG, Garg ML, Gibson PG, 'Asthma and Inflammation', Nutrition and Physical activity in inflammatory diseases, CABI, Oxford, UK 299-321 (2013) [B1]
Co-authors Manohar Garg, Hayley Scott, Lisa Wood
2013 Baines KJ, Simpson JL, Gibson PG, 'Biology of Neutrophils', Middleton's Allergy: Principles and Practice: Eighth Edition 280-191 (2013)
DOI 10.1016/B978-0-323-08593-9.00018-8
Citations Scopus - 1
Co-authors Jodie Simpson, Katherine Baines
2011 Gaga M, Zervas E, Gibson PG, 'Allergic and nonallergic factors in severe asthma', Difficult-to-Treat Severe Asthma, European Respiratory Society, Sheffield, UK 107-119 (2011) [B1]
DOI 10.1183/1025448x.10001210
2011 Gibson PG, Wang F, He XY, Brightling CE, 'Noninvasive assessment of inflammation in severe asthma', Difficult-to-Treat Severe Asthma, European Respiratory Society, Sheffield, UK 208-217 (2011) [B1]
DOI 10.1183/1025448x.10002110
2010 Murphy VE, Gibson PG, 'Asthma and rhinitis in pregnancy', Allergy Frontiers: Therapy and Prevention, Springer, Berlin 485-497 (2010) [B1]
Co-authors Vanessa Murphy
2010 Wark PA, Gibson PG, 'Pathogenesis of ABPA', Aspergillosis: From diagnosis to prevention, Springer, Berlin 695-706 (2010) [B1]
Co-authors Peter Wark
2009 Simpson JL, Baines KJ, Gibson PG, 'Biology of neutrophils', Middleton's Allergy: Principles & Practice, Mosby, Philadelphia, Pennsylvania 283-294 (2009) [B1]
Co-authors Katherine Baines, Jodie Simpson
2009 Murphy VE, Gibson PG, 'Asthma in pregnancy', Pulmonary Problems in Pregnancy, Humana Press, New York 143-164 (2009) [B1]
DOI 10.1007/978-1-59745-445-2
Co-authors Vanessa Murphy
2009 McDonald VM, Gibson PG, 'Asthma patient education', Allergy Frontiers: Diagnosis and Health Economics, Springer, Berlin 475-489 (2009) [B1]
DOI 10.1007/978-4-431-98349-1_26
Co-authors Vanessa Mcdonald
2008 Gibson PG, 'Clinical assessment of asthma', Clinical Asthma, Mosby, Maryland Heights, Missouri 119-126 (2008) [B1]
DOI 10.1016/b978-032304289-5.10013-x
2007 Powell H, Gibson PG, 'Role of self-management in preventing asthma exacerbations', Exacerbations of Asthma, Informa Healthcare, London, United Kingdom 307-320 (2007) [B1]
2007 Wood LG, Gibson PG, Garg ML, 'Alpha-tocopherol and cystic fibrosis', The Encyclopedia of Vitamin E, Centre for Agricultural Bioscience International, Wallingford, United Kingdom 708-718 (2007) [B1]
Co-authors Lisa Wood, Manohar Garg
2005 Gibson PG, simpson JL, 'Inflammatory mediators of asthma in children', Childhood Asthma, CRC Press, New York (2005)
Co-authors Jodie Simpson
2003 Gibson PG, Wark PAB, Simpson JL, 'Induced sputum studies in children', An Atlas of Induced Sputum An Aid for Research and Diagnosis, Taylor & Francis, USA (2003)
Co-authors Jodie Simpson, Peter Wark
2001 Gibson PG, Yates D, Saltos N, 'Examination of Sputum, Nasal Cytology and Exhaled Gases', Manual of Asthma Management, WB Saunders Company Ltd, London 107-118 (2001) [B1]
2001 Gibson PG, Boulet L-P, 'ROLE OF ASTHMA EDUCATION', Evidence-Based Asthma Management, B.C. Decker Inc., Hamilton, Ontario, Canada 275-290 (2001) [B2]
2001 Gibson PG, Simpson JL, 'Measurement of cytokines in induced sputum: application to the investigation of asthma and COPD', Interleukin Protocols, PennWell Corporation, USA (2001)
Co-authors Jodie Simpson
2001 Gibson PG, Simpson J, 'Measurement of Cytokines in Induced Sputum', Interleukin Protocols, Humana Press, Totowa, New Jersey 305-312 (2001) [B1]
2000 Gibson PG, Wilson A, 'Quality of life in asthma', Understanding asthma: a management companion, MacLennan & Petty Pty Limited, Sydney Australia 278-288 (2000) [B1]
Show 18 more chapters

Journal article (613 outputs)

Year Citation Altmetrics Link
2019 Whalen OM, Campbell LE, Murphy VE, Lane AE, Gibson PG, Mattes J, et al., 'Observational study of mental health in asthmatic women during the prenatal and postnatal periods.', J Asthma, 1-13 (2019)
DOI 10.1080/02770903.2019.1621888
Co-authors Adam Collison, Linda E Campbell, Alison Lane, Joerg Mattes, Vanessa Murphy, Frini Karayanidis
2019 Pang Z, Wang G, Gibson P, Guan X, Zhang W, Zheng R, et al., 'Airway Microbiome in Different Inflammatory Phenotypes of Asthma: A Cross-Sectional Study in Northeast China', INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, 16 477-485 (2019)
DOI 10.7150/ijms.29433
2019 Gibson PG, 'Maternal history of miscarriages and measures of fertility in relation to childhood asthma', THORAX, 74 101-102 (2019)
DOI 10.1136/thoraxjnl-2018-212598
Citations Scopus - 1
2019 Gibson PG, 'Management of Cough', Journal of Allergy and Clinical Immunology: In Practice, (2019)

© 2019 People with chronic cough can experience significant quality-of-life impairment. New concepts based around cough reflex hypersensitivity are leading to improved management ... [more]

© 2019 People with chronic cough can experience significant quality-of-life impairment. New concepts based around cough reflex hypersensitivity are leading to improved management strategies and showing promise in relieving the distress from persistent cough. The clinical cough assessment seeks to classify patients on the basis of symptom duration, and to identify and manage exposures and diseases that activate the afferent limb of the cough reflex. Cough hypersensitivity is also addressed by managing laryngeal dysfunction with speech pathology therapy and managing central cough reflex sensitization with neuromodulators. There are prospects for novel therapies based around several new treatment targets.

DOI 10.1016/j.jaip.2019.03.050
Citations Scopus - 1
2019 Luc F, Prieur E, Whitmore GA, Gibson PG, Vandemheen K, Aaron SD, 'Placebo Effects in Clinical Trials Evaluating Patients with Uncontrolled Persistent Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 199 (2019)
2019 Kapela SL, Vertigan AE, G Gibson P, 'Speech Pathology Intervention for Chronic Refractory Cough: A Pilot Study Examining the Benefit of Using Prerecorded Videos as an Adjunct to Therapy', Journal of Voice, (2019)

© 2018 Speech pathology intervention is effective for chronic refractory cough (CRC). Speech pathology treatment for CRC includes therapy exercises to teach cough suppression and ... [more]

© 2018 Speech pathology intervention is effective for chronic refractory cough (CRC). Speech pathology treatment for CRC includes therapy exercises to teach cough suppression and reduce laryngeal closure during respiration. Aim: The aim of this study was to evaluate the benefit of providing patients with supplemental pre-recorded videos of speech pathology exercises for chronic refractory cough (CRC) to assist with patients¿ independent practice. These videos were pre-made recordings of the treating speech pathologist demonstrating specific exercises for chronic cough suppression. Method: This study was a prospective randomized controlled trial design. Participants included 18 adult patients attending a speech pathology outpatient clinic in a tertiary referral hospital for treatment of CRC. Participants were randomized to receive either standard speech pathology intervention (SPI) for CRC combined with supplemental pre-recorded videos for home practice or standard SPI alone. The primary outcome measure was a rating of accuracy during demonstration of the speech pathology exercises for cough suppression. This rating was assigned by the treating speech pathologist from session 2 onwards. The treating speech pathologist asked the patient to demonstrate the exercises they had been practising since the last speech pathology session. Secondary outcome measures included the Symptom Frequency and Severity Rating Scale, Leicester Cough Questionnaire, and Consensus Auditory Perceptual Evaluation of Voice. Results: There was a significant pre- to post-treatment improvement in both groups however the degree of improvement was not significantly different between the two groups. Conclusion: The addition of supplemental pre-recorded videos of SPI for CRC did not lead to greater accuracy of therapy exercise practice or superior treatment outcomes than standard SPI alone. Declaration of interest: There are no interests to declare.

DOI 10.1016/j.jvoice.2018.12.002
Citations Scopus - 1
2019 Busse WW, Bleecker ER, FitzGerald JM, Ferguson GT, Barker P, Sproule S, et al., 'Long-term safety and efficacy of benralizumab in patients with severe, uncontrolled asthma: 1-year results from the BORA phase 3 extension trial', LANCET RESPIRATORY MEDICINE, 7 46-59 (2019)
DOI 10.1016/S2213-2600(18)30406-5
Citations Scopus - 7Web of Science - 3
2019 Denton E, Hore-Lacy F, Radhakrishna N, Gilbert A, Tay T, Lee J, et al., 'Severe Asthma Global Evaluation (SAGE): An Electronic Platform for Severe Asthma.', J Allergy Clin Immunol Pract, 7 1440-1449 (2019)
DOI 10.1016/j.jaip.2019.02.042
Co-authors Erin Harvey
2019 Marsh RL, Smith-Vaughan HC, Chen ACH, Marchant JM, Yerkovich ST, Gibson PG, et al., 'Multiple Respiratory Microbiota Profiles Are¿Associated With Lower Airway¿Inflammation in Children With Protracted Bacterial Bronchitis.', Chest, 155 778-786 (2019)
DOI 10.1016/j.chest.2019.01.002
2019 Zhang L, Zhang X, Zheng J, Liu Y, Wang J, Wang G, et al., 'Depressive symptom-associated IL-1ß and TNF-a release correlates with impaired bronchodilator response and neutrophilic airway inflammation in asthma.', Clin Exp Allergy, 49 770-780 (2019)
DOI 10.1111/cea.13346
2019 Fricker M, Gibson PG, Powell H, Simpson JL, Yang IA, Upham JW, et al., 'A sputum 6-gene signature predicts future exacerbations of poorly controlled asthma.', J Allergy Clin Immunol, (2019)
DOI 10.1016/j.jaci.2018.12.1020
Co-authors Jodie Simpson, Katherine Baines, Michael Fricker
2019 Pizzichini MMM, Rocha CC, de Souza Tavares MG, Steidle LJM, Maureci da Silva R, Dal Pizzol F, et al., 'How does the GINA definition of control correlate with quality of life and sputum cellularity?', ERJ Open Res, 5 (2019)
DOI 10.1183/23120541.00146-2018
2019 McGarvey L, Gibson PG, 'What Is Chronic Cough? Terminology.', J Allergy Clin Immunol Pract, (2019)
DOI 10.1016/j.jaip.2019.04.012
Citations Scopus - 2
2019 Taylor SL, Leong LEX, Mobegi FM, Choo JM, Wesselingh S, Yang IA, et al., 'Long-Term Azithromycin Reduces Haemophilus influenzae and Increases Antibiotic Resistance in Severe Asthma.', Am J Respir Crit Care Med, (2019)
DOI 10.1164/rccm.201809-1739OC
Co-authors Jodie Simpson
2019 Gibson PG, 'Azithromycin and ABBA in the chest clinic: ¿The winner takes it all..¿', Respirology, 24 506-507 (2019)

© 2019 Asian Pacific Society of Respirology See related Article.... [more]

© 2019 Asian Pacific Society of Respirology See related Article.

DOI 10.1111/resp.13545
2019 Jensen ME, Murphy VE, Gibson PG, Mattes J, Camargo CA, 'Vitamin D status in pregnant women with asthma and its association with adverse respiratory outcomes during infancy', Journal of Maternal-Fetal and Neonatal Medicine, 32 1820-1825 (2019) [C1]

© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Background: Vitamin D may influence pregnancy and infant outcomes, especially infant respiratory health... [more]

© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Background: Vitamin D may influence pregnancy and infant outcomes, especially infant respiratory health. This study aimed to examine vitamin D status in pregnant women with asthma, and whether higher vitamin D levels are associated with fewer adverse respiratory outcomes in their infants. Methods: Pregnant women with asthma, recruited from John Hunter Hospital Newcastle Australia (latitude 33°S), had serum total 25-hydroxyvitamin-D (25(OH)D) measured at 16 and 35 weeks gestation. Infant respiratory outcomes were collected at 12 months by parent-report questionnaire. Mother¿infant dyads were grouped by serum 25(OH)D during pregnancy: 25(OH)D < 75 nmol/L (at both time-points) versus 25(OH)D = 75 nmol/L (at one or both time-points). Results: In 52 pregnant women with asthma, mean serum 25(OH)D levels were 61 (range 26¿110) nmol/L at 16 weeks, and 65 (range 32¿116) nmol/L at 35 weeks, gestation. Thirty-one (60%) women had 25(OH)D < 75 nmol/L at both time-points; 21 (40%) had 25(OH)D = 75 nmol/L at one or both time-points. Maternal 25(OH)D < 75 nmol/L during pregnancy was associated with a higher proportion of infants with ¿wheeze ever¿ at 12 months, compared with 25(OH)D = 75 nmol/L (71 versus 43%, p =.04). Infant acute-care presentations (45 versus 13%, p =.02) and oral corticosteroid use (26 versus 4%, p =.03) due to ¿asthma/wheezing¿ were higher in the maternal group with 25(OH)D < 75 nmol/L, versus =75 nmol/L. Conclusions: Most pregnant women with asthma had low vitamin D status, which persisted across gestation. Low maternal vitamin D status was associated with greater risk of adverse respiratory outcomes in their infants, a group at high risk of developing childhood asthma.

DOI 10.1080/14767058.2017.1419176
Co-authors Megan Jensen, Joerg Mattes, Vanessa Murphy
2019 Hill AT, Gold PM, El Solh AA, Metlay JP, Ireland B, Irwin RS, et al., 'Response', Chest, 155 1082-1083 (2019)
DOI 10.1016/j.chest.2019.02.014
2019 Khatri S, Moore W, Gibson PG, Leigh R, Bourdin A, Maspero J, et al., 'Assessment of the long-term safety of mepolizumab and durability of clinical response in patients with severe eosinophilic asthma', Journal of Allergy and Clinical Immunology, 143 1742-1751.e7 (2019)

© 2018 GlaxoSmithKline Background: Mepolizumab has demonstrated favorable safety and efficacy profiles in placebo-controlled trials of 12 months&apos; duration or less; however, l... [more]

© 2018 GlaxoSmithKline Background: Mepolizumab has demonstrated favorable safety and efficacy profiles in placebo-controlled trials of 12 months' duration or less; however, long-term data are lacking. Objective: We sought to evaluate the long-term safety and efficacy of mepolizumab in patients with severe eosinophilic asthma (SEA). Methods: COLUMBA (Open-label Long Term Extension Safety Study of Mepolizumab in Asthmatic Subjects, NCT01691859)was an open-label extension study in patients with SEA previously enrolled in DREAM (Dose Ranging Efficacy And Safety With Mepolizumab in Severe Asthma, NCT01000506). Patients received 100 mg of subcutaneous mepolizumab every 4 weeks plus standard of care until a protocol-defined stopping criterion was met. Safety end points included frequency of adverse events (AEs), serious AEs, and AEs of special interest. Efficacy end points included annualized exacerbation rates, changes from baseline in Asthma Control Questionnaire 5 scores, and blood eosinophil counts. Immunogenicity was also assessed. Results: Overall, 347 patients were enrolled for an average of 3.5 years (maximum, 4.5 years; total exposure, 1201 patient-years). On-treatment AEs were reported in 94% of patients (exposure-adjusted rate, 3688 events/1000 patient-years). The most frequently reported on-treatment AEs were respiratory tract infection, headache, bronchitis, and asthma worsening. Seventy-nine (23%)patients experienced 1 or more on-treatment serious AEs; there were 6 deaths, none of which were assessed as related to mepolizumab. For patients with 156 weeks or greater enrollment, the exacerbation rate was 0.74 events/y (weeks 0¿156), a 56% reduction from the off-treatment period between DREAM and COLUMBA. For all patients, at the first postbaseline assessment, the mean Asthma Control Questionnaire 5 score was reduced by 0.47 points, and blood eosinophil counts were reduced by 78%, with similar improvements maintained throughout the study. The immunogenicity profile (8% anti-drug antibodies)was consistent with previous studies. Conclusion: These data support the long-term safety and efficacy of mepolizumab in patients with SEA.

DOI 10.1016/j.jaci.2018.09.033
Citations Scopus - 3Web of Science - 2
2019 Wood LG, Li Q, Scott HA, Rutting S, Berthon BS, Gibson PG, et al., 'Saturated fatty acids, obesity, and the nucleotide oligomerization domain-like receptor protein 3 (NLRP3) inflammasome in asthmatic patients', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 143 305-315 (2019) [C1]
DOI 10.1016/j.jaci.2018.04.037
Citations Scopus - 3Web of Science - 4
Co-authors Katherine Baines, Jodie Simpson, Hayley Scott, Lisa Wood, Philip Hansbro, Jay Horvat
2019 McDonald VM, Fingleton J, Agusti A, Hiles SA, Clark VL, Holland AE, et al., 'Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report.', The European respiratory journal, 53 (2019) [C1]
DOI 10.1183/13993003.02058-2018
Co-authors Andrew Searles, Vanessa Mcdonald, Vanessa Clark, Sarah Hiles, Peter Wark
2019 McDonald VM, Hiles SA, Godbout K, Harvey ES, Marks GB, Hew M, et al., 'Treatable traits can be identified in a severe asthma registry and predict future exacerbations', Respirology, 24 37-47 (2019) [C1]

© 2018 Asian Pacific Society of Respirology Background and objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases inclu... [more]

© 2018 Asian Pacific Society of Respirology Background and objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk. Methods: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma. Published treatable traits were mapped to registry data fields and their prevalence was described. Participants were characterized at baseline and every 6 months for 24 months. Results: In SAWD, 24 treatable traits were identified in three domains: pulmonary, extrapulmonary and behavioural/risk factors. Patients with severe asthma expressed more pulmonary and extrapulmonary treatable traits than non-severe asthma. Allergic sensitization, upper-airway disease, airflow limitation, eosinophilic inflammation and frequent exacerbations were common in severe asthma. Ten traits predicted exacerbation risk; among the strongest were being prone to exacerbations, depression, inhaler device polypharmacy, vocal cord dysfunction and obstructive sleep apnoea. Conclusion: Treatable traits can be assessed using a severe asthma registry. In severe asthma, patients express more treatable traits than non-severe asthma. Traits may be associated with future asthma exacerbation risk demonstrating the clinical utility of assessing treatable traits.

DOI 10.1111/resp.13389
Citations Scopus - 6Web of Science - 5
Co-authors Sarah Hiles, Peter Wark, Vanessa Mcdonald, Erin Harvey
2019 Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM, 'Physical activity associates with disease characteristics of severe asthma, bronchiectasis and COPD', RESPIROLOGY, 24 352-360 (2019)
DOI 10.1111/resp.13428
Citations Scopus - 2
Co-authors Vanessa Mcdonald
2019 Robijn AL, Murphy VE, Gibson PG, 'Recent developments in asthma in pregnancy', Current opinion in pulmonary medicine, 25 11-17 (2019)

PURPOSE OF REVIEW: Asthma affects up to 13% of pregnancies worldwide and has a varying and unpredictable clinical course during pregnancy. Pharmacological asthma treatment is reco... [more]

PURPOSE OF REVIEW: Asthma affects up to 13% of pregnancies worldwide and has a varying and unpredictable clinical course during pregnancy. Pharmacological asthma treatment is recommended; however, studies show that some pregnant women with asthma cease their medication in early pregnancy. There is likely a large unmet disease burden arising from asthma in pregnancy. RECENT FINDINGS: Antenatal and asthma guidelines lack sufficient information on asthma management in pregnant women, and implementation of the current guidelines seems inadequate. Prescription databases provide evidence of cessation of asthma medication during pregnancy on a population level. Population-based databases also provide evidence of rare adverse perinatal outcomes. The risk of childhood asthma in the offspring of women with asthma is reduced by adequate control of maternal asthma during pregnancy. Vitamin D sufficiency during pregnancy could also reduce the risk of childhood asthma. SUMMARY: The findings of this review demonstrate the need for improved asthma and antenatal guidelines regarding asthma management during pregnancy, and the need of adequate implementation of these guidelines. Furthermore, adequate asthma control during pregnancy is needed to reduce the risk of childhood asthma. To maintain asthma control, prepregnancy medication should be continued throughout pregnancy and adjusted according to the current treatment steps if required.

DOI 10.1097/MCP.0000000000000538
Co-authors Vanessa Murphy
2019 Bulathsinhala L, Eleangovan N, Heaney LG, Menzies-Gow A, Gibson PG, Peters M, et al., 'Development of the International Severe Asthma Registry (ISAR): A Modified Delphi Study', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 7 578-+ (2019)
DOI 10.1016/j.jaip.2018.08.016
Citations Scopus - 3Web of Science - 4
Co-authors Erin Harvey
2019 Gibson PG, 'Chronic Cough', Journal of Allergy and Clinical Immunology: In Practice, (2019)
DOI 10.1016/j.jaip.2019.05.012
2019 Hill AT, Gold PM, El Solh AA, Metlay JP, Ireland B, Irwin RS, et al., 'Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report', Chest, 155 155-167 (2019) [C1]

© 2018 American College of Chest Physicians Background: Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to hel... [more]

© 2018 American College of Chest Physicians Background: Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed. Methods: A systematic search was carried out with eight patient, intervention, comparison, outcome questions related to acute cough due to suspected pneumonia or influenza. Results: There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza who were not hospitalized. Both clinical suggestions and research recommendations were made on the evidence available and CHEST Expert Cough Panel advice. Conclusions: For outpatient adults with acute cough due to suspected pneumonia, we suggest the following clinical symptoms and signs are suggestive of pneumonia: cough; dyspnea; pleural pain; sweating, fevers, or shivers; aches and pains; temperature = 38°C; tachypnea; and new and localizing chest examination signs. Those suspected of having pneumonia should undergo chest radiography to improve diagnostic accuracy. Although the measurement of C-reactive protein levels strengthens both the diagnosis and exclusion of pneumonia, there was no added benefit of measuring procalcitonin levels in this setting. We suggest that there is no need for routine microbiological testing. We suggest the use of empiric antibiotics according to local and national guidelines when pneumonia is suspected in settings in which imaging cannot be performed. Where there is no clinical or radiographic evidence of pneumonia, we do not suggest the routine use of antibiotics. There is insufficient evidence to make recommendations for or against specific nonantibiotic, symptomatic therapies. Finally, for outpatient adults with acute cough and suspected influenza, we suggest that initiating antiviral treatment (according to Centers for Disease Control and Prevention advice) within 48 hours of symptoms could be associated with decreased antibiotic use and hospitalization and improved outcomes.

DOI 10.1016/j.chest.2018.09.016
Citations Scopus - 3Web of Science - 2
2019 Moore A, Harnden A, Grant CC, Patel S, Irwin RS, Altman KW, et al., 'Clinically Diagnosing Pertussis-associated Cough in Adults and Children: CHEST Guideline and Expert Panel Report', Chest, 155 147-154 (2019) [C1]

© 2018 American College of Chest Physicians Background: The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than w... [more]

© 2018 American College of Chest Physicians Background: The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than waiting for laboratory confirmation. The current guideline focuses on making the clinical diagnosis of pertussis-associated cough in adults and children. Methods: The American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on findings from a systematic review that was recently published on the topic; final grading was reached by consensus according to Delphi methodology. The systematic review was carried out to answer the Key Clinical Question: In patients presenting with cough, how can we most accurately diagnose from clinical features alone those who have pertussis-associated cough as opposed to other causes of cough? Results: In adults, after pre-specified meta-analysis exclusions, pooled estimates of sensitivity and specificity were generated for only 4 clinical features: paroxysmal cough, post-tussive vomiting, inspiratory whooping, and absence of fever. Both paroxysmal cough and absence of fever had high sensitivity (93.2% [95% CI, 83.2-97.4] and 81.8% [95% CI, 72.2-88.7], respectively) and low specificity (20.6% [95% CI, 14.7-28.1] and 18.8% [95% CI, 8.1-37.9]). Inspiratory whooping and posttussive vomiting had a low sensitivity (32.5% [95% CI, 24.5-41.6] and 29.8% [95% CI, 18.0-45.2]) but high specificity (77.7% [95% CI, 73.1-81.7] and 79.5% [95% CI, 69.4-86.9]). In children, after pre-specified meta-analysis exclusions, pooled estimates of sensitivity and specificity were generated for only 1 clinical feature in children (0-18 years): posttussive vomiting. Posttussive vomiting in children was only moderately sensitive (60.0% [95% CI, 40.3-77.0]) and specific (66.0% [95% CI, 52.5-77.3]). Conclusions: In adults with acute (< 3 weeks) or subacute (3-8 weeks) cough, the presence of whooping or posttussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out. In children with acute (< 4 weeks) cough, posttussive vomiting is suggestive of pertussis but is much less helpful as a clinical diagnostic test. Guideline suggestions are made based upon these findings and conclusions.

DOI 10.1016/j.chest.2018.09.027
Citations Scopus - 1
2019 Robijn AL, Jensen ME, Gibson PG, Powell H, Giles WB, Clifton VL, et al., 'Trends in asthma self-management skills and inhaled corticosteroid use during pregnancy and postpartum from 2004 to 2017.', The Journal of asthma : official journal of the Association for the Care of Asthma, 56 594-602 (2019) [C1]
DOI 10.1080/02770903.2018.1471709
Citations Web of Science - 1
Co-authors Megan Jensen, Peter Wark, Joerg Mattes, Vanessa Murphy, John Attia
2018 Chen AC-H, Tran HB, Xi Y, Yerkovich ST, Baines KJ, Pizzutto SJ, et al., 'Multiple inflammasomes may regulate the interleukin-1-driven inflammation in protracted bacterial bronchitis.', ERJ open research, 4 1-11 (2018) [C1]
DOI 10.1183/23120541.00130-2017
Co-authors Jodie Simpson, Katherine Baines
2018 Vertigan AE, Kapela SM, Kearney EK, Gibson PG, 'Laryngeal Dysfunction in Cough Hypersensitivity Syndrome: A Cross-Sectional Observational Study', Journal of Allergy and Clinical Immunology: In Practice, 6 2087-2095 (2018) [B1]

© 2018 American Academy of Allergy, Asthma &amp; Immunology Background: Chronic refractory cough (CRC), a phenotype of cough hypersensitivity syndrome (CHS), is a disabling prob... [more]

© 2018 American Academy of Allergy, Asthma & Immunology Background: Chronic refractory cough (CRC), a phenotype of cough hypersensitivity syndrome (CHS), is a disabling problem. Laryngeal dysfunction may be important in CRC and CHS because laryngeal symptoms are common; however, the role of laryngeal dysfunction in CHS has not been systematically examined. Objective: To determine the nature of laryngeal dysfunction in patients with CRC and compare with the related laryngeal conditions of vocal cord dysfunction (VCD) and muscle tension dysphonia (MTD). Methods: A cross-sectional analytic design was used. We recruited 69 participants including healthy controls and patients with CRC, VCD, and MTD who were referred for behavioral speech interventions. Participants underwent a comprehensive assessment of laryngeal function during breathing, phonation, and swallowing. Results: Cough frequency was high in patients with CRC (10.2 coughs/h) and VCD (16.5 coughs/h), but low in healthy controls (1.5 coughs/h) (P <.001). Patients with CRC, VCD, and MTD had impaired voice-related quality of life (vs controls, P <.05) and laryngeal hypersensitivity (vs controls, P <.05). Most voice assessment measures (3 out of 4) were significantly impaired in the CRC group compared with controls and were similar to the VCD and MTD groups. Paradoxical vocal fold movement during respiration was present in 47% of the patients with CRC at rest and in 67% after odor challenge. Mediolateral laryngeal constriction during phonation was present in 45% of the participants with CRC, 93% of the participants with VCD (P <.001 vs CC), and 64% of the participants with MTD. Conclusions: Laryngeal dysfunction is common in CRC and CHS and may contribute to CHS mechanisms. Assessment and treatment of laryngeal dysfunction using speech pathology interventions are likely to be beneficial in CHS.

DOI 10.1016/j.jaip.2018.04.015
Citations Scopus - 3Web of Science - 1
2018 Chang AB, Oppenheimer JJ, Rubin BK, Weinberger M, Irwin RS, 'Chronic Cough Related to Acute Viral Bronchiolitis in Children CHEST Expert Panel Report', CHEST, 154 378-382 (2018)
DOI 10.1016/j.chest.2018.04.019
Citations Scopus - 1Web of Science - 1
2018 Guan X, Lu Y, Wang G, Gibson P, Chen F, Fang K, et al., 'The Role of Regulatory T Cell in Nontypeable Haemophilus influenzae-Induced Acute Exacerbation of Chronic Obstructive Pulmonary Disease', MEDIATORS OF INFLAMMATION, (2018)
DOI 10.1155/2018/8387150
Citations Scopus - 2Web of Science - 2
2018 Taylor SL, Leong LEX, Choo JM, Wesselingh S, Yang IA, Upham JW, et al., 'Inflammatory phenotypes in patients with severe asthma are associated with distinct airway microbiology', Journal of Allergy and Clinical Immunology, 141 94-103.e15 (2018) [C1]

© 2017 The Authors Background Asthma pathophysiology and treatment responsiveness are predicted by inflammatory phenotype. However, the relationship between airway microbiology an... [more]

© 2017 The Authors Background Asthma pathophysiology and treatment responsiveness are predicted by inflammatory phenotype. However, the relationship between airway microbiology and asthma phenotype is poorly understood. Objective We aimed to characterize the airway microbiota in patients with symptomatic stable asthma and relate composition to airway inflammatory phenotype and other phenotypic characteristics. Methods The microbial composition of induced sputum specimens collected from adult patients screened for a multicenter randomized controlled trial was determined by using 16S rRNA gene sequencing. Inflammatory phenotypes were defined by sputum neutrophil and eosinophil cell proportions. Microbiota were defined by using a- and ß-diversity measures, and interphenotype differences were identified by using similarity of percentages, network analysis, and taxon fold change. Phenotypic predictors of airway microbiology were identified by using multivariate linear regression. Results Microbiota composition was determined in 167 participants and classified as eosinophilic (n = 84), neutrophilic (n = 14), paucigranulocytic (n = 60), or mixed neutrophilic-eosinophilic (n = 9) asthma phenotypes. Airway microbiology was significantly less diverse (P =.022) and more dissimilar (P =.005) in neutrophilic compared with eosinophilic participants. Sputum neutrophil proportions, but not eosinophil proportions, correlated significantly with these diversity measures (a-diversity: Spearman r = -0.374, P <.001; ß-diversity: r = 0.238, P =.002). Interphenotype differences were characterized by a greater frequency of pathogenic taxa at high relative abundance and reduced Streptococcus, Gemella, and Porphyromonas taxa relative abundance in patients with neutrophilic asthma. Multivariate regression confirmed that sputum neutrophil proportion was the strongest predictor of microbiota composition. Conclusions Neutrophilic asthma is associated with airway microbiology that is significantly different from that seen in patients with other inflammatory phenotypes, particularly eosinophilic asthma. Differences in microbiota composition might influence the response to antimicrobial and steroid therapies and the risk of lung infection.

DOI 10.1016/j.jaci.2017.03.044
Citations Scopus - 27Web of Science - 23
Co-authors Jodie Simpson
2018 Gibson PG, 'Variability of blood eosinophils as a biomarker in asthma and COPD', RESPIROLOGY, 23 12-13 (2018)
DOI 10.1111/resp.13200
Citations Scopus - 6Web of Science - 6
2018 Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM, 'A Systematic Review of Associations of Physical Activity and Sedentary Time with Asthma Outcomes', Journal of Allergy and Clinical Immunology: In Practice, 6 1968-1981.e2 (2018) [C1]

© 2018 American Academy of Allergy, Asthma &amp; Immunology Background: Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseas... [more]

© 2018 American Academy of Allergy, Asthma & Immunology Background: Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseases. However, their impact in asthma is less clear. Objective: We aimed to synthesize the literature characterizing physical activity and sedentary time in adults with asthma, to estimate activity levels using meta-analysis, and to evaluate associations between physical activity and sedentary time and the clinical and physiological characteristics of asthma. Methods: Articles written in English and addressing the measurement of physical activity or sedentary time in adults =18 years old with asthma were identified using 4 electronic databases. Meta-analysis was used to estimate steps/day in applicable studies. Results: There were 42 studies that met the inclusion criteria. Physical activity in asthma was lower compared with controls. The pooled mean (95% confidence interval) steps/day for people with asthma was 8390 (7361, 9419). Physical activity tended to be lower in females compared with males, and in older people with asthma compared with their younger counterparts. Higher levels of physical activity were associated with better measures of lung function, disease control, health status, and health care use. Measures of sedentary time were scarce, and indicated a similar engagement in this behavior between participants with asthma and controls. High sedentary time was associated with higher health care use, and poorer lung function, asthma control, and exercise capacity. Conclusions: People with asthma engage in lower levels of physical activity compared with controls. Higher levels of physical activity may positively impact on asthma clinical outcomes. Sedentary time should be more widely assessed.

DOI 10.1016/j.jaip.2018.02.027
Citations Scopus - 7Web of Science - 5
Co-authors Vanessa Mcdonald
2018 Gibson PG, 'How does azithromycin improve asthma exacerbations? reply', LANCET, 391 28-29 (2018)
2018 Hiles SA, Harvey ES, McDonald VM, Peters M, Bardin P, Reynolds PN, Upham JW, 'Working while unwell: Workplace impairment in people with severe asthma', CLINICAL AND EXPERIMENTAL ALLERGY, 48 650-662 (2018)
DOI 10.1111/cea.13153
Citations Scopus - 1Web of Science - 2
Co-authors Sarah Hiles, Erin Harvey, Vanessa Mcdonald, Peter Wark
2018 Cordova-Rivera L, Gibson PG, Gardiner PA, Powell H, McDonald VM, 'Physical Activity and Exercise Capacity in Severe Asthma: Key Clinical Associations', Journal of Allergy and Clinical Immunology: In Practice, 6 814-822 (2018) [C1]
DOI 10.1016/j.jaip.2017.09.022
Citations Scopus - 5Web of Science - 4
Co-authors Vanessa Mcdonald
2018 Morten M, Collison A, Murphy VE, Barker D, Oldmeadow C, Attia J, et al., 'Managing Asthma in Pregnancy (MAP) trial: FENO levels and childhood asthma', Journal of Allergy and Clinical Immunology, 142 1765-1772.e4 (2018) [C1]

© 2018 American Academy of Allergy, Asthma &amp; Immunology Background: The single-center double-blind, randomized controlled Managing Asthma in Pregnancy (MAP) trial in Newcast... [more]

© 2018 American Academy of Allergy, Asthma & Immunology Background: The single-center double-blind, randomized controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FENO) in combination with asthma symptoms (FENO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (Australian New Zealand Clinical Trials Registry, no. 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FENO group. However, the effect of FENO-guided management on the development of asthma in the offspring is unknown. Objective: We sought to investigate the effect of FENO-guided asthma management during pregnancy on asthma incidence in childhood. Methods: A total of 179 mothers consented to participate in the Growing into Asthma (GIA) double-blind follow-up study with the primary aim to determine the effect of FENO-guided asthma management on childhood asthma incidence. Results: A total of 140 children (78%) were followed up at 4 to 6 years of age. FENO-guided as compared to symptoms-only approach significantly reduced doctor-diagnosed asthma (25.9% vs 43.2%; odds ratio [OR], 0.46, 95% CI, 0.22-0.96; P =.04). Furthermore, frequent wheeze (OR, 0.27; 95% CI, 0.09-0.87; P =.03), use of short-acting ß-agonists (OR, 0.49; 95% CI, 0.25-0.97; P =.04), and emergency department visits for asthma (OR, 0.17; 95% CI, 0.04-0.76; P =.02) in the past 12 months were less common in children born to mothers from the FENO group. Doctor-diagnosed asthma was associated with common risk alleles for early onset asthma at gene locus 17q21 (P =.01 for rs8069176; P =.03 for rs8076131), and higher airways resistance (P =.02) and FENO levels (P =.03). A causal mediation analysis suggested natural indirect effects of FENO-guided asthma management on childhood asthma through ¿any use¿ and ¿time to first change in dose¿ of inhaled corticosteroids during the MAP trial (OR: 0.83; 95% CI: 0.59-0.99, and OR: 0.90; 95% CI: 0.70-1.03, respectively). Conclusions: FENO-guided asthma management during pregnancy prevented doctor-diagnosed asthma in the offspring at preschool age, in part mediated through changes in use and dosing of inhaled corticosteroids during the MAP trial.

DOI 10.1016/j.jaci.2018.02.039
Citations Scopus - 1Web of Science - 1
Co-authors Vanessa Murphy, Christopher Oldmeadow, Joerg Mattes, John Attia, Daniel Barker, Adam Collison
2018 Pavord ID, Beasley R, Agusti A, Anderson GP, Bel E, Brusselle G, et al., 'After asthma: redefining airways diseases', LANCET, 391 350-400 (2018) [C1]
DOI 10.1016/S0140-6736(17)30879-6
Citations Scopus - 135Web of Science - 113
2018 Hill AT, Barker AF, Bolser DC, Davenport P, Ireland B, Chang AB, et al., 'Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report', Chest, 153 986-993 (2018) [C1]

© 2018 American College of Chest Physicians Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We ... [more]

© 2018 American College of Chest Physicians Background: In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods: The systematic search for evidence examined the question, ¿Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?¿ Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results: In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions: Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.

DOI 10.1016/j.chest.2018.01.014
Citations Scopus - 2Web of Science - 2
2018 Baines KJ, Wright TK, Gibson PG, Powell H, Hansbro PM, Simpson JL, 'Azithromycin treatment modifies airway and blood gene expression networks in neutrophilic COPD.', ERJ open research, 4 (2018) [C1]
DOI 10.1183/23120541.00031-2018
Co-authors Jodie Simpson, Katherine Baines, Philip Hansbro
2018 Porsbjerg C, Sverrild A, Baines KJ, Searles A, Maltby S, Foster PS, et al., 'Advancing the management of obstructive airways diseases through translational research.', Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 48 493-501 (2018) [C1]
DOI 10.1111/cea.13112
Co-authors Paul Foster, Andrew Searles, Steven Maltby, Katherine Baines
2018 Gibson PG, 'Severe asthma: implementing game-changing science', MEDICAL JOURNAL OF AUSTRALIA, 209 66-67 (2018)
DOI 10.5694/mja18.00477
2018 Bacon SL, Gibson PG, 'Behavioral Interventions for Asthma: What Kind of Exercise and Diets Should We Be Prescribing?', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 6 812-813 (2018)
DOI 10.1016/j.jaip.2017.11.042
Citations Scopus - 1Web of Science - 1
2018 McDonald VM, Maltby S, Gibson PG, 'Severe asthma: We can fix it? We can try!', RESPIROLOGY, 23 260-261 (2018)
DOI 10.1111/resp.13249
Citations Scopus - 1Web of Science - 1
Co-authors Vanessa Mcdonald, Steven Maltby
2018 Beaurivage D, Boulet LP, Foster JM, Gibson PG, McDonald VM, 'Validation of the patient-completed asthma knowledge questionnaire (PAKQ)', Journal of Asthma, 55 169-179 (2018) [C1]

© 2018 Taylor &amp; Francis Group, LLC. Background: Asthma is often suboptimally controlled, in part due to patients&apos; disease knowledge. Understanding patients&apos; knowl... [more]

© 2018 Taylor & Francis Group, LLC. Background: Asthma is often suboptimally controlled, in part due to patients' disease knowledge. Understanding patients' knowledge, prior to education may help in individualizing content. However, there are no well validated or internationally relevant patient asthma knowledge questionnaires available. Objective: To translate and validate the rigorously validated Questionnaire de connaissances sur l'asthme destiné aux patients adultes (QCA-PA) based on key points related to asthma knowledge and self-management accordingly to the Global Initiative for Asthma report. Methods: Based on Vallerand's methodology, a preliminary version of the ¿Patient-completed Asthma Knowledge Questionnaire¿ (PAKQ) was back-translated and evaluated by an expert committee. A sample of 20 individuals with asthma pretested the questionnaire, after which 62 adults were recruited. Sociodemographic data were collected and the PAKQ together with a comparator questionnaire (Consumer Questionnaire (CQ)) were completed. Fourteen days after the first visit, participants returned to recomplete both questionnaires; half were randomly selected to receive a one-on-one asthma education session and again completed both questionnaires immediately after education, and at 10 days follow-up. Results: The PAKQ showed good internal consistency (KR-20 = 0.77). Moderate correlation with CQ (r = 0.596, p = 0.01) attested to its concurrent validity. Confirmatory factor analyses confirmed a single factor structure. A repeated measures ANOVA showed its reproducibility (n = 21:F (1) = 3.578, p = 0.07, ¿ p2 = 0.152) and responsiveness (n = 21:F (1) = 26.041, P < 0.05, ¿ p2 = 0.566). Conclusion: The PAKQ is a valid asthma knowledge questionnaire which is based on international asthma recommendations and could help healthcare professionals in individualizing educational interventions for people with asthma.

DOI 10.1080/02770903.2017.1318914
Co-authors Vanessa Mcdonald
2018 Field SK, Escalante P, Fisher DA, Ireland B, Irwin RS, Adams TM, et al., 'Cough Due to TB and Other Chronic Infections: CHEST Guideline and Expert Panel Report', Chest, 153 467-497 (2018) [C1]

© 2017 American College of Chest Physicians Background: Cough is common in pulmonary TB and other chronic respiratory infections. Identifying features that predict whether pulmona... [more]

© 2017 American College of Chest Physicians Background: Cough is common in pulmonary TB and other chronic respiratory infections. Identifying features that predict whether pulmonary TB is the cause would help target appropriate individuals for rapid and cost-effective screening, potentially limiting disease progression and preventing transmission to others. Methods: A systematic literature search for individual studies to answer eight key questions (KQs) was conducted according to established Chest Organization methods by using the following databases: MEDLINE via PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews from January 1, 1984, to April 2014. Searches for KQ 1 and KQ 3 were updated in February 2016. An updated KQ 2 search was undertaken in March 2017. Results: Even where TB prevalence is greatest, most individuals with cough do not have pulmonary TB. There was no evidence that 1, 3, or 4 weeks¿ duration were better predictors than cough lasting = 2 weeks to screen for pulmonary TB. In people living with HIV (PLWHIV), screening for fever, night sweats, hemoptysis, and/or weight loss in addition to cough (any World Health Organization [WHO]-endorsed symptom) increases the diagnostic sensitivity for TB. Although the diagnostic accuracy of symptom-based screening remains low, the negative predictive value of the WHO-endorsed symptom screen in PLWHIV may help to risk-stratify individuals who are not close TB contacts and who do not require further testing for pulmonary TB in resource-limited settings. However, pregnant PLWHIV are more likely to be asymptomatic, and the WHO-endorsed symptom screen is not sensitive enough to be reliable. Combined with passive case finding (PCF), active case finding (ACF) identifies pulmonary TB cases earlier and possibly when less advanced. Whether outcomes are improved or transmission is reduced is unclear. Screening asymptomatic patients is cost-effective only in populations with a very high TB prevalence. The Xpert MTB/RIF assay on sputum is more cost-effective than clinical diagnosis. To our knowledge, no published comparative studies addressed whether the rate of cough resolution is a reliable determinant of the response to treatment or whether the rate of cough resolution was faster in the absence of cavitary lung disease. All studies on cough prevalence in Mycobacterium avium complex (MAC) lung disease, other nontuberculous mycobacterial infections, fungal lung disease, and paragonimiasis were of poor quality and were excluded from the evidence review. Conclusions: On the basis of relatively few studies of fair to good quality, we conclude that most individuals at high risk and household contacts with cough = 2 weeks do not have pulmonary TB, but we suggest screening them regardless of cough duration. In PLWHIV, the addition of the other WHO-endorsed symptoms increases the diagnostic sensitivity of cough. Earlier screening of patients with cough will help diagnose pulmonary TB sooner but will increase the cost of screening. The addition of ACF to PCF will increase the number of pulmonary TB cases identified. Screening asymptomatic individuals is cost-effective only in groups with a very high TB prevalence. Data are insufficient to determine whether cough resolution is delayed in individuals with cavitary lung disease or in those for whom treatment fails because of drug resistance, poor adherence, and/or drug malabsorption compared with results in other individuals with pulmonary TB. Cough is common in patients with lung infections due to MAC, other nontuberculous mycobacteria, fungal diseases, and paragonimiasis.

DOI 10.1016/j.chest.2017.11.018
Citations Scopus - 8Web of Science - 7
2018 Irwin RS, French CL, Chang AB, Altman KW, Adams TM, Azoulay E, et al., 'Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report', Chest, 153 196-209 (2018) [C1]

© 2017 American College of Chest Physicians Background We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the followin... [more]

© 2017 American College of Chest Physicians Background We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? Methods We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patient values and preferences and the clinical context were used to form recommendations or suggestions. Delphi methodology was used to obtain the final grading. Results With respect to acute cough (< 3 weeks), only three studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 CHEST Cough Guidelines, the most common causes were respiratory infections, most likely of viral cause, followed by exacerbations of underlying diseases such as asthma and COPD and pneumonia. The subjects resided on three continents: North America, Europe, and Asia. With respect to subacute cough (duration, 3-8 weeks), only two studies met our criteria for quality assessment, and both had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were postinfectious cough and exacerbation of underlying diseases such as asthma, COPD, and upper airway cough syndrome (UACS). The subjects resided in countries in Asia. With respect to chronic cough (> 8 weeks), 11 studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were UACS from rhinosinus conditions, asthma, gastroesophageal reflux disease, nonasthmatic eosinophilic bronchitis, combinations of these four conditions, and, less commonly, a variety of miscellaneous conditions and atopic cough in Asian countries. The subjects resided on four continents: North America, South America, Europe, and Asia. Conclusions Although the quality of evidence was low, the published literature since 2006 suggests that CHEST's 2006 Cough Guidelines and management algorithms for acute, subacute, and chronic cough in adults appeared useful in diagnosing and treating patients with cough around the globe. These same algorithms have been updated to reflect the advances in cough management as of 2017.

DOI 10.1016/j.chest.2017.10.016
Citations Scopus - 23Web of Science - 12
2018 Chen ACH, Pena OM, Nel HJ, Yerkovich ST, Chang AB, Baines KJ, et al., 'Airway cells from protracted bacterial bronchitis and bronchiectasis share similar gene expression profiles', Pediatric Pulmonology, 53 575-582 (2018) [C1]

© 2018 Wiley Periodicals, Inc. Aim: Protracted bacterial bronchitis (PBB) is a common cause of prolonged cough in young children, and may be a precursor of bronchiectasis. Bacteri... [more]

© 2018 Wiley Periodicals, Inc. Aim: Protracted bacterial bronchitis (PBB) is a common cause of prolonged cough in young children, and may be a precursor of bronchiectasis. Bacteria are often present in the lower airways in both PBB and bronchiectasis and may cause persistent infections. However, there is a paucity of information available on the pathogenesis of PBB and the factors associated with persistent bacterial infection and progression to bronchiectasis. This study hypothesised that lung immune cells in recurrent PBB and bronchiectasis differentially express genes related to immune cell dysfunction compared to lung immune cells from control subjects. Method: Cells isolated from bronchoalveolar lavage (adult-control and PBB BAL cells) were stimulated with nontypeable Haemophilus influenzae (NTHi), and expression of genes involved in various inflammatory pathways was assessed. Result: NTHi induced production of large amounts of IL-1ß, IL-6, and IL-8 in adult-control BAL cells, however BAL cells from PBB airways appeared refractory to NTHi stimulation. BAL cells from PBB and bronchiectasis showed differential expression of several genes relative to control cells, including CCL20, MARCO, CCL24, IL-10, PPAR-¿, CD200R, TREM2, RelB. Expression of genes involved in resolution of inflammation and anti-inflammation response, such as CD200R and IL-10, was associated with the number of pathogenic bacteria found in the airways. Conclusion: In summary, we have shown that the expression of genes related to macrophage function and resolution of inflammation are similar in PBB and bronchiectasis. Lung immune cell dysfunction in PBB and bronchiectasis may contribute to poor bacterial clearance and prolonged resolution of inflammation.

DOI 10.1002/ppul.23984
Citations Scopus - 5Web of Science - 3
Co-authors Katherine Baines
2017 Agustí A, Bafadhel M, Beasley R, Bel EH, Faner R, Gibson PG, et al., 'Precision medicine in airway diseases: moving to clinical practice.', The European Respiratory Journal, 50 1-13 (2017) [C1]
DOI 10.1183/13993003.01655-2017
Citations Scopus - 31Web of Science - 23
Co-authors Vanessa Mcdonald
2017 Jensen ME, Gibson PG, Collins CE, Hilton JM, Wood LG, 'Lifestyle Risk Factors for Weight Gain in Children with and without Asthma', CHILDREN-BASEL, 4 (2017) [C1]
DOI 10.3390/children4030015
Citations Web of Science - 2
Co-authors Clare Collins, Lisa Wood, Megan Jensen
2017 Fricker M, Gibson PG, 'Macrophage dysfunction in the pathogenesis and treatment of asthma', EUROPEAN RESPIRATORY JOURNAL, 50 (2017) [C1]
DOI 10.1183/13993003.00196-2017
Citations Scopus - 4Web of Science - 2
Co-authors Michael Fricker
2017 McDonald VM, Maltby S, Reddel HK, King GG, Wark PAB, Smith L, et al., 'Severe asthma: Current management, targeted therapies and future directions¿A roundtable report', Respirology, 22 53-60 (2017) [C1]

© 2016 Asian Pacific Society of Respirology Asthma is a chronic respiratory disease characterized by respiratory symptoms, airway inflammation, airway obstruction and airway hyper... [more]

© 2016 Asian Pacific Society of Respirology Asthma is a chronic respiratory disease characterized by respiratory symptoms, airway inflammation, airway obstruction and airway hyper-responsiveness. Asthma is common and directly affects 10% of Australians, 1¿5% of adults in Asia and 300 million people worldwide. It is a heterogeneous disorder with many clinical, molecular, biological and pathophysiological phenotypes. Current management strategies successfully treat the majority of patients with asthma who have access to them. However, there is a subset of an estimated 5¿10% of patients with asthma who have severe disease and are disproportionately impacted by symptoms, exacerbations and overall illness burden. The care required for this relatively small proportion of patients is also significant and has a major impact on the healthcare system. A number of new therapies that hold promise for severe asthma are currently in clinical trials or are entering the Australian and international market. However, recognition of severe asthma in clinical practice is variable, and there is little consensus on the best models of care or how to integrate emerging and often costly therapies into current practice. In this article, we report on roundtable discussions held with severe asthma experts from around Australia, and make recommendations about approaches for better patient diagnosis and assessment. We assess current models of care for patient management and discuss how approaches may be optimized to improve patient outcomes. Finally, we propose mechanisms to assess new therapies and how to best integrate these approaches into future treatment.

DOI 10.1111/resp.12957
Citations Scopus - 17Web of Science - 20
Co-authors Steven Maltby, Peter Wark, Vanessa Mcdonald
2017 Murphy VE, Jensen ME, Powell H, Gibson PG, 'Influence of Maternal Body Mass Index and Macrophage Activation on Asthma Exacerbations in Pregnancy', Journal of Allergy and Clinical Immunology: In Practice, 5 981-987.e1 (2017) [C1]

© 2017 American Academy of Allergy, Asthma &amp; Immunology Background Obesity is a risk factor for exacerbations of asthma, but the mechanisms of this effect in pregnancy are u... [more]

© 2017 American Academy of Allergy, Asthma & Immunology Background Obesity is a risk factor for exacerbations of asthma, but the mechanisms of this effect in pregnancy are unknown. Objective This study determined the influence of maternal body mass index, gestational weight gain, eosinophilic inflammation, and systemic macrophage activation on the risk of exacerbations during pregnancy. Methods Women with asthma (n = 164) participated in the study. Body mass index recorded at baseline (17 weeks gestation) was categorized as healthy weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (>30 kg/m2). Exacerbations requiring medical intervention were recorded prospectively. Asthma control, medication use, and fractional exhaled nitric oxide were assessed monthly; additional visits occurred during exacerbations. Peripheral blood was collected at baseline for the measurement of eosinophils, soluble CD-163, C-reactive protein, and IL-6. Results Exacerbations occurred in a higher proportion of overweight (51.1%) and obese (48.4%) women compared with healthy weight women (25%; P =.026). Excess weight gain during pregnancy was not associated with exacerbation risk. Macrophage activation (elevated serum soluble CD-163) was associated with exacerbations requiring oral corticosteroids (P =.043), whereas high peripheral blood eosinophils or fractional exhaled nitric oxide were not associated with exacerbation or oral corticosteroid use. Conclusions Being overweight or obese confers a greater risk of asthma exacerbation during pregnancy, and may be due to systemic macrophage activation.

DOI 10.1016/j.jaip.2017.03.040
Citations Scopus - 5Web of Science - 5
Co-authors Vanessa Murphy, Megan Jensen
2017 Zheng J, Shi Y, Xiong L, Zhang W, Li Y, Gibson PG, et al., 'The Expression of IL-6, TNF- µ and MCP-1 in Respiratory Viral Infection in Acute Exacerbations of Chronic Obstructive Pulmonary Disease', Journal of Immunology Research, 2017 1-10 (2017) [C1]
DOI 10.1155/2017/8539294
Citations Scopus - 4Web of Science - 2
Co-authors Jodie Simpson
2017 Halnes I, Baines KJ, Berthon BS, MacDonald-Wicks LK, Gibson PG, Wood LG, 'Soluble fibre meal challenge reduces airway inflammation and expression of GPR43 and GPR41 in asthma', Nutrients, 9 1-11 (2017) [C1]
DOI 10.3390/nu9010057
Citations Scopus - 24Web of Science - 21
Co-authors Katherine Baines, Lisa Wood, Lesley Wicks
2017 Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial', The Lancet, 390 659-668 (2017) [C1]

© 2017 Elsevier Ltd Background Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require ... [more]

© 2017 Elsevier Ltd Background Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator. Methods We did a randomised, double-blind, placebo controlled parallel group trial to determine whether oral azithromycin decreases the frequency of asthma exacerbations in adults (=18 years) with symptomatic asthma despite current use of inhaled corticosteroid and long-acting bronchodilator, and who had no hearing impairment or abnormal prolongation of the corrected QT interval. Patients were randomly assigned (1:1) to receive azithromycin 500 mg or placebo three times per week for 48 weeks. Patients were centrally allocated using concealed random allocation from a computer-generated random numbers table with permuted blocks of 4 or 6 and stratification for centre and past smoking. Primary efficacy endpoints were the rate of total (severe and moderate) asthma exacerbations over 48 weeks and asthma quality of life. Data were analysed on an intention-to-treat basis. The trial is registered at the Australian and New Zealand Clinical Trials Registry (ANZCTR), number 12609000197235. Findings Between June 12, 2009, and Jan 31, 2015, 420 patients were randomly assigned (213 in the azithromycin group and 207 in the placebo group). Azithromycin reduced asthma exacerbations (1·07 per patient-year [95% CI 0·85¿1·29]) compared with placebo (1·86 per patient-year [1·54¿2·18]; incidence rate ratio [IRR] 0·59 [95% CI 0·47¿0·74]; p<0·0001). The proportion of patients experiencing at least one asthma exacerbation was reduced by azithromycin treatment (127 [61%] patients in the placebo group vs 94 [44%] patients in the azithromycin group, p<0·0001). Azithromycin significantly improved asthma-related quality of life (adjusted mean difference, 0·36 [95% CI 0·21¿0·52]; p=0·001). Diarrhoea was more common in azithromycin-treated patients (72 [34%] vs 39 [19%]; p=0·001). Interpretation Adults with persistent symptomatic asthma experience fewer asthma exacerbations and improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin might be a useful add-on therapy in persistent asthma. Funding National Health and Medical Research Council of Australia, John Hunter Hospital Charitable Trust.

DOI 10.1016/S0140-6736(17)31281-3
Citations Scopus - 83Web of Science - 78
Co-authors Jodie Simpson
2017 Vertigan AE, Kapela SM, Franke I, Gibson PG, 'The Effect of a Vocal Loading Test on Cough and Phonation in Patients With Chronic Cough', Journal of Voice, 31 763-772 (2017) [C1]

© 2017 The Voice Foundation Objective/Hypothesis Talking is a significant trigger for cough in patients with chronic cough; however, the stimulus required to trigger cough has not... [more]

© 2017 The Voice Foundation Objective/Hypothesis Talking is a significant trigger for cough in patients with chronic cough; however, the stimulus required to trigger cough has not been quantified. The aim of this study was to examine the effect of a vocal loading task on phonation and cough behavior in patients with chronic cough and identify change following therapy. Study Design This is a prospective observational study. Methods This study involved 33 patients with chronic cough. Participants were assessed with the lingWAVES Vocal Loading Test protocol before and after intervention for chronic cough. Results At baseline, almost 40% of patients had impaired vocal function and were unable to complete the vocal loading test. This improved following therapy, with 94% of patients being able to complete the test at follow-up. There was difficulty maintaining phonation, with 60% of the task unvoiced at baseline. This improved following therapy. The vocal loading test triggered coughing in 58% of patients; however, this improved following intervention. Acoustic measures during the vocal loading test did not change following therapy. Conclusion Phonation is an important trigger for cough. Patients with chronic cough demonstrated impaired performance on tests of vocal loading. Most parameters improved following therapy.

DOI 10.1016/j.jvoice.2017.03.020
Citations Scopus - 1Web of Science - 1
2017 Gibson PG, Peters MJ, Wainwright CE, 'Targeted therapy for chronic respiratory disease: a new paradigm', MEDICAL JOURNAL OF AUSTRALIA, 206 136-140 (2017)
DOI 10.5694/mja16.00731
Citations Scopus - 2Web of Science - 2
2017 Wang L, Liang R, Zhou T, Zheng J, Liang BM, Zhang HP, et al., 'Identification and validation of asthma phenotypes in Chinese population using cluster analysis', Annals of Allergy, Asthma and Immunology, 119 324-332 (2017) [C1]
DOI 10.1016/j.anai.2017.07.016
Citations Scopus - 4Web of Science - 4
2017 Condreay L, Chiano M, Ortega H, Buchan N, Harris E, Bleecker ER, et al., 'No genetic association detected with mepolizumab efficacy in severe asthma', RESPIRATORY MEDICINE, 132 178-188 (2017)
DOI 10.1016/j.rmed.2017.10.019
Citations Scopus - 1Web of Science - 2
2017 Brooks CR, van Dalen CJ, Hermans IF, Gibson PG, Simpson JL, Douwes J, 'Sputum basophils are increased in eosinophilic asthma compared with non-eosinophilic asthma phenotypes', Allergy: European Journal of Allergy and Clinical Immunology, 72 1583-1586 (2017) [C1]
DOI 10.1111/all.13185
Citations Scopus - 6Web of Science - 5
Co-authors Jodie Simpson
2017 Rosen MJ, Ireland B, Narasimhan M, French C, Irwin RS, Adams TM, et al., 'Cough in Ambulatory Immunocompromised Adults: CHEST Expert Panel Report', Chest, 152 1038-1042 (2017) [C1]

© 2017 American College of Chest Physicians Background Cough is a common symptom prompting patients to seek medical care. Like patients in the general population, patients with co... [more]

© 2017 American College of Chest Physicians Background Cough is a common symptom prompting patients to seek medical care. Like patients in the general population, patients with compromised immune systems also seek care for cough. However, it is unclear whether the causes of cough in immunocompromised patients who are deemed unlikely to have a life-threating condition and a normal or unchanged chest radiograph are similar to those in persons with cough and normal immune systems. Methods We conducted a systematic review to answer the question: What are the most common causes of cough in ambulatory immunodeficient adults with normal chest radiographs? Studies of patients = 18 years of age with immune deficiency, cough of any duration, and normal or unchanged chest radiographs were included and assessed for relevance and quality. Based on the systematic review, suggestions were developed and voted on using the American College of Chest Physicians (CHEST) methodology framework. Results The results of the systematic review revealed no high-quality evidence to guide the clinician in determining the likely causes of cough specifically in immunocompromised ambulatory patients with normal chest radiographs. Conclusions Based on a systematic review, we found no evidence to assess whether or not the proper initial evaluation of cough in immunocompromised patients is different from that in immunocompetent persons. A consensus of the panel suggested that the initial diagnostic algorithm should be similar to that for immunocompetent persons but that the context of the type and severity of the immune defect, geographic location, and social determinants be considered. The major modifications to the 2006 CHEST Cough Guidelines are the suggestions that TB should be part of the initial evaluation of patients with cough and HIV infection who reside in regions with a high prevalence of TB, regardless of the radiographic findings, and that specific causes and immune defects be considered in all patients in whom the initial evaluation is unrevealing.

DOI 10.1016/j.chest.2017.07.039
Citations Scopus - 4Web of Science - 4
2017 Wang G, Wang F, Gibson PG, Guo M, Zhang WJ, Gao P, et al., 'Severe and uncontrolled asthma in China: A cross-sectional survey from the Australasian Severe Asthma Network', Journal of Thoracic Disease, 9 1333-1344 (2017) [C1]
DOI 10.21037/jtd.2017.04.74
Citations Scopus - 7Web of Science - 6
Co-authors Erin Harvey
2017 Pabreja K, Gibson P, Lochrin AJ, Wood L, Baines KJ, Simpson JL, 'Sputum colour can identify patients with neutrophilic inflammation in asthma', BMJ Open Respiratory Research, 4 (2017) [C1]

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Introduction Sputum colour is associated with neutrophilic... [more]

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Introduction Sputum colour is associated with neutrophilic inflammation in chronic bronchitis and chronic obstructive pulmonary disease (COPD). Neutrophilia and sputum expectoration is notable in asthma, but whether sputum colour is associated with and predicts the presence of neutrophilic inflammation in asthma is unknown. The objective of the study is to assess the ability of sputum colour in distinguishing asthma inflammatory phenotypes. Methods Induced sputum samples collected from 271 adults with stable asthma were retrospectively assessed. Sputum colour was determined using the BronkoTest sputum colour chart and correlated to differential cell counts and CXCL-8 concentration. Neutrophilic inflammation was defined as an age-corrected sputum neutrophil proportion (=61.6% for age 20¿40 years; =63.2% for age 40¿60 and =67.2% for age >60 years), whereas neutrophilic bronchitis (NB) was defined as high total cell count (=5.1×106 cells/mL) plus an increased age-corrected neutrophil proportion. The optimal cut-off for sputum colour to predict neutrophilic inflammation and NB was determined using receiver operator characteristic curve analysis. Results A sputum colour score of =3 represented and predicted neutrophilic inflammation with modest accuracy (area under the curve (AUC)=0.64; p<0.001, specificity=78.4%, sensitivity=49.2%). Participants with a sputum colour score of =3 had significantly (p<0.05) higher CXCL-8, total cells and neutrophil number and proportion. Sputum colour score was also positively correlated with these factors. Sputum colour score =3 predicted NB with reasonably good accuracy (AUC=0.79, p<0.001, specificity=79.3%, sensitivity=70.7%). Conclusions Visual gradation of sputum colour in asthma relates to high total cell count and neutrophilic inflammation. Assessment of sputum colour can identify adults with asthma who are likely to have NB without the need for sputum processing and differential cell count, which may facilitate asthma management.

DOI 10.1136/bmjresp-2017-000236
Citations Scopus - 2
Co-authors Katherine Baines, Kavita Pabreja, Jodie Simpson, Lisa Wood
2017 Gibson PG, McDonald VM, 'Management of severe asthma: targeting the airways, comorbidities and risk factors', Internal Medicine Journal, 47 623-631 (2017) [C1]

© 2017 Royal Australasian College of Physicians Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidit... [more]

© 2017 Royal Australasian College of Physicians Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidities and risk factors. In mild to moderate asthma, the burden of disease can be minimised by inhaled corticosteroids, bronchodilators and self-management education. In severe asthma, however, management is more complex. When patients with asthma continue to experience symptoms and exacerbations despite optimal management, severe refractory asthma (SRA) should be suspected and confirmed, and other aetiologies ruled out. Once a diagnosis of SRA is established, patients should undergo a systematic and multidimensional assessment to identify inflammatory endotypes, risk factors and comorbidities, with targeted and individualised management initiated. We describe a practical approach to assessment and management of patients with SRA.

DOI 10.1111/imj.13441
Citations Scopus - 6Web of Science - 9
Co-authors Vanessa Mcdonald
2017 Malesker MA, Callahan-Lyon P, Ireland B, Irwin RS, Adams TM, Altman KW, et al., 'Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report', Chest, 152 1021-1037 (2017) [C1]

© 2017 American College of Chest Physicians Background Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment app... [more]

© 2017 American College of Chest Physicians Background Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. Methods This systematic review of randomized controlled trials (RCTs) asked the question: Is there evidence of clinically relevant treatment effects for pharmacologic or nonpharmacologic therapies in reducing the duration/severity of acute CACC? Studies of adults and pediatric patients with CACC were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on using the American College of Chest Physicians organization methodology. Results Six systematic reviews and four primary studies identified from updated literature searches for each of the reviews or from hand searching were included and reported data on 6,496 participants with CACC who received one or more of a variety of interventions. The studies used an assortment of descriptors and assessments to identify CACC. Conclusions The evidence supporting the management of CACC is overall of low quality. This document provides treatment suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.

DOI 10.1016/j.chest.2017.08.009
Citations Scopus - 11Web of Science - 7
2017 Chang AB, Oppenheimer JJ, Weinberger M, Grant CC, Rubin BK, Irwin RS, et al., 'Etiologies of Chronic Cough in Pediatric Cohorts: CHEST Guideline and Expert Panel Report', Chest, 152 607-617 (2017) [C1]

© 2017 Background There is no published systematic review on the etiologies of chronic cough or the relationship between OSA and chronic cough in children aged = 14 years. We thus... [more]

© 2017 Background There is no published systematic review on the etiologies of chronic cough or the relationship between OSA and chronic cough in children aged = 14 years. We thus undertook a systematic review based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. The KQs follow: Among children with chronic (> 4 weeks) cough (KQ 1) are the common etiologies different from those in adults? (KQ 2) Are the common etiologies age or setting dependent, or both? (KQ 3) Is OSA a cause of chronic cough in children? Methods We used the CHEST Expert Cough Panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patients¿ values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus. Results Combining KQs 1 and 2, we found moderate-level evidence from 10 prospective studies that the etiologies of cough in children are different from those in adults and are setting dependent. Data from three studies found that common etiologies of cough in young children were different from those in older children. However, data relating sleep abnormalities to chronic cough in children were found only in case studies. Conclusions There is moderate-quality evidence that common etiologies of chronic cough in children are different from those in adults and are dependent on age and setting. As there are few data relating OSA and chronic cough in children, the panel suggested that these children should be managed in accordance with pediatric sleep guidelines.

DOI 10.1016/j.chest.2017.06.006
Citations Scopus - 7Web of Science - 9
2017 Murphy VE, Jensen ME, Gibson PG, 'Asthma during Pregnancy: Exacerbations, Management, and Health Outcomes for Mother and Infant', SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE, 38 160-173 (2017) [C1]
DOI 10.1055/s-0037-1600906
Citations Scopus - 5Web of Science - 3
Co-authors Megan Jensen, Vanessa Murphy
2017 Baines KJ, Fu JJ, McDonald VM, Gibson PG, 'Airway gene expression of IL-1 pathway mediators predicts exacerbation risk in obstructive airway disease', International Journal of COPD, 12 541-550 (2017) [C1]

© 2017 Baines et al. Background: Exacerbations of asthma and COPD are a major cause of morbidity and mortality and are responsible for significant health care costs. This study fu... [more]

© 2017 Baines et al. Background: Exacerbations of asthma and COPD are a major cause of morbidity and mortality and are responsible for significant health care costs. This study further investigates interleukin (IL)-1 pathway activation and its relationship with exacerbations of asthma and COPD. Methods: In this prospective cohort study, 95 participants with stable asthma (n=35) or COPD (n=60) were recruited and exacerbations recorded over the following 12 months. Gene expressions of IL-1 pathway biomarkers, including the IL-1 receptors (IL1R1, IL1R2, and IL1RN), and signaling molecules (IRAK2, IRAK3, and PELI1), were measured in sputum using real-time quantitative polymerase chain reaction. Mediators were compared between the frequent (2 exacerbations in the 12 months) and infrequent exacerbators, and the predictive relationships investigated using receiver operating characteristic curves and area under the curve (AUC) values. Results: Of the 95 participants, 89 completed the exacerbation follow-up, where 30 participants (n=22 COPD, n=8 asthma) had two or more exacerbations. At the baseline visit, expressions of IRAK2, IRAK3, PELI1, and IL1R1 were elevated in participants with frequent exacerbations of both asthma and COPD combined and separately. In the combined population, sputum gene expression of IRAK3 (AUC=75.4%; P,0.001) was the best predictor of future frequent exacerbations, followed by IL1R1 (AUC=72.8%; P,0.001), PELI1 (AUC=71.2%; P,0.001), and IRAK2 (AUC=68.6; P=0.004). High IL-1 pathway gene expression was associated with frequent prior year exacerbations and correlated with the number and severity of exacerbations. Conclusion: The upregulation of IL-1 pathway mediators is associated with frequent exacerbations of obstructive airway disease. Further studies should investigate these mediators as both potential diagnostic biomarkers predicting at-risk patients and novel treatment targets.

DOI 10.2147/COPD.S119443
Citations Scopus - 5Web of Science - 4
Co-authors Vanessa Mcdonald, Katherine Baines
2017 Berthon BS, Gibson PG, Wood LG, MacDonald-Wicks LK, Baines KJ, 'A sputum gene expression signature predicts oral corticosteroid response in asthma', EUROPEAN RESPIRATORY JOURNAL, 49 (2017) [C1]
DOI 10.1183/13993003.00180-2017
Citations Scopus - 6Web of Science - 8
Co-authors Lisa Wood, Katherine Baines, Lesley Wicks
2017 McDonald VM, Gibson PG, '"To define is to limit": perspectives on asthma-COPD overlap syndrome and personalised medicine', EUROPEAN RESPIRATORY JOURNAL, 49 (2017)
DOI 10.1183/13993003.00336-2017
Citations Scopus - 4Web of Science - 5
Co-authors Vanessa Mcdonald
2017 Gibson P, 'Effectiveness trials in asthma: time to SaLSA?', LANCET, 390 2217-2218 (2017)
DOI 10.1016/S0140-6736(17)32398-X
Citations Scopus - 1
2017 Maltby S, Gibson PG, Powell H, McDonald VM, 'Omalizumab Treatment Response in a Population With Severe Allergic Asthma and¿Overlapping COPD', Chest, 151 78-89 (2017) [C1]

© 2016 American College of Chest Physicians Background Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairm... [more]

© 2016 American College of Chest Physicians Background Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. Methods Data from the Australian Xolair Registry were used to compare treatment responses in individuals with asthma-COPD overlap with responses in patients with severe asthma alone. Participants were assessed at baseline and after 6¿months of omalizumab treatment. We used several different definitions of asthma-COPD overlap. First, we compared participants with a previous physician diagnosis of COPD to participants with no COPD diagnosis. We then made¿comparisons based on baseline lung function, comparing participants with an FEV1 <¿80%¿predicted to those with an FEV1 > 80%¿predicted after bronchodilator use. In the population with an FEV1< 80%, analysis was further stratified based on smoking history. Results Omalizumab treatment markedly improved asthma control and health-related quality of life in all populations assessed based on the Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores. Omalizumab treatment did not improve lung function (FEV1, FVC, or FEV1/FVC ratio) in populations that were enriched for asthma-COPD overlap (diagnosis of COPD or FEV1¿< 80%/ever smokers). Conclusions Our study suggests that omalizumab improves asthma control and health-related quality of life in individuals with severe allergic asthma and overlapping COPD. These findings provide real-world efficacy data for this patient population and suggest that omalizumab is useful in the management of severe asthma with COPD overlap.

DOI 10.1016/j.chest.2016.09.035
Citations Scopus - 25Web of Science - 27
Co-authors Vanessa Mcdonald, Steven Maltby
2017 Boulet LP, Turmel J, Irwin RS, Altman KW, Barker AF, Birring SS, et al., 'Cough in the Athlete: CHEST Guideline and Expert Panel Report', Chest, 151 441-454 (2017) [C1]

© 2016 American College of Chest Physicians Background Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess t... [more]

© 2016 American College of Chest Physicians Background Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess the following in this population: (1) the main causes of acute and recurrent cough, either exercise-induced or not, (2) how cough is assessed, and (3) how cough is treated in this population. From the systematic review, suggestions for management were developed. Methods This review was performed according to the CHEST methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework until April 2015. To be included, studies had to meet the following criteria: participants had to be athletes and adults and adolescents aged¿= 12 years and had to complain of cough, regardless of its duration or relationship to exercise. The Expert Cough Panel based their suggestions on the data extracted from the review and final grading by consensus according to a Delphi process. Results Only 60 reports fulfilled the inclusion criteria, and the results of our analysis revealed only low-quality evidence on the causes of cough and how to assess and treat cough specifically in athletes. Although there was no formal evaluation of causes of cough in the athletic population, the most common causes reported were asthma, exercise-induced bronchoconstriction, respiratory tract infection (RTI), upper airway cough syndrome (UACS) (mostly from rhinitis), and environmental exposures. Cough was also reported to be related to exercise-induced vocal cord dysfunction among a variety of less common causes. Although gastroesophageal reflux disease (GERD) is frequent in athletes, we found no publication on cough and GERD in this population. Assessment of the causes of cough was¿performed mainly with bronchoprovocation tests and suspected disease-specific investigations. The evidence to guide treatment of cough in the athlete was weak or nonexistent, depending on the cause. As data on cough in athletes were hidden in a set of other data (respiratory symptoms), evidence tables were difficult to produce and were done only for cough treatment in athletes. Conclusions The causes of cough in the athlete appear to differ slightly from those in the general population. It is often associated with environmental exposures related to the sport training environment and occurs predominantly following intense exercise. Clinical history and specific investigations should allow identification of the cause of cough as well as targeting of the treatment. Until management studies have been performed in the athlete, current guidelines that exist for the general population should be applied for the evaluation and treatment of cough in the athlete, taking into account specific training context and anti-doping regulations.

DOI 10.1016/j.chest.2016.10.054
Citations Scopus - 8Web of Science - 7
2017 Molassiotis A, Smith JA, Mazzone P, Blackhall F, Irwin RS, 'Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer CHEST Guideline and Expert Panel Report', CHEST, 151 861-874 (2017)
DOI 10.1016/j.chest.2016.12.028
Citations Scopus - 8Web of Science - 5
2017 Kim RY, Pinkerton JW, Essilfie AT, Robertson AAB, Baines KJ, Brown AC, et al., 'Role for NLRP3 inflammasome-mediated, IL-1ß-dependent responses in severe, steroid-resistant asthma', American Journal of Respiratory and Critical Care Medicine, 196 283-297 (2017) [C1]

© 2017 by the American Thoracic Society. Rationale: Severe, steroid-resistant asthma is the major unmet need in asthma therapy. Disease heterogeneity and poor understanding of pat... [more]

© 2017 by the American Thoracic Society. Rationale: Severe, steroid-resistant asthma is the major unmet need in asthma therapy. Disease heterogeneity and poor understanding of pathogenic mechanisms hampers the identification of therapeutic targets. Excessive nucleotide-binding oligomerization domain-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome and concomitant IL-1ß responses occur in chronic obstructive pulmonary disease, respiratory infections, and neutrophilic asthma. However, the direct contributions to pathogenesis, mechanisms involved, and potential for therapeutic targeting remain poorly understood, and are unknown in severe, steroid-resistant asthma. Objectives: To investigate the roles and therapeutic targeting of the NLRP3 inflammasome and IL-1ß in severe, steroid-resistant asthma. Methods: We developed mouse models of Chlamydia and Haemophilus respiratory infection-mediated, ovalbumin-induced severe, steroid-resistant allergic airway disease. These models share the hallmark features of human disease, including elevated airway neutrophils, and NLRP3 inflammasome and IL-1ß responses. The roles and potential for targeting of NLRP3 inflammasome, caspase-1, and IL-1ß responses in experimental severe, steroid-resistant asthma were examined using a highly selective NLRP3 inhibitor, MCC950; the specific caspase-1 inhibitor Ac-YVAD-cho; and neutralizing anti-IL-1ß antibody. Roles for IL-1ß-induced neutrophilic inflammation were examined using IL-1ß and anti-Ly6G. Measurements and Main Results: Chlamydia and Haemophilus infections increase NLRP3, caspase-1, IL-1ß responses that drive steroid-resistant neutrophilic inflammation and airway hyperresponsiveness. Neutrophilic airway inflammation, disease severity, and steroid resistance in human asthma correlate with NLRP3 and IL-1ß expression. Treatment with anti-IL-1ß, Ac- YVAD-cho, and MCC950 suppressed IL-1ß responses and the important steroid-resistant features of disease in mice, whereas IL-1ß administration recapitulated these features. Neutrophil depletion suppressed IL-1ß-induced steroid-resistant airway hyperresponsiveness. Conclusions: NLRP3 inflammasome responses drive experimental severe, steroid-resistant asthma and are potential therapeutic targets in this disease.

DOI 10.1164/rccm.201609-1830OC
Citations Scopus - 47Web of Science - 41
Co-authors Lisa Wood, Jodie Simpson, Nicole Hansbro, Jay Horvat, Philip Hansbro, Malcolm Starkey, Katherine Baines, Darryl Knight, Peter Wark
2017 Negewo NA, Gibson PG, Wark PAB, Simpson JL, McDonald VM, 'Treatment burden, clinical outcomes, and comorbidities in COPD: An examination of the utility of medication regimen complexity index in COPD', International Journal of COPD, 12 2929-2942 (2017) [C1]

© 2017 Negewo et al. Background: COPD patients are often prescribed multiple medications for their respiratory disease and comorbidities. This can lead to complex medication regim... [more]

© 2017 Negewo et al. Background: COPD patients are often prescribed multiple medications for their respiratory disease and comorbidities. This can lead to complex medication regimens resulting in poor adherence, medication errors, and drug-drug interactions. The relationship between clinical outcomes and medication burden beyond medication count in COPD is largely unknown. Objectives: The aim of this study was to explore the relationships of medication burden in COPD with clinical outcomes, comorbidities, and multidimensional indices. Methods: In a cross-sectional study, COPD patients (n=222) were assessed for demographic information, comorbidities, medication use, and clinical outcomes. Complexity of medication regimens was quantified using the validated medication regimen complexity index (MRCI). Results: Participants (58.6% males) had a mean (SD) age of 69.1 (8.3) years with a postbronchodilator forced expiratory volume in 1 second % predicted of 56.5 (20.4) and a median of five comorbidities. The median (q1, q3) total MRCI score was 24 (18.5, 31). COPD-specific medication regimens were more complex than those of non-COPD medications (median MRCI: 14.5 versus 9, respectively; P<0.0001). Complex dosage formulations contributed the most to higher MRCI scores of COPD-specific medications while dosing frequency primarily drove the complexity associated with non-COPD medications. Participants in Global Initiative for Chronic Obstructive Lung Disease quadrant D had the highest median MRCI score for COPD medications (15.5) compared to those in quadrants A (13.5; P=0.0001) and B (12.5; P<0.0001). Increased complexity of COPD-specific treatments showed significant but weak correlations with lower lung function and 6-minute walk distance, higher St George¿s Respiratory Questionnaire and COPD assessment test scores, and higher number of prior year COPD exacerbations and hospitalizations. Comorbid cardiovascular, gastrointestinal, or metabolic diseases individually contributed to higher total MRCI scores and/or medication counts for all medications. Charlson Comorbidity Index and COPD-specific comorbidity test showed the highest degree of correlation with total MRCI score (¿=0.289 and ¿=0.326; P<0.0001, respectively). Conclusion: In COPD patients, complex medication regimens are associated with disease severity and specific class of comorbidities.

DOI 10.2147/COPD.S136256
Citations Scopus - 9Web of Science - 6
Co-authors Jodie Simpson, Netsanet Negewo, Peter Wark, Vanessa Mcdonald
2017 Scott HA, Wood LG, Gibson PG, 'Role of Obesity in Asthma: Mechanisms and Management Strategies', Current Allergy and Asthma Reports, 17 1-10 (2017) [C1]
DOI 10.1007/s11882-017-0719-9
Citations Scopus - 6Web of Science - 8
Co-authors Lisa Wood, Hayley Scott
2017 Chen ACH, Xi Y, Carroll M, Petsky HL, Gardiner SJ, Pizzutto SJ, et al., 'Cytokine responses to two common respiratory pathogens in children are dependent on interleukin-1ß', ERS Monograph, 3 (2017) [C1]
DOI 10.1183/23120541.00025-2017
Co-authors Katherine Baines
2017 Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID, McDonald VM, 'Multidimensional assessment of severe asthma: A systematic review and meta-analysis', Respirology, 22 1262-1275 (2017) [C1]

© 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective stra... [more]

© 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries). Study type determined the comprehensiveness of the assessment. Assessed traits were classified into three domains (airways, co-morbidities and risk factors). The airway domain had the largest number of traits assessed (mean ± SD = 4.2 ± 1.7) compared with co-morbidities (3.6 ± 2.2) and risk factors (3.9 ± 2.1). Bronchodilator reversibility and airflow limitation were assessed in 92% of studies, whereas airway inflammation was only assessed in 50%. Commonly assessed co-morbidities were psychological dysfunction, sinusitis (both 73%) and gastro-oesophageal reflux disease (GORD; 69%). Atopic and smoking statuses were the most commonly assessed risk factors (85% and 86%, respectively). There were six outcome studies, of which five concluded that MDA is effective at improving asthma-related outcomes. Among these studies, significantly more traits were assessed than treated. MDA studies have assessed a variety of different traits and have shown evidence of improved outcomes. This promising model of care requires more research to inform which traits should be assessed, which traits should be treated and what effect MDA has on patient outcomes.

DOI 10.1111/resp.13134
Citations Scopus - 12Web of Science - 11
Co-authors Vanessa Clark, Sarah Hiles, Vanessa Mcdonald
2017 McDonald VM, Wood LG, Holland AE, Gibson PG, 'Obesity in COPD: to treat or not to treat?', EXPERT REVIEW OF RESPIRATORY MEDICINE, 11 81-83 (2017)
DOI 10.1080/17476348.2017.1267570
Citations Scopus - 2Web of Science - 2
Co-authors Lisa Wood, Vanessa Mcdonald
2017 McLoughlin RF, McDonald VM, Gibson PG, Scott HA, Hensley MJ, MacDonald-Wicks L, Wood LG, 'The Impact of a Weight Loss Intervention on Diet Quality and Eating Behaviours in People with Obesity and COPD.', Nutrients, 9 1-14 (2017) [C1]
DOI 10.3390/nu9101147
Citations Scopus - 1Web of Science - 1
Co-authors Vanessa Mcdonald, Lisa Wood, Lesley Wicks, Michael Hensley, Hayley Scott
2016 Gibson PG, 'A red flag is seen in a perfect asthma storm', RESPIROLOGY, 21 1146-1147 (2016)
DOI 10.1111/resp.12870
2016 Li Q, Baines KJ, Gibson PG, Wood LG, 'Changes in expression of genes regulating airway inflammation following a high-fat mixed meal in asthmatics', Nutrients, 8 (2016) [C1]

© 2016 by the authors; licensee MDPI, Basel, Switzerland. Consumption of a high fat meal can increase neutrophilic airway inflammation in asthma subjects. This study investigates ... [more]

© 2016 by the authors; licensee MDPI, Basel, Switzerland. Consumption of a high fat meal can increase neutrophilic airway inflammation in asthma subjects. This study investigates the molecular mechanisms driving airway neutrophilia following a high fat meal in asthmatics. Subjects with asthma (n = 11) and healthy controls (n = 8) consumed a high-fat/energy meal, containing total energy (TE) of 3846 kJ and 48 g of total fat (20.5 g saturated). Sputum was induced at 0 and 4 h, and gene expression was examined by microarray and quantitative real-time PCR (qPCR). Following the high fat dietary challenge, 168 entities were significantly differentially expressed greater than >1.5 fold in subjects with asthma, whereas, in healthy controls, only 14 entities were differentially expressed. Of the 168 genes that were changed in asthma, several biological processes were overrepresented, with 25 genes involved in "immune system processes". qPCR confirmed that S100P, S100A16, MAL and MUC1 were significantly increased in the asthma group post-meal. We also observed a strong correlation and a moderate correlation between the change in NLRP12 and S100A16 gene expression at 4 h compared to baseline, and the change in total and saturated non-esterified plasma fatty acid levels at 2 h compared to baseline. In summary, our data identifies differences in inflammatory gene expression that may contribute to increased airway neutrophilia following a high fat meal in subjects with asthma and may provide useful therapeutic targets for immunomodulation. This may be particularly relevant to obese asthmatics, who are habitually consuming diets with a high fat content.

DOI 10.3390/nu8010030
Citations Scopus - 9Web of Science - 4
Co-authors Katherine Baines, Lisa Wood
2016 Chang AB, Upham JW, Masters IB, Redding GR, Gibson PG, Marchant JM, Grimwood K, 'Protracted bacterial bronchitis: The last decade and the road ahead', Pediatric Pulmonology, 51 225-242 (2016) [C1]

© 2015 Wiley Periodicals, Inc. Cough is the single most common reason for primary care physician visits and, when chronic, a frequent indication for specialist referrals. In child... [more]

© 2015 Wiley Periodicals, Inc. Cough is the single most common reason for primary care physician visits and, when chronic, a frequent indication for specialist referrals. In children, a chronic cough (>4 weeks) is associated with increased morbidity and reduced quality of life. One common cause of childhood chronic cough is protracted bacterial bronchitis (PBB), especially in children aged <6 years. PBB is characterized by a chronic wet or productive cough without signs of an alternative cause and responds to 2 weeks of appropriate antibiotics, such as amoxicillin-clavulanate. Most children with PBB are unable to expectorate sputum. If bronchoscopy and bronchoalveolar lavage are performed, evidence of bronchitis and purulent endobronchial secretions are seen. Bronchoalveolar lavage specimens typically reveal marked neutrophil infiltration and culture large numbers of respiratory bacterial pathogens, especially Haemophilus influenzae. Although regarded as having a good prognosis, recurrences are common and if these are frequent or do not respond to antibiotic treatments of up to 4-weeks duration, the child should be investigated for other causes of chronic wet cough, such as bronchiectasis. The contribution of airway malacia and pathobiologic mechanisms of PBB remain uncertain and, other than reduced alveolar phagocytosis, evidence of systemic, or local immune deficiency is lacking. Instead, pulmonary defenses show activated innate immunity and increased gene expression of the interleukin-1ß signalling pathway. Whether these changes in local inflammatory responses are cause or effect remains to be determined. It is likely that PBB and bronchiectasis are at the opposite ends of the same disease spectrum, so children with chronic wet cough require close monitoring. Pediatr Pulmonol. 2016;51:225-242.

DOI 10.1002/ppul.23351
Citations Scopus - 53Web of Science - 49
2016 Hodge S, Hodge G, Simpson JL, Yang IA, Upham J, James A, et al., 'Blood cytotoxic/inflammatory mediators in non-eosinophilic asthma', Clinical and Experimental Allergy, 46 60-70 (2016) [C1]

© 2016 John Wiley &amp; Sons Ltd. Background: Non-eosinophilic asthma (NEA) is a distinct, often corticosteroid-resistant inflammatory asthma phenotype. NK and NKT-like cells ar... [more]

© 2016 John Wiley & Sons Ltd. Background: Non-eosinophilic asthma (NEA) is a distinct, often corticosteroid-resistant inflammatory asthma phenotype. NK and NKT-like cells are effector lymphocytes that we have shown, like CD28null T cells, to be relatively resistant to steroids and major sources of pro-inflammatory/cytotoxic mediators. We hypothesized that these cells and mediators would be increased in peripheral blood in NEA. Methods: Adults with severe asthma and variable airflow obstruction, poorly controlled despite maintenance therapy with inhaled glucocorticosteroids and long-acting bronchodilators, were recruited. Blood was assessed in those with eosinophilic asthma (n = 12), NEA (n = 25) and healthy non-smoking controls (n = 30). We applied flow cytometry to measure T, CD28null, NK and NKT-like cells and their expression of granzyme B, perforin, and killer inhibitory/activating receptors CD94(Kp43), CD158b and CD107A. Intracellular pro-inflammatory cytokine production (IFN-¿ and TNF-a) was assessed in 18 controls and 10 patients with asthma/group. Results: In NEA, there was increased expression of granzyme B by CD8+ T cells vs. controls. There was increased expression of granzyme B and CD158 and decreased CD94 on NK cells, vs. healthy controls and those with eosinophilic asthma. IFN-¿ production by NK cells and TNF-a production by NKT-like cells in NEA were significantly increased vs. controls. In both eosinophilic and NEA phenotypes, there were significant increases in CD4+28null T cells (72% and 81% increases, respectively, vs. controls) and their expression of pro-inflammatory cytokines. Significant correlations were noted between blood CD4+28null T cells and neutrophil numbers in induced sputum, and between corticosteroid dose and blood NKT-like cells, and their production of granzyme B and TNF-a and NK IFN-¿. Conclusion and clinical relevance: In poorly controlled asthma, altered expression of cytotoxic/pro-inflammatory mediators can be seen on a variety of lymphocyte subsets in the peripheral blood; these changes are most apparent in NEA. Whether this pattern of expression is a marker of treatment responsiveness and future risk of exacerbations remains to be determined.

DOI 10.1111/cea.12634
Citations Scopus - 5Web of Science - 5
Co-authors Jodie Simpson
2016 Wang G, Baines KJ, Fu JJ, Wood LG, Simpson JL, McDonald VM, et al., 'Sputum mast cell subtypes relate to eosinophilia and corticosteroid response in asthma', European Respiratory Journal, 47 1123-1133 (2016) [C1]

Copyright © ERS 2016. Mast cells are a resident inflammatory cell of the airways, involved in both the innate and adaptive immune response. The relationship between mast cells and... [more]

Copyright © ERS 2016. Mast cells are a resident inflammatory cell of the airways, involved in both the innate and adaptive immune response. The relationship between mast cells and inflammatory phenotypes and treatment response of asthma is not clear. Clinical characteristics of subjects with stable asthma (n=55), inflammatory cell counts and gene expression microarrays in induced sputum were analysed. Sputum mast cell subtypes were determined by molecular phenotyping based on expression of mast cell biomarkers (tryptase (TPSAB1), chymase (CMA1) and carboxypeptidase A3 (CPA3)). Effects of mast cell subtypes on steroid response were observed in a prospective cohort study (n=50). MCT (n=18) and MCT/CPA3 (mRNA expression of TPSAB1 and CPA3; n=29) subtypes were identified, as well as a group without mast cell gene expression (n=8). The MCT/CPA3 subtype had elevated exhaled nitric oxide fraction, sputum eosinophils, bronchial sensitivity and reactivity, and poorer asthma control. This was accompanied by upregulation of 13 genes. Multivariable logistic regression identified CPA3 (OR 1.21, p=0.004) rather than TPSAB1 (OR 0.92, p=0.502) as a determinant of eosinophilic asthma. The MCT/CPA3 subtype had a better clinical response and reduced signature gene expression with corticosteroid treatment. Sputum mast cell subtypes of asthma can be defined by a molecular phenotyping approach. The MCT/CPA3 subtype demonstrated increased bronchial sensitivity and reactivity, and signature gene expression, which was associated with airway eosinophilia and greater corticosteroid responsiveness.

DOI 10.1183/13993003.01098-2015
Citations Scopus - 18Web of Science - 18
Co-authors Vanessa Mcdonald, Jodie Simpson, Katherine Baines, Lisa Wood
2016 Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS, 'Treatment of unexplained chronic cough chest guideline and expert panel report', Chest, 149 27-44 (2016) [C1]

BACKGROUND: Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC. METHODS: This syst... [more]

BACKGROUND: Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC. METHODS: This systematic review of randomized controlled trials (RCTs) asked: What is the efficacy of treatment compared with usual care for cough severity, cough frequency, and cough-related quality of life in patients with UCC? Studies of adults and adolescents aged 12 years with a chronic cough of 8 weeks' duration that was unexplained after systematic investigation and treatment were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the American College of Chest Physicians organization methodology. RESULTS: Eleven RCTs and five systematic reviews were included. The 11 RCTs reported data on 570 participants with chronic cough who received a variety of interventions. Study quality was high in 10 RCTs. The studies used an assortment of descriptors and assessments to identify UCC. Although gabapentin and morphine exhibited positive effects on cough-related quality of life, only gabapentin was supported as a treatment recommendation. Studies of inhaled corticosteroids (ICS) were affected by intervention fidelity bias; when this factor was addressed, ICS were found to be ineffective for UCC. Esomeprazole was ineffective for UCC without features of gastroesophageal acid reflux. Studies addressing nonacid gastroesophageal reflux disease were not identified. A multimodality speech pathology intervention improved cough severity. CONCLUSIONS: The evidence supporting the diagnosis and management of UCC is limited. UCC requires further study to establish agreed terminology and the optimal methods of investigation using established criteria for intervention fidelity. Speech pathology-based cough suppression is suggested as a treatment option for UCC. This guideline presents suggestions for diagnosis and treatment based on the best available evidence and identifies gaps in our knowledge as well as areas for future research. Copyright &copy; 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

DOI 10.1378/chest.15-1496
Citations Scopus - 58Web of Science - 46
2016 Simpson JL, Baines KJ, Horvat JC, Essilfie AT, Brown AC, Tooze M, et al., 'COPD is characterized by increased detection of Haemophilus influenzae, Streptococcus pneumoniae and a deficiency of Bacillus species', Respirology, 21 697-704 (2016) [C1]

© 2016 Asian Pacific Society of Respirology. Background and objective Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and inflammat... [more]

© 2016 Asian Pacific Society of Respirology. Background and objective Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and inflammation. Airway bacterial colonization is increased in COPD; however, the role of potentially pathogenic and non-pathogenic bacteria in the pathogenesis of disease is unclear. This study characterized the presence of bacteria in a well-characterized cohort of adults with COPD and healthy controls. Methods Adults with COPD (n = 70) and healthy controls (n = 51) underwent clinical assessment and sputum induction. Sputum was dispersed, and total and differential cell counts were performed. Bacteria were cultured, identified and enumerated. Supernatants were assessed for neutrophil elastase (NE) and IL-1ß. Common respiratory pathogens were also determined using real-time PCR. Results Participants with COPD had a typical neutrophilic inflammatory profile. The total load of bacteria was increased in COPD and was associated with poorer respiratory health status, as measured by the St George's Respiratory Questionnaire (Spearman's r = 0.336, P = 0.013). Significantly lower levels of culturable Bacillus species were identified compared with healthy controls. PCR analyses revealed increased rates of detection of potentially pathogenic bacteria with Haemophilus influenzae detection associated with higher sputum levels of NE and IL-1ß, while Streptococcus pneumoniae was more common in male ex-smokers with emphysema and a deficit in diffusion capacity. Conclusion Non-pathogenic and pathogenic bacteria were altered in the sputum of patients with COPD. These observations highlight the potential to identify treatment and management strategies that both target specific bacterial pathogens and restore the microbial balance, which may lead to reductions in inflammation and subsequent improvements in lung health.

DOI 10.1111/resp.12734
Citations Scopus - 16Web of Science - 17
Co-authors Philip Hansbro, Katherine Baines, Jay Horvat, Jodie Simpson, Vanessa Mcdonald
2016 Maltby S, Gibson P, Mattes J, McDonald VM, 'How to treat Severe Asthma ¿ Part 2 Management.', Australian Doctor, (2016)
Co-authors Steven Maltby, Vanessa Mcdonald, Joerg Mattes
2016 Maltby S, Gibson P, Mattes J, McDonald VM, 'How to treat Severe Asthma ¿ Part 1 Diagnosis', Australian Doctor, (2016)
Co-authors Joerg Mattes, Steven Maltby, Vanessa Mcdonald
2016 McDonald VM, Gibson PG, 'Phenotyping Asthma and Chronic Obstructive Pulmonary Disease (COPD)', BRN Reviews, 2 239-252 (2016) [C1]
Co-authors Vanessa Mcdonald
2016 Brooks CR, Van Dalen CJ, Zacharasiewicz A, Simpson JL, Harper JL, Le Gros G, et al., 'Absence of airway inflammation in a large proportion of adolescents with asthma', Respirology, 21 460-466 (2016) [C1]

© 2015 Asian Pacific Society of Respirology. Background and objective Neutrophilic inflammation has been implicated in non-eosinophilic asthma (NEA) in adults, but little is known... [more]

© 2015 Asian Pacific Society of Respirology. Background and objective Neutrophilic inflammation has been implicated in non-eosinophilic asthma (NEA) in adults, but little is known about NEA in children/adolescents. We assessed clinical and inflammatory characteristics of NEA in adolescent asthma. Methods Airway inflammation, sputum endotoxin, airway hyper-reactivity, atopy and lung function were assessed in 77 adolescents with asthma and 68 without asthma (12-17 years). Asthma was identified on the basis of wheeze and asthma history. Results The proportion of NEA (sputum eosinophils <2.5%) was 54%. In this group, atopy, sputum neutrophil, eosinophil, eosinophil cationic protein (ECP), endotoxin, neutrophil elastase and IL-8 levels were not different from those without asthma. In contrast, eosinophilic asthma (EA) was associated with atopy and sputum ECP and IL-8. The majority of NEA had no evidence of inflammation; only 14% had neutrophilia (=61% neutrophils), compared with 11% of EA, and 15% of those without asthma. Small differences in FEV1 (NS) were found between EA and NEA, but symptom prevalence and severity was not different (63% of EA and 52% of NEA were classified moderate to severe). Conclusion NEA is common in adolescent asthma and has similar clinical characteristics as EA. Neutrophils do not appear to play a role in NEA in adolescents, and underlying mechanisms may not involve airway inflammation. Our study suggests that many adolescents with stable asthma do not appear to correspond to the conventional notion that asthma is 'an inflammatory disorder of the airways'. In the absence of overt inflammation, the mechanisms responsible for asthma symptoms in a large proportion of adolescent with asthma remain unknown.

DOI 10.1111/resp.12701
Citations Scopus - 9Web of Science - 7
Co-authors Jodie Simpson
2016 Sverrild A, Bergqvist A, Baines KJ, Porsbjerg C, Andersson CK, Thomsen SF, et al., 'Airway responsiveness to mannitol in asthma is associated with chymase-positive mast cells and eosinophilic airway inflammation', Clinical and Experimental Allergy, 46 288-297 (2016) [C1]

© 2016 John Wiley &amp; Sons Ltd. Background: Airway hyperresponsiveness (AHR) to inhaled mannitol is associated with indirect markers of mast cell activation and eosinophilic a... [more]

© 2016 John Wiley & Sons Ltd. Background: Airway hyperresponsiveness (AHR) to inhaled mannitol is associated with indirect markers of mast cell activation and eosinophilic airway inflammation. It is unknown how AHR to mannitol relates to mast cell phenotype, mast cell function and measures of eosinophilic inflammation in airway tissue. We compared the number and phenotype of mast cells, mRNA expression of mast cell-associated genes and number of eosinophils in airway tissue of subjects with asthma and healthy controls in relation to AHR to mannitol. Methods: Airway hyperresponsiveness to inhaled mannitol was measured in 23 non-smoking, corticosteroid-free asthmatic individuals and 10 healthy controls. Mast cells and eosinophils were identified in mucosal biopsies from all participants. Mast cells were divided into phenotypes based on the presence of chymase. mRNA expression of mast cell-associated genes was measured by real-time PCR. Results: The proportion of submucosal MCTCwas higher in asthmatic individuals with AHR to mannitol compared with asthmatic individuals without AHR (median: 40.3% vs. 18.7%, P=0.03). Increased submucosal MCTCnumbers were associated with increased levels of mRNA for thymic stromal lymphopoietin (TSLP) and CPA3 in asthmatics. Reactivity to mannitol correlated significantly with eosinophils in submucosa (r(s): 0.56, P=0.01). Conclusion: Airway hyperresponsiveness to inhaled mannitol is associated with an altered submucosal mast cell profile in asthmatic individuals. This mast cell profile is associated with increased levels of TSLP and CPA3. The degree of AHR to mannitol is correlated with the degree of eosinophilic inflammation in the airway submucosa.

DOI 10.1111/cea.12609
Citations Scopus - 11Web of Science - 10
Co-authors Katherine Baines
2016 Simpson JL, Carroll M, Yang IA, Reynolds PN, Hodge S, James AL, et al., 'Reduced antiviral interferon production in poorly controlled asthma is associated with neutrophilic inflammation and high-dose inhaled corticosteroids', Chest, 149 704-713 (2016) [C1]

© 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. BACKGROUND: Asthma is a heterogeneous chronic inflammatory disease in which host defen... [more]

© 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. BACKGROUND: Asthma is a heterogeneous chronic inflammatory disease in which host defense against respiratory viruses such as human rhinovirus (HRV) may be abnormal. This is a matter of some controversy, with some investigators reporting reduced type I interferon (IFN) synthesis and others suggesting that type I IFN synthesis is relatively normal in asthma. OBJECTIVE: The objective of this study was to examine the responsiveness of circulating mononuclear cells to HRV in a large cohort of participants with poorly controlled asthma and determine whether IFN-a and IFN-ß synthesis varies across different inflammatory phenotypes. METHODS: Eligible adults with asthma (n = 86) underwent clinical assessment, sputum induction, and blood sampling. Asthma inflammatory subtypes were defined by sputum cell count, and supernatant assessed for IL-1ß. Peripheral blood mononuclear cells (PBMCs) were exposed to HRV serotype 1ß, and IFN-a and IFN-ß release was measured by enzymelinked immunosorbent assay. RESULTS: Participants (mean age, 59 years; atopy, 76%) had suboptimal asthma control (mean asthma control questionnaire 6, 1.7). In those with neutrophilic asthma (n = 12), HRV1ß-stimulated PBMCs produced significantly less IFN-a than PBMCs from participants with eosinophilic (n = 35) and paucigranulocytic asthma (n = 35). Sputum neutrophil proportion and the dose of inhaled corticosteroids were independent predictors of reduced IFN-a production after HRV1ß exposure. CONCLUSIONS: Antiviral type I IFN production is impaired in those with neutrophilic airway inflammation and in those prescribed high doses of inhaled corticosteroids. Our study is an important step toward identifying those with poorly controlled asthma who might respond best to inhaled IFN therapy during exacerbations.

DOI 10.1016/j.chest.2015.12.018
Citations Scopus - 12Web of Science - 10
Co-authors Jodie Simpson
2016 Nguyen TH, Maltby S, Simpson JL, Eyers F, Baines KJ, Gibson PG, et al., 'TNF-a and macrophages are critical for respiratory syncytial virus-induced exacerbations in a mouse model of allergic airways disease', Journal of Immunology, 196 3547-3558 (2016) [C1]

Viral respiratory infections trigger severe exacerbations of asthma, worsen disease symptoms, and impair lung function. To investigate the mechanisms underlying viral exacerbation... [more]

Viral respiratory infections trigger severe exacerbations of asthma, worsen disease symptoms, and impair lung function. To investigate the mechanisms underlying viral exacerbation, we established a mouse model of respiratory syncytial virus (RSV)-induced exacerbation after allergen sensitization and challenge. RSV infection of OVA-sensitized/challenged BALB/c mice resulted in significantly increased airway hyperresponsiveness (AHR) and macrophage and neutrophil lung infiltration. Exacerbation was accompanied by increased levels of inflammatory cytokines (including TNF-a, MCP-1, and keratinocyte-derived protein chemokine [KC]) compared with uninfected OVA-treated mice or OVA-treated mice exposed to UV-inactivated RSV. Dexamethasone treatment completely inhibited all features of allergic disease, including AHR and eosinophil infiltration, in uninfected OVAsensitized/challenged mice. Conversely, dexamethasone treatment following RSV-induced exacerbation only partially suppressed AHR and failed to dampen macrophage and neutrophil infiltration or inflammatory cytokine production (TNF-a, MCP-1, and KC). This mimics clinical observations in patients with exacerbations, which is associated with increased neutrophils and often poorly responds to corticosteroid therapy. Interestingly, we also observed increased TNF-a levels in sputum samples from patients with neutrophilic asthma. Although RSV-induced exacerbation was resistant to steroid treatment, inhibition of TNF-a and MCP-1 function or depletion of macrophages suppressed features of disease, including AHR and macrophage and neutrophil infiltration. Our findings highlight critical roles for macrophages and inflammatory cytokines (including TNF-a and MCP-1) in viral-induced exacerbation of asthma and suggest examination of these pathways as novel therapeutic approaches for disease management.

DOI 10.4049/jimmunol.1502339
Citations Scopus - 16Web of Science - 16
Co-authors Jodie Simpson, Paul Foster, Ming Yang, Steven Maltby, Katherine Baines
2016 Scott HA, Gibson PG, Garg ML, Upham JW, Wood LG, 'Sex hormones and systemic inflammation are modulators of the obese-asthma phenotype', Allergy: European Journal of Allergy and Clinical Immunology, 71 1037-1047 (2016) [C1]

© 2016 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd. Background Both systemic inflammation and sex hormones have been proposed as potential mediators of t... [more]

© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Background Both systemic inflammation and sex hormones have been proposed as potential mediators of the obese-asthma phenotype. The aim of this study was to examine the associations between sex hormones, oral contraceptive pill (OCP) use, systemic inflammation and airway inflammation in adults with asthma. Methods Obese (n = 39) and nonobese (n = 42) females and obese (n = 24) and nonobese (n = 25) males with asthma were recruited. Females were further categorized as reproductive-aged (<50 years old; n = 36) or older (>50 years old; n = 45). Thirteen (36.1%) reproductive-aged females were using the OCP. Participants had induced sputum cell counts measured and blood analysed for sex hormones and inflammatory markers. Results Obese reproductive-aged females had higher sputum %neutrophils than nonobese reproductive-aged females (45.4 ± 24.3% vs 27.5 ± 17.5%, P = 0.016); however, there was no difference in sputum neutrophils in obese compared with nonobese males (P = 0.620) or older females (P = 0.087). Multiple linear regression analysis found testosterone and OCP use to be negative predictors of sputum %neutrophils, while C-reactive protein and IL-6 were positive predictors of sputum %neutrophils. BMI and age were not significant predictors in the multivariate model. Reproductive-aged females using the OCP had significantly lower sputum %neutrophils than those not using the OCP (23.2 ± 12.6% vs 42.1 ± 23.8%, P = 0.015). Conclusions This study suggests that sex hormones and systemic inflammation may be mediating the obese-asthma phenotype. The observation that OCP use was associated with lower sputum %neutrophils in reproductive-aged females warrants further investigation.

DOI 10.1111/all.12891
Citations Scopus - 16Web of Science - 17
Co-authors Manohar Garg, Lisa Wood, Hayley Scott
2016 Thorburn AN, Tseng H-Y, Donovan C, Hansbro NG, Jarnicki AG, Foster PS, et al., 'TLR2, TLR4 AND MyD88 Mediate Allergic Airway Disease (AAD) and Streptococcus pneumoniae-Induced Suppression of AAD.', PLoS One, 11 e0156402 (2016) [C1]
DOI 10.1371/journal.pone.0156402
Citations Scopus - 8Web of Science - 6
Co-authors Paul Foster, Philip Hansbro, Nicole Hansbro, Chantal Donovan
2016 Agusti A, Bel E, Thomas M, Vogelmeier C, Brusselle G, Holgate S, et al., 'Treatable traits: Toward precision medicine of chronic airway diseases', European Respiratory Journal, 47 410-419 (2016) [C1]

Copyright © 2016 by the European Respiratory Society. Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway diseases that have a high personal a... [more]

Copyright © 2016 by the European Respiratory Society. Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway diseases that have a high personal and social impact. They likely represent a continuum of different diseases that may share biological mechanisms (i.e. endotypes), and present similar clinical, functional, imaging and/or biological features that can be observed (i.e. phenotypes) which require individualised treatment. Precision medicine is defined as "treatments targeted to the needs of individual patients on the basis of genetic, biomarker, phenotypic, or psychosocial characteristics that distinguish a given patient from other patients with similar clinical presentations". In this Perspective, we propose a precision medicine strategy for chronic airway diseases in general, and asthma and COPD in particular.

DOI 10.1183/13993003.01359-2015
Citations Scopus - 215Web of Science - 232
2016 Ballantyne D, Scott H, MacDonald-Wicks L, Gibson PG, Wood LG, 'Resistin is a predictor of asthma risk and resistin:adiponectin ratio is a negative predictor of lung function in asthma', Clinical and Experimental Allergy, 46 1056-1065 (2016) [C1]

© 2016 John Wiley &amp; Sons Ltd Background: Adipokines, such as resistin and adiponectin, modify inflammation and may contribute to increased asthma risk and severity in obese ... [more]

© 2016 John Wiley & Sons Ltd Background: Adipokines, such as resistin and adiponectin, modify inflammation and may contribute to increased asthma risk and severity in obese people. Objective: To examine plasma resistin and resistin:adiponectin ratio (i) in asthmatics compared to healthy controls, (ii) according to asthma severity, obesity and gender (iii) following weight loss in obese asthmatics. Methods: In a cross-sectional observational study of asthmatic adults (n = 96) and healthy controls (n = 46), plasma resistin and adiponectin were measured. In a separate intervention study, obese asthmatic adults (n = 27) completed a 10-week weight loss intervention and plasma resistin and adiponectin concentrations were analysed. Results: Plasma resistin and resistin:adiponectin ratio were higher in asthma compared to controls and were higher again in subjects with a severe vs. mild-to-moderate asthma pattern. Amongst asthmatic subjects, resistin was not modified by gender or obesity, while adiponectin was lower in males and obese subjects. As a result, resistin:adiponectin ratio was higher in obese males, non-obese males and obese females, compared to non-obese females. In a logistic regression model, plasma resistin concentration was a predictor of asthma risk. In a multiple linear regression model, plasma resistin:adiponectin ratio was a negative predictor of FEV1 in asthma. Following weight loss, neither resistin, adiponectin nor resistin:adiponectin ratio was changed. However, the change (¿) in %body fat was associated with ¿ resistin:adiponectin ratio. Post-intervention ¿ resistin was negatively correlated with both ¿FRC and ¿RV. Conclusion and clinical relevance: This study demonstrates that resistin and resistin:adiponectin ratio are higher in asthma and are higher again in subjects who have more severe disease. Resistin:adiponectin ratio is highest in obese male asthmatics. As resistin is a predictor of asthma risk and resistin:adiponectin is a predictor of FEV1 in asthma, these adipokines may be contributing to the obese asthma phenotype, thus providing a potential therapeutic target for obese asthma.

DOI 10.1111/cea.12742
Citations Scopus - 12Web of Science - 13
Co-authors Lesley Wicks, Lisa Wood, Hayley Scott
2016 Zosky GR, Hoy RF, Silverstone EJ, Brims FJ, Miles S, Johnson AR, et al., 'Coal workers¿ pneumoconiosis: An Australian perspective', Medical Journal of Australia, 204 414-418.e2 (2016) [C1]

© 2016 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Coal workers¿ pneumoconiosis (CWP) is an untreatable but preventable lung disease arising from chronic inhal... [more]

© 2016 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Coal workers¿ pneumoconiosis (CWP) is an untreatable but preventable lung disease arising from chronic inhalation of coal dust. Recent reports of CWP in Queensland, along with international data, suggest that there is a resurgence in pneumoconiosis. The prevalence of CWP varies considerably between countries. In Australia, there is no mandatory reporting system and no national data on the prevalence of CWP. The symptoms and manifestations of CWP vary depending on the composition of the inhaled dust, duration of exposure, stage of disease and host-related factors. CWP may develop into progressive massive fibrosis (PMF), which can be fatal. Radiological assessment should be performed according to evidence-based standards using the ILO (International Labour Office) International Classification of Radiographs of Pneumoconioses. As preventing exposure to coal dust prevents CWP, it is important to implement and enforce appropriate standards limiting exposure. In Australia, these standards currently vary between states and are not in keeping with international understanding of the levels of coal dust that cause disease. Longitudinal screening programs are crucial for monitoring the health of coal workers to identify individuals with early-stage disease and prevent progression from mild disease to PMF. We recommend: standardisation of coal dust exposure limits, with harmonisation to international regulations; implementation of a national screening program for at-risk workers, with use of standardised questionnaires, imaging and lung function testing; development of appropriate training materials to assist general practitioners in identifying pneumoconiosis; and a system of mandatory reporting of CWP to a centralised occupational lung disease register.

DOI 10.5694/mja16.00357
Citations Scopus - 9Web of Science - 2
2016 Wright TK, Gibson PG, Simpson JL, McDonald VM, Wood LG, Baines KJ, 'Neutrophil extracellular traps are associated with inflammation in chronic airway disease', Respirology, 21 467-475 (2016) [C1]

© 2016 Asian Pacific Society of Respirology. Background and objective Neutrophil extracellular traps (NETs) are web-like structures comprising DNA and antimicrobial proteins, expe... [more]

© 2016 Asian Pacific Society of Respirology. Background and objective Neutrophil extracellular traps (NETs) are web-like structures comprising DNA and antimicrobial proteins, expelled from neutrophils during NETosis. Persistence of NETs can be pro-inflammatory, yet their role in respiratory disease remains unclear. This study aimed to investigate the presence of NETs in sputum from patients with asthma and COPD, and the relationship of NETs with inflammatory phenotype and disease severity. Methods Induced sputum was collected from healthy controls, asthma and COPD patients. Extracellular DNA (eDNA) was quantified by PicoGreen. LL-37, a-defensins1-3, NE, IL-1ß and CXCL8 were quantified by ELISA. PAD4 and NLRP3 gene expression was performed using qPCR. NETs were imaged in sputum smears using immunofluorescence microscopy. Results Sputum eDNA and NET neutrophil antimicrobial proteins were significantly elevated in asthma and COPD compared with healthy controls. Levels of eDNA and NET components were significantly higher in neutrophilic versus non-neutrophilic asthma and COPD. NETs were clearly visualized in sputum smears. PAD4 mRNA was upregulated in neutrophilic COPD. The level of eDNA was higher in severe asthma. High eDNA levels were associated with heightened innate immune responses, including elevated CXCL8 and IL-1ß, and NLRP3 gene expression in both COPD and asthma. Antimicrobial proteins and eDNA were positively correlated with airway neutrophils, and negatively correlated with lung function and symptoms. Conclusion NETs are present in the airways of subjects with asthma and COPD. Accumulation of excessive NETs was associated with activation of innate immune responses contributing to disease pathogenesis in chronic airway disease.

DOI 10.1111/resp.12730
Citations Scopus - 37Web of Science - 39
Co-authors Vanessa Mcdonald, Lisa Wood, Jodie Simpson, Katherine Baines
2016 Hew M, Gillman A, Sutherland M, Wark P, Bowden J, Guo M, et al., 'Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria', Clinical and Experimental Allergy, 46 1407-1415 (2016) [C1]

© 2016 John Wiley &amp; Sons Ltd Background: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omali... [more]

© 2016 John Wiley & Sons Ltd Background: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30¿1500 IU/mL) and bodyweight (30¿150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR). Objectives: To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. Methods: Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). Results: Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV1) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV1. Conclusions and Clinical Relevance: Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.

DOI 10.1111/cea.12774
Citations Scopus - 14Web of Science - 10
Co-authors Vanessa Mcdonald, Peter Wark
2016 Hull JH, Backer V, Gibson PG, Fowler SJ, 'Laryngeal dysfunction: Assessment and management for the clinician', American Journal of Respiratory and Critical Care Medicine, 194 1062-1072 (2016) [C1]

© 2016 by the American Thoracic Society. The larynxis one of the most highly innervate dorgansinhumansand serves a number of vitally important, complex, and highly evolved biologi... [more]

© 2016 by the American Thoracic Society. The larynxis one of the most highly innervate dorgansinhumansand serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.

DOI 10.1164/rccm.201606-1249CI
Citations Scopus - 18Web of Science - 14
2016 Murphy VE, Jensen ME, Mattes J, Hensley MJ, Giles WB, Peek MJ, et al., 'The Breathing for Life Trial: a randomised controlled trial of fractional exhaled nitric oxide (FENO)-based management of asthma during pregnancy and its impact on perinatal outcomes and infant and childhood respiratory health', BMC PREGNANCY AND CHILDBIRTH, 16 (2016)
DOI 10.1186/s12884-016-0890-3
Citations Scopus - 10Web of Science - 9
Co-authors Vanessa Murphy, Joerg Mattes, Megan Jensen, John Attia, Andrew Searles, Michael Hensley
2016 Backer V, Baines KJ, Powell H, Porsbjerg C, Gibson PG, 'Increased asthma and adipose tissue inflammatory gene expression with obesity and Inuit migration to a western country', Respiratory Medicine, 111 8-15 (2016) [C1]

© 2015 Elsevier Ltd. Background An overlap between obesity and asthma exists, and inflammatory cells in adipose tissue could drive the development of asthma. Comparison of adipose... [more]

© 2015 Elsevier Ltd. Background An overlap between obesity and asthma exists, and inflammatory cells in adipose tissue could drive the development of asthma. Comparison of adipose tissue gene expression among Inuit living in Greenland to those in Denmark provides an opportunity to assess how changes in adipose tissue inflammation can be modified by migration and diet. Objective To examine mast cell and inflammatory markers in adipose tissue and the association with asthma. Methods Two Inuit populations were recruited, one living in Greenland and another in Denmark. All underwent adipose subcutaneous biopsy, followed by clinical assessment of asthma, and measurement of AHR. Adipose tissue biopsies were homogenised, RNA extracted, and PCR was performed to determine the relative gene expression of mast cell (tryptase, chymase, CPA3) and inflammatory markers (IL-6, IL-1ß, and CD163). Results Of the 1059 Greenlandic Inuit participants, 556 were living in Greenland and 6.4% had asthma. Asthma was increased in Denmark (9%) compared to Greenland (3.6%, p < 0.0001) and associated with increased adipose tissue IL-6 gene expression and increased BMI. There was no association between asthma and adipose tissue mast cell gene expression. Pro-inflammatory gene expression (IL-6, IL-1ß) was higher in those living in Denmark, and with increasing BMI and dietary changes. The anti-inflammatory (M2) macrophage marker, CD163, was higher in Greenland-dwelling Inuit (p < 0.01). Conclusions No association was found between gene expression of mast cell markers in adipose tissue and asthma. Among Greenlandic Inuit, adipose tissue inflammation is also increased in those who migrate to Denmark, possibly as a result of dietary changes.

DOI 10.1016/j.rmed.2015.12.003
Citations Scopus - 3Web of Science - 4
Co-authors Katherine Baines
2016 Simpson JL, Daly J, Baines KJ, Yang IA, Upham JW, Reynolds PN, et al., 'Airway dysbiosis: Haemophilus influenza and Tropheryma in poorly controlled asthma', European Respiratory Journal, 47 792-800 (2016) [C1]

© ERS 2016. Asthma is a chronic inflammatory disorder of the airways where bacteria may act as protagonists of chronic inflammation. Little is known about the relation of airway i... [more]

© ERS 2016. Asthma is a chronic inflammatory disorder of the airways where bacteria may act as protagonists of chronic inflammation. Little is known about the relation of airway inflammation to the presence of specific bacterial taxa. We sought to describe the sputum microbiome in adults with poorly controlled asthma. DNA was extracted from induced sputum and microbial communities were profiled using 16S rRNA pyrosequencing. Bacterial species were characterised, and the relationship between microbial populations, asthma inflammatory subtypes and other covariates was explored. Real-time PCR was used to identify Tropheryma whipplei and Haemophilus influenzae in sputum. Adults with neutrophilic asthma had reduced bacterial diversity and species richness. Tropheryma was identified and confirmed with real-time PCR in 12 (40%) participants. Haemophilus occurred most often in a group of younger atopic males with an increased proportion of neutrophils. PCR confirmed the presence of H. influenzae in 35 (76%) participants with poorly controlled asthma. There are phenotype-specific alterations to the airway microbiome in asthma. Reduced bacterial diversity combined with a high prevalence of H. influenzae was observed in neutrophilic asthma, whereas eosinophilic asthma had abundant T. whipplei.

DOI 10.1183/13993003.00405-2015
Citations Scopus - 45Web of Science - 47
Co-authors Jodie Simpson, Katherine Baines
2016 Tarlo SM, Altman KW, Oppenheimer J, Lim K, Vertigan A, Prezant D, Irwin RS, 'Occupational and Environmental Contributions to Chronic Cough in Adults Chest Expert Panel Report', CHEST, 150 894-907 (2016) [C1]
DOI 10.1016/j.chest.2016.07.029
Citations Scopus - 5Web of Science - 3
2016 Vertigan A, Kapela S, Ryan NM, Birring S, McElduff P, Gibson P, 'Pregabalin and speech pathology combination therapy for refractory chronic cough: A randomised controlled trial.', Chest, 149 639-648 (2016) [C1]
DOI 10.1378/chest.15-1271
Citations Scopus - 52Web of Science - 45
Co-authors Nicole Ryan, Patrick Mcelduff
2016 Hodge S, Upham JW, Pizzutto S, Petsky HL, Yerkovich S, Baines KJ, et al., 'Is alveolar macrophage phagocytic dysfunction in children with protracted bacterial bronchitis a forerunner to bronchiectasis?', Chest, 149 508-515 (2016) [C1]

Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. Background: Children with recurrent protracted bacterial bronchitis (PBB) an... [more]

Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. Background: Children with recurrent protracted bacterial bronchitis (PBB) and bronchiectasis share common features, and PBB is likely a forerunner to bronchiectasis. Both diseases are associated with neutrophilic inflammation and frequent isolation of potentially pathogenic microorganisms, including nontypeable Haemophilus influenzae (NTHi), from the lower airway. Defective alveolar macrophage phagocytosis of apoptotic bronchial epithelial cells (efferocytosis), as found in other chronic lung diseases, may also contribute to tissue damage and neutrophil persistence. Thus, in children with bronchiectasis or PBB and in control subjects, we quantified the phagocytosis of airway apoptotic cells and NTHi by alveolar macrophages and related the phagocytic capacity to clinical and airway inflammation. Methods: Children with bronchiectasis (n = 55) or PBB (n = 13) and control subjects (n = 13) were recruited. Alveolar macrophage phagocytosis, efferocytosis, and expression of phagocytic scavenger receptors were assessed by flow cytometry. Bronchoalveolar lavage fluid interleukin (IL) 1ß was measured by enzyme-linked immunosorbent assay. Results: For children with PBB or bronchiectasis, macrophage phagocytic capacity was significantly lower than for control subjects (P=.003 and P<.001 for efferocytosis and P=.041 and P = .004 for phagocytosis of NTHi; PBB and bronchiectasis, respectively); median phagocytosis of NTHi for the groups was as follows: bronchiectasis, 13.7% (interquartile range [IQR], 11%-16%); PBB, 16% (IQR, 11%-16%); control subjects, 19.0% (IQR, 13%-21%); and median efferocytosis for the groups was as follows: bronchiectasis, 14.1% (IQR, 10%-16%); PBB, 16.2% (IQR, 14%-17%); control subjects, 18.1% (IQR, 16%-21%). Mannose receptor expression was significantly reduced in the bronchiectasis group (P = .019), and IL-1ß increased in both bronchiectasis and PBB groups vs control subjects. Conclusions: A reduced alveolar macrophage phagocytic host response to apoptotic cells or NTHi may contribute to neutrophilic inflammation and NTHi colonization in both PBB and bronchiectasis. Whether this mechanism also contributes to the progression of PBB to bronchiectasis remains unknown.

DOI 10.1016/j.chest.2015.10.066
Citations Scopus - 17Web of Science - 16
Co-authors Jodie Simpson, Katherine Baines
2016 Negewo NA, McDonald VM, Baines KJ, Wark PAB, Simpson JL, Jones PW, Gibson PG, 'Peripheral blood eosinophils: A surrogate marker for airway eosinophilia in stable COPD', International Journal of COPD, 11 1495-1504 (2016) [C1]

© 2016 Negewo et al. Introduction: Sputum eosinophilia occurs in approximately one-third of stable chronic obstructive pulmonary disease (COPD) patients and can predict exacerbat... [more]

© 2016 Negewo et al. Introduction: Sputum eosinophilia occurs in approximately one-third of stable chronic obstructive pulmonary disease (COPD) patients and can predict exacerbation risk and response to corticosteroid treatments. Sputum induction, however, requires expertise, may not always be successful, and does not provide point-of-care results. Easily applicable diagnostic markers that can predict sputum eosinophilia in stable COPD patients have the potential to progress COPD management. This study investigated the correlation and predictive relationship between peripheral blood and sputum eosinophils. It also examined the repeatability of blood eosinophil counts. Methods: Stable COPD patients (n=141) were classified as eosinophilic or noneosinophilic based on their sputum cell counts (=3%), and a cross-sectional analysis was conducted comparing their demographics, clinical characteristics, and blood cell counts. Receiver operating characteristic curve analysis was used to assess the predictive ability of blood eosinophils for sputum eosinophilia. Intraclass correlation coefficient was used to examine the repeatability of blood eosinophil counts. Results: Blood eosinophil counts were significantly higher in patients with sputum eosinophilia (n=45) compared to those without (0.3×10 9 /L vs 0.15×10 9 /L; P<0.0001). Blood eosinophils correlated with both the percentage (¿=0.535; P<0.0001) and number of sputum eosinophils (¿=0.473; P<0.0001). Absolute blood eosinophil count was predictive of sputum eosinophilia (area under the curve =0.76, 95% confidence interval [CI] =0.67¿0.84; P<0.0001). At a threshold of =0.3×10 9 /L (specificity =76%, sensitivity =60%, and positive likelihood ratio =2.5), peripheral blood eosinophil counts enabled identification of the presence or absence of sputum eosinophilia in 71% of the cases. A threshold of =0.4×10 9 /L had similar classifying ability but better specificity (91.7%) and higher positive likelihood ratio (3.7). In contrast, =0.2×10 9 /L offered a better sensitivity (91.1%) for ruling out sputum eosinophilia. There was a good agreement between two measurements of blood eosinophil count over a median of 28 days (intraclass correlation coefficient =0.8; 95% CI =0.66¿0.88; P<0.0001). Conclusion: Peripheral blood eosinophil counts can help identify the presence or absence of sputum eosinophilia in stable COPD patients with a reasonable degree of accuracy.

DOI 10.2147/COPD.S100338
Citations Scopus - 35Web of Science - 38
Co-authors Netsanet Negewo, Peter Wark, Katherine Baines, Jodie Simpson, Vanessa Mcdonald
2016 McDonald VM, Gibson PG, Scott HA, Baines PJ, Hensley MJ, Pretto JJ, Wood LG, 'Should we treat obesity in COPD? The effects of diet and resistance exercise training', Respirology, 21 875-882 (2016) [C1]

© 2016 Asian Pacific Society of Respirology Background and objective: Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pulm... [more]

© 2016 Asian Pacific Society of Respirology Background and objective: Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pulmonary disease (COPD), it is associated with improved survival and lung function. A major evidence gap exisits to inform treatment recommendations for patients with COPD who are obese. We aimed to determine the effect of weight reduction involving a low-energy diet utilizing a partial meal replacement plan, coupled with resistance exercise training in obese COPD patients. Methods: In a proof of concept before¿after clinical trial, obese (body mass index =30 kg/m2) COPD patients received a 12 week weight reduction programme involving meal replacements, dietary counselling by a dietitian and resistance exercise training prescribed and supervised by a physiotherapist. Patients were reviewed face to face by the dietitian and physiotherapist every 2 weeks for counselling. Results: Twenty-eight participants completed the intervention. Mean (standard deviation) body mass index was 36.3 kg/m2 (4.6) at baseline and reduced by 2.4 kg/m2 ((1.1) P < 0.0001) after the intervention. Importantly, skeletal muscle mass was maintained. Clinical outcomes improved with weight loss including exercise capacity, health status, dyspnea, strength and functional outcomes. There was also a significant reduction in the body mass index, obstruction, dyspnea and exercise score (BODE). Systemic inflammation measured by C-reactive protein however did not change. Conclusion: In obese COPD patients, dietary energy restriction coupled with resistance exercise training results in clinically significant improvements in body mass index, exercise tolerance and health status, whilst preserving skeletal muscle mass. This novel study provides a framework for development of guidelines for the management of obese COPD patients and in guiding future research.

DOI 10.1111/resp.12746
Citations Scopus - 19Web of Science - 19
Co-authors Lisa Wood, Hayley Scott, Vanessa Mcdonald, Michael Hensley
2016 Kahrilas PJ, Altman KW, Chang AB, Field SK, Harding SM, Lane AP, et al., 'Chronic Cough Due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report', Chest, 150 1341-1360 (2016) [C1]

© 2016 American College of Chest Physicians Background We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. Methods Two population, inter... [more]

© 2016 American College of Chest Physicians Background We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. Methods Two population, intervention, comparison, outcome (PICO) questions were addressed by systematic review: (1) Can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and (2) Are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux? Results We found no high-quality studies pertinent to either question. From available randomized controlled trials (RCTs) addressing question #1, we concluded that (1) there was¿a strong placebo effect for cough improvement; (2) studies including diet modification and weight loss had better cough outcomes; (3) although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, proton pump inhibitors (PPIs) demonstrated no benefit when used in isolation; and (4) because of potential carryover effect, crossover studies using PPIs should be avoided. For question #2, we concluded from the available observational trials that (1) an algorithmic approach to management resolved chronic cough in 82%¿to 100%¿of instances; (2) cough variant asthma and upper airway cough syndrome (UACS) (previously referred to as postnasal drip syndrome) from rhinosinus conditions were the most commonly reported causes; and (3) the reported prevalence of reflux-cough syndrome varied widely. Conclusions The panelists (1) endorsed the use of a diagnostic/therapeutic algorithm addressing causes of common cough, including symptomatic reflux; (2) advised that although lifestyle modifications and weight reduction may be beneficial in suspected reflux-cough syndrome, PPIs demonstrated no benefit when used in isolation; and (3) suggested that physiological testing be reserved for refractory patients being considered for antireflux surgery or for those in whom there is strong clinical suspicion warranting diagnostic testing.

DOI 10.1016/j.chest.2016.08.1458
Citations Scopus - 22Web of Science - 19
2016 Dong Z, Xiong L, Zhang W, Gibson PG, Wang T, Lu Y, et al., 'Holding the Inflammatory System in Check: TLRs and Their Targeted Therapy in Asthma', MEDIATORS OF INFLAMMATION, (2016)
DOI 10.1155/2016/2180417
Citations Scopus - 13Web of Science - 12
2016 Zosky GR, Hoy RF, Silverstone EJ, Brims FJ, Miles S, Johnson AR, et al., 'Coal workers' pneumoconiosis: an Australian perspective', MEDICAL JOURNAL OF AUSTRALIA, 204 414-+ (2016)
DOI 10.5694/mja16.00357
Citations Web of Science - 11
2016 Williams EJ, Baines KJ, Smart JM, Gibson PG, Wood LG, 'Rosuvastatin, lycopene and omega-3 fatty acids: A potential treatment for systemic inflammation in COPD; a pilot study', Journal of Nutrition and Intermediary Metabolism, 5 86-95 (2016) [C1]

© 2016 The Authors Background/Aims Chronic Obstructive Pulmonary Disease (COPD) is characterized by airway inflammation, in which contributes to loss of lung function. Systemic in... [more]

© 2016 The Authors Background/Aims Chronic Obstructive Pulmonary Disease (COPD) is characterized by airway inflammation, in which contributes to loss of lung function. Systemic inflammation is also a feature of COPD contributing to many associated co-morbidities. Statins, omega-3 fatty acids (docosahexanoic acid, DHA and eicosapentanoic acid, EPA) and lycopene have been shown to decrease systemic inflammation; however their combined effects have not been investigated. This study aims to identify changes in systemic and airway inflammation induced by statins alone or in combination with DHA, EPA and lycopene in COPD. Methods COPD patients (n¿=¿11) received rosuvastatin (20¿mg/day) for 4 weeks, then a combination of rosuvastatin (20¿mg/day), DHA and EPA (1.5¿g/day) and lycopene (45¿mg/day) for 8 weeks. Blood and sputum were collected and lung function measured by spirometry at baseline, week 4 and 12. Plasma fatty acids were measured using gas chromatography, while plasma carotenoids were analysed using high-performance liquid chromatography. Plasma CRP and IL-6 concentrations were measured using ELISA; and peripheral blood gene expression was measured using the nCounter¿ GX Human Inflammation Kit 2. Results Following the interventions, clinical characteristics and plasma IL-6 and CRP were unchanged. Sputum neutrophil proportion and absolute count was increased and macrophage proportion decreased by rosuvastatin (P¿=¿0.020 and P¿=¿0.015; respectively). Rosuvastatin increased LTB4R and decreased CXCL10 and AGER gene expression in white blood cells. The addition of lycopene and omega-3 fatty acids decreased LTB4R and increased CXCL10 to basal levels, whilst combined use of interventions increased ALOX15 blood gene expression. Conclusion This study shows that rosuvastatin, omega-3 fatty acids and lycopene have some anti-inflammatory effects systemically, but rosuvastatin may increase airway neutrophils, which would be undesirable in COPD patients, warranting further investigation.

DOI 10.1016/j.jnim.2016.04.006
Citations Scopus - 2
Co-authors Lisa Wood, Katherine Baines
2016 Skloot GS, Busse PJ, Braman SS, Kovacs EJ, Dixon AE, Fragoso CAV, et al., 'An Official American Thoracic Society Workshop Report: Evaluation and Management of Asthma in the Elderly', ANNALS OF THE AMERICAN THORACIC SOCIETY, 13 2064-2077 (2016)
DOI 10.1513/AnnalsATS.201608-658ST
Citations Scopus - 20Web of Science - 24
2016 Gibson PG, Reddel H, McDonald VM, Marks G, Jenkins C, Gillman A, et al., 'Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry', INTERNAL MEDICINE JOURNAL, 46 1054-1062 (2016) [C1]
DOI 10.1111/imj.13166
Citations Scopus - 21Web of Science - 20
Co-authors Peter Wark, Vanessa Mcdonald
2016 Simpson JL, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'Periostin levels and eosinophilic inflammation in poorly-controlled asthma.', BMC pulmonary medicine, 16 67 (2016) [C1]
DOI 10.1186/s12890-016-0230-4
Citations Scopus - 23Web of Science - 21
Co-authors Jodie Simpson
2016 Wark PAB, Hew M, Maltby S, McDonald VM, Gibson PG, 'Diagnosis and investigation in the severe asthma clinic.', Expert Rev Respir Med, 10 491-503 (2016) [C1]
DOI 10.1586/17476348.2016.1165096
Citations Scopus - 10Web of Science - 11
Co-authors Steven Maltby, Peter Wark, Vanessa Mcdonald
2016 Porsbjerg C, Baines K, Gibson P, Bergqvist A, Erjefält JS, Sverrild A, Backer V, 'IL-33 is related to innate immune activation and sensitization to HDM in mild steroid-free asthma', Clinical and Experimental Allergy, 46 564-574 (2016) [C1]

© 2016 John Wiley &amp; Sons Ltd. Summary: Background: IL-33 represents a potential link between the airway epithelium and induction of a Th2-type inflammatory response in asthm... [more]

© 2016 John Wiley & Sons Ltd. Summary: Background: IL-33 represents a potential link between the airway epithelium and induction of a Th2-type inflammatory response in asthma. However, the association with markers of eosinophilic airway inflammation has not previously been reported in patients with steroid-free asthma. Aim: To describe the relationship between airway IL-33 and markers of eosinophilic airway inflammation, as well potential triggers of IL-33, in mild, steroid-free asthma. Methods: IL-33 mRNA expression and IL-33 immunoreactivity were measured in bronchial biopsies from patients with asthma untreated with inhaled steroids and healthy individuals. Furthermore, fractional exhaled nitric oxide (FeNO) and eosinophils in sputum and BAL were measured, as well as airway hyperresponsiveness to mannitol and methacholine. Epithelial integrity was assessed by computerized image analysis on haematoxylin-stained sections, and TLR mRNA expression by PCR. Results: A total of 23 patients with asthma and 10 healthy individuals were examined (age: 24 years (20-40); females: 53%). The level of IL-33 mRNA expression was significantly higher in patients with asthma compared to healthy individuals (Median (IQR) 1.12 (0.78) vs. 0.86, P = 0.04). There was a positive correlation between IL-33 mRNA expression and the level of FeNO (r = 0.56, P = 0.01), whereas there was no association with airway or blood eosinophils. IL-33 expression was unrelated to loss of epithelial integrity, but correlated with an increased expression of TLR2 and TLR4 (TLR2: = 0.47, P = 0.04; TLR4: 0.68, P < 0.001), as well allergy to house dust mites (HDMs). Conclusion: In mild untreated asthma, the expression of IL-33 mRNA in bronchial mucosa is related to innate immune activation and allergic sensitization to HDM, rather than epithelial damage, and correlates with FeNO. These findings suggest that in mild allergic asthma, IL-33 may represent a link between innate immune activation and FeNO production.

DOI 10.1111/cea.12702
Citations Scopus - 10Web of Science - 9
Co-authors Katherine Baines
2016 Scott HA, Wood LG, Gibson PG, 'What About Neutrophils in Obese Asthma?', AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY, 55 462-462 (2016)
DOI 10.1165/rcmb.2016-0085LE
Citations Scopus - 2Web of Science - 2
Co-authors Lisa Wood, Hayley Scott
2016 Yates DH, Gibson PG, Hoy R, Zosky G, Miles S, Johnson AR, et al., 'Down Under in the Coal Mines', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 194 772-773 (2016)
DOI 10.1164/rccm.201603-0615LE
Citations Scopus - 1Web of Science - 1
2015 Periyalil HA, Wood LG, Scott HA, Jensen ME, Gibson PG, 'Macrophage activation, age and sex effects of immunometabolism in obese asthma', European Respiratory Journal, 45 388-395 (2015) [C1]

Copyright © ERS 2015. Obese asthma is characterised by infiltration of adipose tissue by activated macrophages and mast cells. The aim of this study was to examine the age and sex... [more]

Copyright © ERS 2015. Obese asthma is characterised by infiltration of adipose tissue by activated macrophages and mast cells. The aim of this study was to examine the age and sex effects of immunometabolism in obese asthma. Obese and non-obese asthmatic children and adults underwent spirometry, body composition assessment by dual energy X-ray absorptiometry and measurement of serum soluble CD163 (sCD163), tryptase, C-reactive protein (CRP) and other adipocytokines. Plasma CRP (p<0.01) and leptin (p<0.01) were elevated in obese asthmatic adults, and sCD163 (p=0.003) was elevated in obese asthmatic children. We observed significantly higher sCD163 in obese female children compared to obese female adults and male children, and higher CRP in obese female adults compared to obese male children and adults. Serum tryptase concentrations were not significantly different across age groups. sCD163 positively correlated with the proportion of android fat in obese female children (r=0.70, p=0.003) and obese female adults (r=0.65, p=0.003). In obese female children, sCD163 was inversely associated with forced expiratory volume in 1 s % predicted (r=-0.55, p=0.02) and was positively associated with the Asthma Control Questionnaire (r=0.57, p=0.02). Obese children with asthma have sex-specific macrophage activation, which may contribute to worse asthma control and lung function. The heterogeneous systemic inflammatory profile across age and sex suggests the existence of sub-phenotypes in obese asthma at the molecular level.

DOI 10.1183/09031936.00080514
Citations Scopus - 18Web of Science - 18
Co-authors Hayley Scott, Megan Jensen, Lisa Wood
2015 Berthon BS, Gibson PG, Mcelduff P, Macdonald-Wicks LK, Wood LG, 'Effects of short-term oral corticosteroid intake on dietary intake, body weight and body composition in adults with asthma - a randomized controlled trial', Clinical and Experimental Allergy, 45 908-919 (2015) [C1]

© 2015 John Wiley &amp; Sons Ltd. Background: Oral corticosteroids (OCS) are an efficacious treatment for asthma exacerbations, yet risk of adverse effects may decrease patient ... [more]

© 2015 John Wiley & Sons Ltd. Background: Oral corticosteroids (OCS) are an efficacious treatment for asthma exacerbations, yet risk of adverse effects may decrease patient adherence to therapy. In particular, changes in appetite and dietary intake, which lead to weight gain and changes in body composition, are considered undesirable. Objective: To determine whether 10-day OCS therapy in adults with asthma causes changes in leptin, appetite, dietary intake, body weight and body composition. Methods: Double-blinded, placebo-controlled randomized cross-over trial of 10 days prednisolone (50 mg) in adults with stable asthma (n = 55) (ACTRN12611000562976). Pre- and post-assessment included spirometry, body weight, body composition measured by dual-energy X-ray absorptiometry and bioelectrical impedance analysis, appetite measured using a validated visual analogue scale (VAS) and dietary intake assessed using 4-day food records. Leptin was measured as a biomarker of appetite and eosinophils as an adherence biomarker. Outcomes were analysed by generalized linear mixed models. Results: Subject adherence was confirmed by a significant decrease in blood eosinophils (× 109/L) following prednisolone compared to placebo [Coef. -0.29, 95% CI: (-0.39, -0.19) P < 0.001]. There was no difference in serum leptin (ng/mL) [Coef. 0.13, 95% CI: (-3.47, 3.72) P = 0.945] or appetite measured by VAS (mm) [Coef. -4.93, 95% CI: (-13.64, 3.79) P = 0.267] following prednisolone vs. placebo. There was no difference in dietary intake (kJ/day) [Coef. 255, 95% CI: (-380, 891) P = 0.431], body weight (kg) [Coef. -0.38, 95% CI: (-0.81, 0.05) P = 0.083] or body fat (%) [Coef. -0.31, 95% CI: (-0.81, 0.20) P = 0.230]. Symptoms including sleep and gastrointestinal disturbance were reported significantly more often during prednisolone vs. placebo. Conclusions and Clinical Relevance: Short-term OCS in stable asthma did not induce significant changes in appetite, dietary intake, body weight or composition, although other adverse effects may require medical management. This evidence may assist in increasing medication adherence of asthmatics prescribed OCS for exacerbations.

DOI 10.1111/cea.12505
Citations Scopus - 6Web of Science - 7
Co-authors Lesley Wicks, Lisa Wood, Patrick Mcelduff
2015 Essilfie A, Horvat JC, Kim RY, Mayall JR, Pinkerton JW, Beckett EL, et al., 'Macrolide therapy suppresses key features of experimental steroid-sensitive and steroid-insensitive asthma', Thorax Journal, 70 458-467 (2015) [C1]
DOI 10.1136/thoraxjnl-2014-206067
Citations Scopus - 47Web of Science - 49
Co-authors Philip Hansbro, Emma Beckett, Paul Foster, Malcolm Starkey, Jay Horvat, Jodie Simpson
2015 Thorburn AN, McKenzie CI, Shen S, Stanley D, MacIa L, Mason LJ, et al., 'Evidence that asthma is a developmental origin disease influenced by maternal diet and bacterial metabolites', Nature Communications, 6 (2015) [C1]

© 2015 Macmillan Publishers Limited. All rights reserved. Asthma is prevalent in Western countries, and recent explanations have evoked the actions of the gut microbiota. Here we ... [more]

© 2015 Macmillan Publishers Limited. All rights reserved. Asthma is prevalent in Western countries, and recent explanations have evoked the actions of the gut microbiota. Here we show that feeding mice a high-fibre diet yields a distinctive gut microbiota, which increases the levels of the short-chain fatty acid, acetate. High-fibre or acetate-feeding led to marked suppression of allergic airways disease (AAD, a model for human asthma), by enhancing T-regulatory cell numbers and function. Acetate increases acetylation at the Foxp3 promoter, likely through HDAC9 inhibition. Epigenetic effects of fibre/acetate in adult mice led us to examine the influence of maternal intake of fibre/acetate. High-fibre/acetate feeding of pregnant mice imparts on their adult offspring an inability to develop robust AAD. High fibre/acetate suppresses expression of certain genes in the mouse fetal lung linked to both human asthma and mouse AAD. Thus, diet acting on the gut microbiota profoundly influences airway responses, and may represent an approach to prevent asthma, including during pregnancy.

DOI 10.1038/ncomms8320
Citations Scopus - 187Web of Science - 182
Co-authors Joerg Mattes, Lisa Wood, Vanessa Murphy
2015 Wark PAB, McDonald VM, Gibson PG, 'Adjusting prednisone using blood eosinophils reduces exacerbations and improves asthma control in difficult patients with asthma.', Respirology, 20 1282-1284 (2015) [C1]
DOI 10.1111/resp.12602
Citations Scopus - 15Web of Science - 17
Co-authors Peter Wark, Vanessa Mcdonald
2015 Vanders RL, Murphy VE, Gibson PG, Hansbro PM, Wark PAB, 'CD8 T cells and dendritic cells: Key players in the attenuated maternal immune response to influenza infection', Journal of Reproductive Immunology, 107 1-9 (2015) [C1]

© 2014 Elsevier Ireland Ltd. Pregnancy provides a unique challenge for maternal immunity, requiring the ability to tolerate the presence of a semi-allogeneic foetus, and yet still... [more]

© 2014 Elsevier Ireland Ltd. Pregnancy provides a unique challenge for maternal immunity, requiring the ability to tolerate the presence of a semi-allogeneic foetus, and yet still being capable of inducing an immune response against invading pathogens. To achieve this, numerous changes must occur in the activity and function of maternal immune cells throughout the course of pregnancy. Respiratory viruses take advantage of these changes, altering the sensitive balance of maternal immunity, leaving the mother with increased susceptibility to viral infections and increased disease severity. Influenza virus is one of the most common respiratory virus infections during pregnancy, leading to an increased risk of ICU hospitalisations, pneumonia, acute respiratory distress syndrome and even death. Whilst much research has been performed to understand the changes that must take place in maternal immunity during pregnancy, considerable work is still needed to fully comprehend this tremendous feat. To date, few studies have focused on the alterations that occur in maternal immunity during respiratory virus infections. This review highlights the role of dendritic cells (DCs) and CD8 T cells during pregnancy, and the changes that occur in these antiviral cells following influenza virus infections.

DOI 10.1016/j.jri.2014.09.051
Citations Scopus - 7Web of Science - 8
Co-authors Vanessa Murphy, Peter Wark, Rebecca Vanders, Philip Hansbro
2015 Tang FSM, Foxley GJ, Gibson PG, Burgess JK, Baines KJ, Oliver BG, 'Altered Innate Immune Responses in Neutrophils from Patients with Well- and Suboptimally Controlled Asthma', Mediators of Inflammation, 2015 1-11 (2015) [C1]
DOI 10.1155/2015/219374
Citations Scopus - 3Web of Science - 2
Co-authors Katherine Baines
2015 Wood LG, Shivappa N, Berthon BS, Gibson PG, Hebert JR, 'Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma', Clinical and Experimental Allergy, 45 177-183 (2015) [C1]

© 2014 John Wiley &amp; Sons Ltd. Background: Asthma prevalence has increased in recent years, and evidence suggests that diet may be a contributing factor. Increased use of pro... [more]

© 2014 John Wiley & Sons Ltd. Background: Asthma prevalence has increased in recent years, and evidence suggests that diet may be a contributing factor. Increased use of processed foods has led to a decrease in diet quality, which may be creating a pro-inflammatory environment, thereby leading to the development and/or progression of various chronic inflammatory diseases and conditions. Recently, the dietary inflammatory index (DII) has been developed and validated to assess the inflammatory potential of individual diets. Objective: This study aimed to examine the DII in subjects with asthma compared to healthy controls and to relate the DII to asthma risk, lung function and systemic inflammation. Methods: Subjects with asthma (n = 99) and healthy controls (n = 61) were recruited. Blood was collected and spirometry was performed. The DII was calculated from food frequency questionnaires administered to study subjects. Results: The mean DII score for the asthmatics was higher than the mean DII score for healthy controls (- 1.40 vs. - 1.86, P = 0.04), indicating that their diets were more pro-inflammatory. For every 1 unit increase in DII score, the odds of having asthma increased by 70% (OR: 1.70, 95% CI: 1.03, 2.14; P = 0.040). FEV1 was significantly associated with DII score (ß = - 3.44, 95% CI: - 6.50, - 0.39; P = 0.020), indicating that for every 1 unit increase in DII score, FEV1 decreased by 3.44 times. Furthermore, plasma IL-6 concentrations were positively associated with DII score (ß = 0.13, 95% CI: 0.05, 0.21; P = 0.002). Conclusion and Clinical Relevance: As assessed using the DII score, the usual diet consumed by asthmatics in this study was pro-inflammatory relative to the diet consumed by the healthy controls. The DII score was associated with increased systemic inflammation and lower lung function. Hence, consumption of pro-inflammatory foods may contribute to worse asthma status, and targeting an improvement in DII in asthmatics, as an indicator of suitable dietary intake, might be a useful strategy for improving clinical outcomes in the disease.

DOI 10.1111/cea.12323
Citations Scopus - 117Web of Science - 104
Co-authors Lisa Wood
2015 Baines KJ, Backer V, Gibson PG, Powell H, Porsbjerg CM, 'Investigating the effects of arctic dietary intake on lung health', European Journal of Clinical Nutrition, 69 1262-1266 (2015) [C1]

© 2015 Macmillan Publishers Limited. Background/Objective:Preservation of lung health requires understanding the modifiable risk factors of airflow limitation. This study investig... [more]

© 2015 Macmillan Publishers Limited. Background/Objective:Preservation of lung health requires understanding the modifiable risk factors of airflow limitation. This study investigates the association between diet and lung function in a population of Greenland Inuit residing in the Arctic (Greenland) or Western Europe (Denmark).Subjects/Methods:Two unselected Inuit populations were recruited, one living in Greenland (Urban (Nuuk) n=358; Rural (Uummannaq) n=207) and the other in Denmark (n=539). Lung function was measured using spirometry and diet by a food frequency questionnaire. Factors associated with airflow limitation were assessed using multiple linear regression models.Results:The dietary composition differed significantly in the two regions, with higher whale, seal and wild meat intake and lower fruit and vegetable intake in the Arctic regions compared with Denmark. Consumption of vegetables (P=0.004) and whale and/or seal (P<0.0001) was significantly and positively associated with FEV 1, as well as with FVC (vegetables: P=0.001, whale and/or seal: P=0.002). Regular fruit intake was included in the statistical models; however, it did not reach statistical significance (FEV 1: P=0.053; FVC: P=0.055).Conclusions:High dietary intake of vegetables as well as intake of arctic marine mammals had independent positive associations with lung function in this cohort of Greenlandic Inuit. These findings suggest an additive role of dietary intake of antioxidants and unsaturated fatty acids in lung health, which warrants prospective evaluation.

DOI 10.1038/ejcn.2015.85
Citations Scopus - 6Web of Science - 6
Co-authors Katherine Baines
2015 Fu J-J, McDonald VM, Baines KJ, Gibson PG, 'Airway IL-1 beta and Systemic Inflammation as Predictors of Future Exacerbation Risk in Asthma and COPD', CHEST, 148 618-629 (2015) [C1]
DOI 10.1378/chest.14-2337
Citations Scopus - 41Web of Science - 37
Co-authors Vanessa Mcdonald, Katherine Baines
2015 Powell H, Murphy VE, Hensley MJ, Giles W, Clifton VL, Gibson PG, 'Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life', Journal of Asthma, (2015) [C1]

© 2015 Taylor &amp; Francis. Objective: To describe the pattern and severity of rhinitis in pregnancy and the impact rhinitis has on asthma control and quality of life (QoL) in pr... [more]

© 2015 Taylor & Francis. Objective: To describe the pattern and severity of rhinitis in pregnancy and the impact rhinitis has on asthma control and quality of life (QoL) in pregnant women with asthma. Methods: Two hundred and eighteen non-smoking pregnant women with asthma were participants in a randomised controlled trial of exhaled nitric oxide guided treatment adjustment. Rhinitis was assessed using a visual analogue scale (VAS) scored from 0 to 10 and classified as current (VAS¿>¿2.5), moderate/severe versus mild (VAS¿>¿6 vs <5), atopic versus non-atopic and pregnancy rhinitis. At baseline, women completed the 20-Item Sino-Nasal Outcome Test (SNOT20), asthma-specific (AQLQ-M) QoL questionnaires and the Six-Item Short-Form State Trait Anxiety Inventory (STAI-6). Asthma control was assessed using the asthma control questionnaire (ACQ). Perinatal outcomes were collected after delivery. Results: Current rhinitis was present in 142 (65%) women including 45 (20%) women who developed pregnancy rhinitis. Women with current rhinitis had higher scores for ACQ (p¿=¿0.004), SNOT20 (p¿<¿0.0001) and AQLQ-M (p¿<¿0.0001) compared to women with no rhinitis. Current rhinitis was associated with increased anxiety symptoms (p¿=¿0.002), rhinitis severity was associated with higher ACQ score (p¿=¿0.004) and atopic rhinitis was associated with poorer lung function (p¿=¿0.037). Rhinitis symptom severity improved significantly during gestation (p¿<¿0.0001). There was no impact on perinatal outcomes. Improved asthma control was associated with improvement in rhinitis. Conclusion: Rhinitis in pregnant women with asthma is common and associated with poorer asthma control, sino-nasal and asthma-specific QoL impairment and anxiety. In the context of active asthma management there was significant improvement in rhinitis symptoms and severity as pregnancy progressed.

DOI 10.3109/02770903.2015.1054403
Citations Scopus - 10Web of Science - 9
Co-authors Vanessa Murphy, Michael Hensley
2015 Burgess L, McCaffery K, Powell H, Murphy VE, Gibson PG, Turner RM, 'The influence of asthma control on psychosocial outcomes for pregnant women with asthma', Journal of Asthma, (2015) [C1]

© 2015 Taylor &amp; Francis. Objective: To investigate the relationship between asthma control and psychosocial outcomes in pregnant women with asthma. Methods: Secondary analysis... [more]

© 2015 Taylor & Francis. Objective: To investigate the relationship between asthma control and psychosocial outcomes in pregnant women with asthma. Methods: Secondary analysis (N¿=¿221) of a randomized controlled trial of treatment adjustments, based on fractional exhaled nitric oxide versus clinical guideline-based algorithms. Psychosocial variables included generic and asthma-specific quality of life (SF12, AQLQ-M), illness perceptions (BIPQ), perceived control (PCAQ), perceived risk of side effects (PRSE) and anxiety (STAI-6). Asthma control was defined as controlled (Asthma Control Questionnaire (ACQ7)¿=1.5 at randomization and end of study), improved (ACQ7¿>¿1.5 at randomization and =1.5 at end of study) and unimproved (ACQ7¿>1.5 at end of study). Regression models were fitted for each psychosocial measure at the end of the study, with adjustment for baseline values and smoking status, with predictor variable asthma control. Results: Women with unimproved asthma had poorer physical (SF12, p¿=¿0.012) and asthma-specific quality of life across all domains (AQLQ-M, p¿=¿0.012) compared to women with controlled asthma. They believed that they had less control over their asthma (PCAQ total p¿=¿0.014), had more symptoms and that their illness had a greater effect on their emotions and their lives in general (BIPQ identity, consequences, concern, emotional response p¿=¿0.015). Women with improved asthma control had significantly lower AQLQ-M breathlessness (p¿=¿0.048) and lower total scores (p¿=¿0.04) than women with controlled asthma. Conclusions: Pregnant women who are not able to get control of their asthma symptoms may experience worse quality of life and are likely to have more negative perceptions about their condition.

DOI 10.3109/02770903.2015.1038833
Citations Scopus - 4Web of Science - 3
Co-authors Vanessa Murphy
2015 Gibson PG, Vertigan AE, 'Gabapentin in chronic cough', PULMONARY PHARMACOLOGY & THERAPEUTICS, 35 145-148 (2015) [C1]
DOI 10.1016/j.pupt.2015.06.007
Citations Scopus - 6Web of Science - 6
2015 Negewo NA, Gibson PG, McDonald VM, 'COPD and its comorbidities: Impact, measurement and mechanisms', RESPIROLOGY, 20 1160-1171 (2015) [C1]
DOI 10.1111/resp.12642
Citations Scopus - 27Web of Science - 26
Co-authors Netsanet Negewo, Vanessa Mcdonald
2015 Gibson PG, Vertigan AE, 'Management of chronic refractory cough.', BMJ, 351 h5590 (2015) [C1]
DOI 10.1136/bmj.h5590
Citations Scopus - 30Web of Science - 22
2015 Chang AB, Grimwood K, Gibson PG, Upham JW, 'PBB: Definition, mechanisms, and treatment', The Lancet Respiratory Medicine, (2015) [C3]
DOI 10.1016/S2213-2600(15)00243-X
Citations Scopus - 7Web of Science - 4
2015 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Determinants of weight loss success utilizing a meal replacement plan and/or exercise, in overweight and obese adults with asthma', Respirology, 20 243-250 (2015) [C1]

© 2014 Asian Pacific Society of Respirology. Background and objective While weight loss has been shown to reduce obesity-related comorbidity, many weight loss treatments fail. Fac... [more]

© 2014 Asian Pacific Society of Respirology. Background and objective While weight loss has been shown to reduce obesity-related comorbidity, many weight loss treatments fail. Factors that enhance weight loss success are unknown, particularly in those with asthma. The aim of the study was to identify patient characteristics that predict weight loss success in adults with asthma. Methods Baseline and change in asthma characteristics and eating behaviours were investigated for relationships with weight loss and fat loss using multiple linear regression, in 38 overweight and obese adults with asthma randomized to dietary, exercise or combined interventions targeting weight loss for 10 weeks. Results Mean ± standard deviation weight loss was 6.6 ± 5.1 kg. Greater %weight loss and %fat loss was achieved in those with poorer asthma-related quality of life at baseline ((rs = 0.398, P = 0.015) and (rs = 0.455, P = 0.005) respectively), with 1.7% greater absolute weight loss at week 10 corresponding to each one unit reduction in the asthma-related quality of life score at baseline. Furthermore, a lower baseline forced expiratory volume in 1 s/forced vital capacity correlated with greater weight loss (rs = 0.398, P = 0.015). Male sex was associated with a 3.6 kg greater weight loss (P = 0.087). Reducing emotional eating during the programme was associated with greater weight loss in women (rs = 0.576, P = 0.010). Conclusions This study demonstrates that individuals with more severe asthma at baseline are more successful in achieving weight loss, which could be a consequence of greater motivation and could be used as a motivational tool within the clinical setting. Gender tailoring of weight loss programmes may be useful to enhance weight loss success. Future studies are urgently needed to establish predictors of long-term weight loss maintenance in those with asthma. See Editorial, page 179 This study is the first to demonstrate that more severe asthma at baseline, male sex, and improvements in eating behaviours during weight loss are associated with greater weight loss success in overweight and obese adults with asthma. Our findings may inform the development of asthma-specific weight management guidelines.

DOI 10.1111/resp.12423
Citations Scopus - 7Web of Science - 7
Co-authors Philip Morgan, Manohar Garg, Lisa Wood, Robin Callister, Hayley Scott
2015 Mandaliya PH, Morten M, Kumar R, James A, Deshpande A, Murphy VE, et al., 'Ventilation inhomogeneities in children with congenital thoracic malformations', BMC Pulmonary Medicine, 15 (2015) [C1]

© Morten et al.; licensee BioMed Central. Background: Congenital thoracic malformations (CTM) are rare lung lesions that are managed with surgical resection or active surveillance... [more]

© Morten et al.; licensee BioMed Central. Background: Congenital thoracic malformations (CTM) are rare lung lesions that are managed with surgical resection or active surveillance. Methods: Nitrogen lung clearance index (LCI), reactance and resistance (X5Hz and R5Hz), forced expiratory volume in 1 s and forced vital capacity (FEV1 and FVC) were prospectively measured in 10 children with CTM (mean age/SD: 7.6/1.3) who had undergone surgical resection in early life and in 17 healthy children (mean age/SD: 4.8/0.4). Total lung capacity (TLC) was also conducted in children older than 7 years of age with CTM (n = 8). Results: Mean LCI was 8.0 (95% CI 7.5 to 8.5) in the CTM group and 7.3 (95% CI 7.0 to 7.6) in healthy children (p = 0.016). Mean X5Hz was -0.44kPa/l/s (95% CI -0.58 to -0.31) in the CTM group and -0.31kPa/l/s (95% CI -0.35 to -0.27) in healthy children (p = 0.02). Mean Z score for X5Hz was -2.11 (95% CI -3.59 to -0.63) in the CTM group and -0.11 (95% CI -0.55 to 0.33) in healthy children (p = 0.0008). Mean FEV1 was 1.21 L (95% CI 0.97 to 1.45) in the CTM group and 1.02 L (95% CI 0.90 to 1.15) in healthy children (p = 0.22). Mean % predicted FEV1 was 83% (95% CI 74 to 92) in the CTM group and 97% (95% CI 87 to 107) in healthy children (p < 0.05). Mean % predicted TLC in CTM children was 121.3% (95% CI 88.45 to 154.1). Mean LCI was inversely correlated with height z-scores in the CTM group (rs = -0.88, p = 0.002) but not in healthy children (rs = 0.22, p = 0.4). Conclusions: Children with CTM have impaired lung function as demonstrated by the significant differences in LCI, reactance and FEV1 but not FVC, resistance and TLC. These findings may be of clinical relevance as ventilation inhomogeneities are closely correlated with somatic growth in this study.

DOI 10.1186/s12890-015-0023-1
Citations Scopus - 4Web of Science - 4
Co-authors Aniruddh Deshpande, Joerg Mattes, Vanessa Murphy
2015 Gao P, Gibson PG, Baines KJ, Yang IA, Upham JW, Reynolds PN, et al., 'Anti-inflammatory deficiencies in neutrophilic asthma: Reduced galectin-3 and IL-1RA/IL-1ß', Respiratory Research, 16 1-10 (2015) [C1]
DOI 10.1186/s12931-014-0163-5
Citations Scopus - 32Web of Science - 31
Co-authors Jodie Simpson, Katherine Baines
2015 Gibson PG, McDonald VM, 'Asthma-COPD overlap 2015: Now we are six', Thorax, 70 683-691 (2015) [C1]

Background: The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma-COPD overlap. ... [more]

Background: The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma-COPD overlap. Method: A systematic literature review of cluster analyses of asthma and COPD was performed. Articles from 2009 to the present dealing with prevalence, morbidity and treatment of asthma-COPD overlap were identified and reviewed. Results: Asthma-COPD overlap was consistently recognised in studies using a variety of different study designs and sampling. The prevalence was approximately 20% in patients with obstructive airways diseases. Asthma-COPD overlap was associated with increased morbidity and possibly an increased mortality and comorbidity. There was evidence of a heterogeneous pattern of airway inflammation that included eosinophilic (in adult asthma), neutrophilic or mixed patterns (in severe asthma and COPD). Systemic inflammation was present in asthma-COPD overlap and resembled that of COPD. Within asthma-COPD overlap, there is evidence of different subgroups, and recognition using bronchodilator responsiveness has not been successful. Guidelines generally recommend a serial approach to assessment, with treatment recommendations dominated by an asthma paradigm. Research is needed into key clinical features that impact outcome, mechanisms and treatment approaches in asthma-COPD overlap. Identifying and treating disease components by multidimensional assessment shows promise. Conclusions: Asthma-COPD overlap has drawn attention to the significant heterogeneity that exists within obstructive airway diseases. It should be replaced by novel approaches that identify and manage the components of this heterogeneity, such as multidimensional assessment and treatment. Future research is needed to test these novel and personalised approaches.

DOI 10.1136/thoraxjnl-2014-206740
Citations Scopus - 91Web of Science - 80
Co-authors Vanessa Mcdonald
2015 Baines KJ, Wright TK, Simpson JL, McDonald VM, Wood LG, Parsons KS, et al., 'Airway beta-Defensin-1 Protein Is Elevated in COPD and Severe Asthma', MEDIATORS OF INFLAMMATION, (2015) [C1]
DOI 10.1155/2015/407271
Citations Scopus - 9Web of Science - 10
Co-authors Peter Wark, Vanessa Mcdonald, Lisa Wood, Katherine Baines, Jodie Simpson
2015 Kim RY, Pinkerton JW, Gibson PG, Cooper MA, Horvat JC, Hansbro PM, 'Inflammasomes in COPD and neutrophilic asthma', THORAX, 70 1199-1201 (2015) [C1]
DOI 10.1136/thoraxjnl-2014-206736
Citations Scopus - 32Web of Science - 32
Co-authors Jay Horvat, Philip Hansbro
2015 Wood LG, Lagleva M, Shah S, Berthon BS, Galbraith S, Henry R, et al., 'Dietary changes in migrant adolescents with increasing length of stay in Australia and associated risk of wheeze - a retrospective, cross sectional study', BMC Pediatrics, 15 (2015) [C1]

© 2015 Wood et al. Background: Recent studies have reported that asthma prevalence increases on migration to Australia. We hypothesised that changes in dietary intake contribute t... [more]

© 2015 Wood et al. Background: Recent studies have reported that asthma prevalence increases on migration to Australia. We hypothesised that changes in dietary intake contribute to this phenomenon. The aim of this study was to assess dietary intake in relation to migration status, length of stay in Australia and the association with self-reported wheeze. Methods: Students (n = 144) in a multicultural high school in Western Sydney completed the asthma symptoms ISAAC video questionnaire (AVQ3.0), spirometry and allergy skin prick tests. A dietitian administered a'Food Frequency' and 'Food Habits' questionnaire and a dietary history interview. Results: Students who spoke a language other than English, consumed a traditional or mixed dietary pattern, with lower consumption of saturated fat, compared to students who spoke English only. Saturated fat intake increased and fibre intake decreased with length of time in Australia. Intake of foods high in saturated or trans fatty acids were positively associated with length of stay in Australia. No associations between nutrient intake or whole food intake and self-reported wheeze were observed. Conclusion: As time progressed, dietary intake of immigrant children changed. While this was not associated with the development of wheeze in the students in this cohort, these changes are likely to have negative health consequences.

DOI 10.1186/s12887-015-0420-x
Citations Scopus - 4Web of Science - 3
Co-authors Lisa Wood
2014 Gibson PG, Foster PS, 'Asthma 2014: from monoclonals to the microbiome.', Lancet Respir Med, 2 956-958 (2014) [C3]
DOI 10.1016/S2213-2600(14)70275-9
Co-authors Paul Foster
2014 Fu J-J, Mcdonald VM, Wang G, Gibson PG, 'Asthma control: How it can be best assessed?', Current Opinion in Pulmonary Medicine, 20 1-7 (2014) [C1]
DOI 10.1097/MCP.0000000000000003
Citations Scopus - 6Web of Science - 6
Co-authors Vanessa Mcdonald
2014 Simpson JL, Powell H, Baines KJ, Milne D, Coxson HO, Hansbro PM, Gibson PG, 'The Effect of Azithromycin in Adults with Stable Neutrophilic COPD: A Double Blind Randomised, Placebo Controlled Trial', PLOS ONE, 9 (2014) [C1]
DOI 10.1371/journal.pone.0105609
Citations Scopus - 31Web of Science - 33
Co-authors Jodie Simpson, Philip Hansbro, Katherine Baines
2014 Mattes J, Gibson PG, 'The early origins of copd in severe asthma: The one thing that leads to another or the two things that come together?', Thorax, 69 789-790 (2014) [C3]
DOI 10.1136/thoraxjnl-2013-204815
Citations Scopus - 7Web of Science - 7
Co-authors Joerg Mattes
2014 Tai A, Tran H, Roberts M, Clarke N, Wilson J, Robertson CF, 'The association between childhood asthma and adult chronic obstructive pulmonary disease.', Thorax, 69 805-810 (2014)
DOI 10.1136/thoraxjnl-2013-204815
2014 Baines KJ, Upham JW, Yerkovich ST, Chang AB, Marchant JM, Carroll M, et al., 'Mediators of neutrophil function in children with protracted bacterial bronchitis', Chest, 146 1013-1020 (2014) [C1]

© 2014 American College of Chest Physicians. BACKGROUND: Protracted bacterial bronchitis (PBB) is a common and treatable cause of chronic wet cough in children in which the mechan... [more]

© 2014 American College of Chest Physicians. BACKGROUND: Protracted bacterial bronchitis (PBB) is a common and treatable cause of chronic wet cough in children in which the mechanisms are not understood. Th is study investigates the IL-1 pathway and a neutrophil gene expression signature in PBB.METHODS: BAL was collected from children in an experimental cohort (n = 21, PBB; n = 33, control subjects), and a second validation cohort (n = 36, PBB; n = 11, control subjects). IL-1ß , IL-1 receptor antagonist (IL-1RA), and a -defensins 1-3 were assayed by enzyme-linked immunosorbent assay, western blot, and quantitative real-time polymerase chain reaction, together with selected IL-1 pathway members and neutrophil-related molecules.RESULTS: In the experimental cohort, children with symptomatic PBB had significantly higher levels of IL-1ß and a -defensin gene and protein expression. Expression of the neutrophil chemokine receptor C-X-C motif receptor 2 was also higher in PBB. IL-1RA protein was higher, however, the IL-1RA:IL-1ß ratio was lower in children with PBB than control subjects. In the validation cohort, protein and gene expression of IL-1ß and a -defensins 1-3 were confirmed higher, as was gene expression of IL-1 pathway members and C-X-C motif receptor 2. IL-1ß and a -defensin 1-3 levels lowered when PBB was treated and resolved. In children with recurrent PBB, gene expression of the IL-1ß signaling molecules pellino-1 and IL-1 receptor-associated kinase 2 was significantly higher. IL-1ß protein levels correlated with BAL neutrophilia and the duration and severity of cough symptoms. IL-1ß and a -defensin 1-3 levels were highly correlated.CONCLUSIONS: PBB is characterized by increased IL-1ß pathway activation. IL-1ß and related mediators were associated with BAL neutrophils, cough symptoms, and disease recurrence, providing insight into PBB pathogenesis.

DOI 10.1378/chest.14-0131
Citations Scopus - 25Web of Science - 23
Co-authors Jodie Simpson, Katherine Baines
2014 Gunawardhana LP, Gibson PG, Simpson JL, Benton MC, Lea RA, Baines KJ, 'Characteristic DNA methylation profiles in peripheral blood monocytes are associated with inflammatory phenotypes of asthma.', Epigenetics, 9 1302-1316 (2014) [C1]
DOI 10.4161/epi.33066
Citations Scopus - 24Web of Science - 20
Co-authors Jodie Simpson, Katherine Baines
2014 Baines KJ, Backer V, Gibson PG, Powel H, Porsbjerg CM, 'Impaired lung function is associated with systemic inflammation and macrophage activation.', The European Respiratory Journal, 45 557-559 (2014) [C1]
Citations Scopus - 9Web of Science - 10
Co-authors Katherine Baines
2014 Fu JJ, Gibson PG, Simpson JL, McDonald VM, 'Longitudinal changes in clinical outcomes in older patients with asthma, COPD and asthma-COPD overlap syndrome', Respiration, 87 63-74 (2014) [C1]

Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults i... [more]

Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults is not well understood. Objective: To examine the prognosis of OADs and to identify potential determinants for longitudinal changes in clinical outcomes. Methods: We consecutively recruited 99 older adults (>55 years) with OADs who underwent a multidimensional assessment at baseline and 4 years which involved spirometry, 6-min walk distance (6MWD), assessments of health status (Saint George's Respiratory Questionnaire, SGRQ), comorbidity, and serum and sputum biomarkers. All-cause mortality and respiratory hospitalisation during the follow-up period were recorded. Clinical outcomes were compared between basal and final visits, and changes in clinical outcomes were compared among asthma, COPD and asthma-COPD overlap groups. Associations between clinical parameters, biomarkers and prognosis were examined. Results: After a median follow-up of 4.2 years, outcome data were available for 75 (75.8%) patients. There were 16 (16.2%) deaths. The BODE index predicted all-cause mortality in older people with OADs. While spirometry, 6MWD and SGRQ deteriorated significantly over the 4 years, there was significant heterogeneity in the longitudinal changes in these clinical outcomes. Participants with COPD had a significant decline in FEV1 (p = 0.003), SGRQ (p = 0.030) and 6MWD [decline of 75.5 (93.4) m, p = 0.024]. The change in 6MWD was lower in the asthma-COPD overlap group. Airflow reversibility was associated with a reduced decline in 6MWD. Conclusion: COPD patients had a poor prognosis compared with asthma and asthma-COPD overlap patients. The BODE index is a useful prognostic indicator in older adults with OADs. Both airway disease diagnosis and BODE index warrant specific attention in clinical practice. © 2013 S. Karger AG, Basel.

DOI 10.1159/000352053
Citations Scopus - 58Web of Science - 55
Co-authors Vanessa Mcdonald, Jodie Simpson
2014 Jensen ME, Gibson PG, Collins CE, Wood LG, 'Lean mass, not fat mass, is associated with lung function in male and female children with asthma', Pediatric Research, 75 93-98 (2014) [C1]

Background:Whether body composition is associated with lung function in asthmatic children has not been investigated. This study aimed to primarily investigate whether BMI z-score... [more]

Background:Whether body composition is associated with lung function in asthmatic children has not been investigated. This study aimed to primarily investigate whether BMI z-score and body composition were associated with respiratory function in asthmatic children.Methods:In a cross-sectional study, male (n = 27; mean age: 11.9 y (SD: 2.3)) and female (n = 21; mean age: 13.6 y (SD: 2.2)) asthmatic children underwent clinical assessment.Results:BMI z-score was associated with forced expiratory volume in 1 s (FEV 1; r = 0.458), forced vital capacity (FVC; r = 0.477), and total lung capacity (TLC; r = 0.451) in males only (P < 0.05). Total lean mass was associated with FEV 1 (r = 0.655), FVC (r = 0.562), and TLC (r = 0.635) in males, as was thoracic lean mass (FEV 1 (r = 0.573), FVC (r = 0.526), and TLC (r = 0.497); P < 0.05). TLC was associated with total (r = 0.522) and thoracic (r = 0.532) lean mass in females (P < 0.05). Fat mass was not associated with lung function in this group.Conclusion:Lean mass, not fat mass, is associated with lung function in children with asthma. The positive association between BMI z-score and respiratory function in male children is driven by lean mass. Although body weight can be easily monitored in the clinical setting, body composition can provide important information. Future research exploring lean mass and lung function associations could inform future interventions. Copyright © 2014 International Pediatric Research Foundation, Inc.

DOI 10.1038/pr.2013.181
Citations Scopus - 5Web of Science - 5
Co-authors Lisa Wood, Megan Jensen, Clare Collins
2014 Mattes J, Murphy VE, Powell H, Gibson PG, 'Prenatal origins of bronchiolitis: Protective effect of optimised asthma management during pregnancy', Thorax, 69 383-384 (2014) [C1]

Objective Maternal asthma is the most common chronic disease complicating pregnancy and is a risk factor for bronchiolitis in infancy. Recurrent episodes of bronchiolitis are stro... [more]

Objective Maternal asthma is the most common chronic disease complicating pregnancy and is a risk factor for bronchiolitis in infancy. Recurrent episodes of bronchiolitis are strongly associated with the development of childhood asthma. Methods We conducted a follow-up study of infants born to women with asthma who completed a double-blind randomised controlled trial during pregnancy. In this trial, pregnant women with asthma were assigned to treatment adjustment by an algorithm using clinical symptoms (clinical group) or the fraction of exhaled nitric oxide (FeNO group) and we showed that the FeNO group had significantly lower asthma exacerbation rates in pregnancy. Results 146 infants attended the 12-month follow-up visit. Infants born to mothers from the FeNO group were significantly less likely to have recurrent episodes of bronchiolitis in the first year of life (OR 0.08, 95% CI 0.01 to 0.62; p=0.016) as compared with the clinical group. Conclusions Optimised management of asthma during pregnancy may reduce recurrent episodes of bronchiolitis in infancy, which could potentially modulate the risk to develop or the severity of emerging childhood asthma.

DOI 10.1136/thoraxjnl-2013-203388
Citations Scopus - 19Web of Science - 15
Co-authors Joerg Mattes, Vanessa Murphy
2014 Simpson JL, Baines KJ, Ryan N, Gibson PG, 'Neutrophilic asthma is characterised by increased rhinosinusitis with sleep disturbance and GERD', Asian Pacific Journal of Allergy and Immunology, 32 66-74 (2014) [C1]

Background: Asthma is a heterogeneous inflammatory disease and eosinophilic, noneosinophilic and neutrophilic forms are recognised. While clinically similar to eosinophilic asthma... [more]

Background: Asthma is a heterogeneous inflammatory disease and eosinophilic, noneosinophilic and neutrophilic forms are recognised. While clinically similar to eosinophilic asthma, patients with non-eosinophilic asthma have different responses to treatment and little is known about the triggers of symptoms and inflammation. Objective: This study sought to characterise asthma control, exacerbation frequency and potential triggers of non-eosinophilic and specifically neutrophilic asthma such as infection, gastroesophageal reflux disease, and rhinosinusitis. Methods: Adults with asthma (n=65; doctor's diagnosis plus demonstrated response to bronchodilator and/or airways hyperresponsiveness to hypertonic saline) were recruited from the Respiratory and Sleep Medicine Ambulatory Care Service at John Hunter Hospital, NSW, Australia. Questionnaires were administered to assess gastroesophageal reflux disease, rhinosinusitis and asthma control. A sputum induction was performed and sputum was processed for assessment of inflammatory cells, infection, and lipid laden macrophages (Oil Red O). Results: Participants with neutrophilic asthma (n=11, 23%) had a higher frequency of primary care doctor visits for asthma exacerbations and a high prevalence (>70%) of chest infections in the previous 12 months. There was also an increased prevalence of rhinosinusitis (64%) and increased symptoms of gastroesophageal reflux disease compared to those with eosinophilic asthma. Conclusions: The clinical pattern of neutrophilic asthma is different from paucigranulocytic and eosinophilic asthma with evidence of abnormal upper airways responses. Specific and targeted treatment of these airway problems may assist in the control and management of neutrophilic asthma.

DOI 10.12932/AP0322.32.1.2014
Citations Scopus - 17Web of Science - 13
Co-authors Katherine Baines, Jodie Simpson, Nicole Ryan
2014 Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, et al., 'Mepolizumab Treatment in Patients with Severe Eosinophilic Asthma', New England Journal of Medicine, 371 1198-1207 (2014)
DOI 10.1056/nejmoa1403290
2014 Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON, Yancey SW, et al., 'Oral Glucocorticoid-Sparing Effect of Mepolizumab in Eosinophilic Asthma', New England Journal of Medicine, 371 1189-1197 (2014)
DOI 10.1056/nejmoa1403291
2014 Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al., 'International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma', EUROPEAN RESPIRATORY JOURNAL, 43 343-373 (2014) [C1]
DOI 10.1183/09031936.00202013
Citations Scopus - 1097Web of Science - 1022
2014 Simpson JL, Phipps S, Baines KJ, Oreo KM, Gunawardhana L, Gibson PG, 'Elevated expression of the NLRP3 inflammasome in neutrophilic asthma', European Respiratory Journal, 43 1067-1076 (2014) [C1]

Asthma is a heterogeneous inflammatory airways disorder where interleukin (IL)-1ß is thought to be a key mediator, especially in the neutrophilic subtype of asthma. The generation... [more]

Asthma is a heterogeneous inflammatory airways disorder where interleukin (IL)-1ß is thought to be a key mediator, especially in the neutrophilic subtype of asthma. The generation of active IL-1ß requires proteolytic cleavage typically mediated through the formation of a caspase-1-containing inflammasome. This study hypothesised that an IL-1ß endotype associated with the nucleotide-binding domain, leucine-rich repeat-containing family protein (NLRP)3/apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC)/caspase-1 inflammasome is characteristic of patients with the neutrophilic subtype of asthma. Participants with asthma (n=85) and healthy controls (n=27) underwent clinical assessment, spirometry and sputum induction. Sputum was processed for differential cell count, gene expression and protein mediators. NLRP3 and caspase-1 expression was also determined by immunocytochemistry. Sputum macrophages were isolated (n=8) and gene expression of NLRP3 and IL-1ß determined. There was significantly elevated gene expression of NLRP3, caspase-1, caspase-4, caspase-5 and IL-1ß in participants with neutrophilic asthma. Protein levels of IL-1ß were significantly higher in those with neutrophilic asthma and correlated with sputum IL-8 levels. Sputum macrophages, as well as sputum neutrophils in neutrophilic asthma, expressed NLRP3 and caspase-1 protein. NLRP3 inflammasome is upregulated in neutrophilic asthma and may regulate the inflammation process observed in this asthma phenotype through production of IL-1ß. Copyright © ERS 2014.

DOI 10.1183/09031936.00105013
Citations Scopus - 86Web of Science - 77
Co-authors Katherine Baines, Jodie Simpson
2014 Murphy VE, Mattes J, Powell H, Baines KJ, Gibson PG, 'Respiratory viral infections in pregnant women with asthma are associated with wheezing in the first 12 months of life', Pediatric Allergy and Immunology, 25 151-158 (2014) [C1]

Background: There are few studies investigating the relationship between respiratory viral infection in pregnancy and asthma in the offspring, and none among mothers with asthma. ... [more]

Background: There are few studies investigating the relationship between respiratory viral infection in pregnancy and asthma in the offspring, and none among mothers with asthma. Infants of mothers with asthma are more likely to wheeze and have a higher risk of developing asthma than infants of non-asthmatic mothers. Methods: A prospective cohort study of viral infection in pregnancy was conducted between 2007 and 2009, and a subgroup of infants of mothers with asthma was followed up at 6 and 12 months of age. During common colds, nasal and throat swabs were collected from mothers and respiratory viruses detected by polymerase chain reaction. Respiratory health of infants was assessed by parent-completed questionnaire. Results: Twelve-month-old infants whose mothers had confirmed viral infections in pregnancy (n = 26) reported more frequent wheeze (40% had 4-12 wheeze attacks compared with 0%), sleep disturbed by wheeze (1 night per week or more in 60% vs. 11%), beta agonist treatment for wheeze (27% vs. 0%), prolonged colds (2 wk or longer 31% vs. 0%), more eczema (40% vs. 6.3%), and parent-perceived asthma (32% vs. 0%), compared with infants whose mothers had common colds without laboratory-confirmed viral infection (n = 16). Conclusions: This study demonstrates a relationship between maternal respiratory viral infection in pregnancy and wheezing illness in infants of mothers with asthma. Viral infections are the most common cause of asthma exacerbations in pregnancy, and infants of asthmatic mothers are at increased risk of asthma themselves. Further research is needed to elucidate the mechanisms involved. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

DOI 10.1111/pai.12156
Citations Scopus - 12Web of Science - 12
Co-authors Katherine Baines, Vanessa Murphy, Joerg Mattes
2014 Oreo KM, Gibson PG, Simpson JL, Wood LG, Mcdonald VM, Baines KJ, 'Sputum ADAM8 expression is increased in severe asthma and COPD', Clinical and Experimental Allergy, 44 342-352 (2014) [C1]

Background: Severe asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases in which the mechanisms are not fully understood. A disintegrin... [more]

Background: Severe asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases in which the mechanisms are not fully understood. A disintegrin and metalloproteinase domain 8 (ADAM8) is an enzyme expressed on most leucocytes and may be important for facilitating leucocyte migration in respiratory disease. Objective: To investigate ADAM8 mRNA and protein expression in asthma and COPD and its relationship between asthma severity and inflammatory phenotypes. Methods: Induced sputum was collected from 113 subjects with asthma (severe n = 31, uncontrolled n = 39 and controlled n = 35), 20 subjects with COPD and 21 healthy controls. Sputum ADAM8 mRNA expression was measured by qPCR, and soluble ADAM8 (sADAM8) protein was measured in the sputum supernatant by validated ELISA. Results: ADAM8 mRNA correlated with ADAM8 protein levels (r = 0.27, P < 0.01). ADAM8 mRNA (P = 0.004) and sADAM8 protein (P = 0.014) levels were significantly higher in both asthma and COPD compared with healthy controls. ADAM8 mRNA (P = 0.035) and sADAM8 protein (P = 0.002) levels were significantly higher in severe asthma compared with controlled asthma. Total inflammatory cell count (P < 0.01) and neutrophils (P < 0.01) were also elevated in severe asthmatic sputum. Although ADAM8 mRNA was significantly higher in eosinophilic and neutrophilic asthma (P < 0.001), sADAM8 did not differ between asthma inflammatory phenotypes. ADAM8 expression positively correlated with sputum total cell count and sputum neutrophils. Conclusions and Clinical Relevance: ADAM8 expression is increased in both severe asthma and COPD and associated with sputum total cell count and neutrophils. ADAM8 may facilitate neutrophil migration to the airways in severe asthma and COPD. © 2013 John Wiley & Sons Ltd.

DOI 10.1111/cea.12223
Citations Scopus - 16Web of Science - 18
Co-authors Katherine Baines, Vanessa Mcdonald, Lisa Wood, Jodie Simpson
2014 Zhang XY, Simpson JL, Powell H, Yang IA, Upham JW, Reynolds PN, et al., 'Full blood count parameters for the detection of asthma inflammatory phenotypes', Clinical and Experimental Allergy, 44 1137-1145 (2014) [C1]

Summary: Background: In asthma, the airway inflammatory phenotype influences clinical characteristics and treatment response. Although induced sputum is the gold standard test for... [more]

Summary: Background: In asthma, the airway inflammatory phenotype influences clinical characteristics and treatment response. Although induced sputum is the gold standard test for phenotyping asthma, a more accessible method is needed for clinical practice. Objective: To investigate whether white blood cell counts and/or their derived ratios can predict sputum eosinophils or neutrophils in uncontrolled asthma. Methods: This cross-sectional study evaluated 164 treated but uncontrolled asthmatic patients with sputum induction and blood collection. Receiver-operating characteristic (ROC) curves were used to assess the relationship between blood and sputum parameters. Results: There was a significant positive relationship between blood eosinophil parameters and the percentage of sputum eosinophil count. A weak but significant correlation was found between sputum neutrophil percentage and blood neutrophil percentage (r = 0.219, P = 0.005). ROC curve analysis identified that blood eosinophil percentage count was the best predictor for eosinophilic asthma, with an area under the curve (AUC) of 0.907 (P < 0.001). The optimum cut-point for blood eosinophil percentage was 2.7%, and this yielded a sensitivity of 92.2% and a specificity of 75.8%. The absolute blood eosinophil count was also highly predictive with an AUC of 0.898 (P < 0.0001) at a blood eosinophil cut-off of 0.26 × 10<sup>9</sup>/L. The blood eosinophil/lymphocyte ratio (ELR) and eosinophil/neutrophil ratio (ENR) were increased in eosinophilic asthma, and the neutrophil/lymphocyte ratio (NLR) was increased in neutrophilic asthma. Neutrophilic asthma could also be detected by blood neutrophil percentages and NLR, but with less accuracy. Conclusions and Clinical Relevance: Blood eosinophil counts and derived ratios (ELR and ENR) can accurately predict eosinophilic asthma in patients with persistent uncontrolled asthma despite treatment. Blood neutrophil parameters are poor surrogates for the proportion of sputum neutrophils. Blood counts may be a useful aid in the monitoring of uncontrolled asthma. © 2014 John Wiley & Sons Ltd.

DOI 10.1111/cea.12345
Citations Scopus - 87Web of Science - 83
Co-authors Jodie Simpson
2014 Zhang HP, Jia CE, Lv Y, Gibson PG, Wang G, 'Montelukast for prevention and treatment of asthma exacerbations in adults: Systematic review and meta-analysis', Allergy and Asthma Proceedings, 35 278-287 (2014) [C1]

It has proven efficacy in reducing asthma exacerbations, but the effect size of montelukast (a leukotriene receptor antagonist) for varied severity of asthma exacerbations is not ... [more]

It has proven efficacy in reducing asthma exacerbations, but the effect size of montelukast (a leukotriene receptor antagonist) for varied severity of asthma exacerbations is not systematically assessed. This study was designed to systematically explore the evidence for montelukast, as first-line or add-on therapy, in preventing and treating asthma exacerbations in adult patients with asthma. Randomized controlled trials were searched in PubMed, CENTRAL, COPY Web of Science, Embase, and OVID up to March 2013, where montelukast prevented or treated asthma exacerbations in adults. Primary outcomes were the number of patients experiencing exacerbations in chronic asthma and hospitalizations in acute asthma. Odds ratio (OR) with 95% confidence intervals (CI), risk difference, and number needed to treat (NNT) were calculated and pooled. Adverse events were also assessed in chronic asthma. Twenty trials for chronic asthma and six for acute asthma were identified. In comparison with placebo, adults with chronic asthma receiving montelukast had significantly reduced number of exacerbations (OR = 0.60 and 95% CI, 0.49, 0.74; NNT = 17 and 95% CI, 12, 29). However, montelukast was inferior to inhaled corticosteroids (ICSs) (OR = 1.63; 95% CI, 1.29, 2.0) and ICS plus long-acting beta2-agonist (LABA; OR = 3.94; 95% CI, 1.64, 9.48) as the first-line therapies and LABA (OR = 1.22; 95% CI, 1.05, 1.42) as the add-on therapies in reducing asthma exacerbations. In acute asthma, montelukast could statistically improve peak expiratory flow percent predicted (p = 0.008) and reduce systemic corticosteroid intake (p = 0.005). Montelukast had low risk in hoarseness and insomnia. Our meta-analysis suggests that montelukast significantly reduces mild, moderate, and part of severe exacerbations in chronic mild to moderate asthma, but it has inferior efficacy to ICS or ICS plus LABA. Copyright © 2014, OceanSide Publications, Inc.

DOI 10.2500/aap.2014.35.3745
Citations Scopus - 13Web of Science - 11
2014 Simpson JL, Gibson PG, Yang IA, Upham J, James A, Reynolds PN, Hodge S, 'Altered sputum granzyme B and granzyme B/proteinase inhibitor-9 in patients with non-eosinophilic asthma', RESPIROLOGY, 19 280-287 (2014) [C1]
DOI 10.1111/resp.12213
Citations Scopus - 6Web of Science - 6
Co-authors Jodie Simpson
2014 Gibson P, 'Laryngeal botoxification for severe asthma', RESPIROLOGY, 19 467-468 (2014) [C3]
DOI 10.1111/resp.12278
Citations Scopus - 2Web of Science - 2
2014 Gunawardhana LP, Gibson PG, Simpson JL, Powell H, Baines KJ, 'Activity and expression of histone acetylases and deacetylases in inflammatory phenotypes of asthma', Clinical & Experimental Allergy, 44 47-57 (2014) [C1]
DOI 10.1111/cea.12168
Citations Scopus - 22Web of Science - 24
Co-authors Katherine Baines, Jodie Simpson
2014 Hodge S, Hodge G, Pizzutto S, Petsky H, Gibson P, Chang A, Upham J, 'REDUCED MACROPHAGE PHAGOCYTIC HOST RESPONSE TO NTHI IN CHILDREN WITH BRONCHIECTASIS', RESPIROLOGY, 19 86-86 (2014)
Citations Web of Science - 2
2014 Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al., 'Erratum: International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma (European Respiratory Journal (2014) 43 (343¿373) DOI: 10.1183/09031936.00202013)', European Respiratory Journal, 52 (2014)

Copyright ©ERS 2018. This article from the February 2014 issue of the European Respiratory Journal was originally published with errors in the criteria used to define severe asthm... [more]

Copyright ©ERS 2018. This article from the February 2014 issue of the European Respiratory Journal was originally published with errors in the criteria used to define severe asthma on page 350 and in table 3. At both aforementioned points in the article, the ¿poor symptom control¿ criterion for severe asthma should have been defined as: Asthma Control Questionnaire (ACQ) consistently 1.5 or Asthma Control Test (ACT) <20, rather than as ACQ >1.5 or ACT <20; similarly, the ¿frequent severe exacerbations¿ criterion should have been defined as: those requiring two or more bursts of systemic corticosteroids (3 days each) in the previous year, not those requiring two or more bursts of systemic corticosteroids (>3 days each) in the previous year.

DOI 10.1183/13993003.52020-2013
2014 Gibson PG, Simpson JL, Ryan NM, Vertigan AE, 'Mechanisms of cough', CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, 14 55-61 (2014) [C1]
DOI 10.1097/ACI.0000000000000027
Citations Scopus - 15Web of Science - 14
Co-authors Jodie Simpson, Nicole Ryan
2014 Vertigan AE, Bone SL, Gibson PG, 'Development and validation of the Newcastle laryngeal hypersensitivity questionnaire', Acta Veterinaria Scandinavica, 10 1-13 (2014) [C1]
DOI 10.1186/1745-9974-10-1
Citations Scopus - 30
2014 Baines KJ, Simpson JL, Wood LG, Scott RJ, Fibbens NL, Powell H, et al., 'Sputum gene expression signature of 6 biomarkers discriminates asthma inflammatory phenotypes', Journal of Allergy and Clinical Immunology, 133 997-1007 (2014) [C1]

Background Airway inflammation is associated with asthma exacerbation risk, treatment response, and disease mechanisms. Objective This study aimed to identify and validate a sputu... [more]

Background Airway inflammation is associated with asthma exacerbation risk, treatment response, and disease mechanisms. Objective This study aimed to identify and validate a sputum gene expression signature that discriminates asthma inflammatory phenotypes. Methods An asthma phenotype biomarker discovery study generated gene expression profiles from induced sputum of 47 asthmatic patients. A clinical validation study (n = 59 asthmatic patients) confirmed differential expression of key genes. A 6-gene signature was identified and evaluated for reproducibility (n = 30 asthmatic patients and n = 20 control subjects) and prediction of inhaled corticosteroid (ICS) response (n = 71 asthmatic patients). Receiver operating characteristic curves were calculated, and area under the curve (AUC) values were reported. Results From 277 differentially expressed genes between asthma inflammatory phenotypes, we identified 23 genes that showed highly significant differential expression in both the discovery and validation populations. A signature of 6 genes, including Charcot-Leydon crystal protein (CLC); carboxypeptidase A3 (CPA3); deoxyribonuclease I-like 3 (DNASE1L3); IL-1ß (IL1B); alkaline phosphatase, tissue-nonspecific isozyme (ALPL); and chemokine (C-X-C motif) receptor 2 (CXCR2), was reproducible and could significantly (P <.0001) discriminate eosinophilic asthma from other phenotypes, including patients with noneosinophilic asthma (AUC, 89.6%), paucigranulocytic asthma (AUC, 92.6%), or neutrophilic asthma (AUC, 91.4%) and healthy control subjects (AUC, 97.6%), as well as discriminating patients with neutrophilic asthma from those with paucigranulocytic asthma (AUC, 85.7%) and healthy control subjects (AUC, 90.8). The 6-gene signature predicted ICS response (>12% change in FEV1; AUC, 91.5%). ICS treatment reduced the expression of CLC, CPA3, and DNASE1L3 in patients with eosinophilic asthma. Conclusions A sputum gene expression signature of 6 biomarkers reproducibly and significantly discriminates inflammatory phenotypes of asthma and predicts ICS treatment response. This signature has the potential to become a useful diagnostic tool to assist in the clinical diagnosis and management of asthma. © 2013 American Academy of Allergy, Asthma & Immunology.

DOI 10.1016/j.jaci.2013.12.1091
Citations Scopus - 79Web of Science - 73
Co-authors Jodie Simpson, Lisa Wood, Katherine Baines, Rodney Scott
2014 Ryan NM, Gibson PG, 'Recent additions in the treatment of cough', JOURNAL OF THORACIC DISEASE, 6 S739-S747 (2014) [C1]
DOI 10.3978/j.issn.2072-1439.2014.03.13
Citations Scopus - 5Web of Science - 5
Co-authors Nicole Ryan
2014 Ryan NM, Birring SS, Gibson PG, 'Arnold¿s nerve cough reflex: evidence for chronic cough as a sensory vagal neuropathy', Journal of Thoracic Disease, 6 S748-S752 (2014) [C3]
DOI 10.3978/j.issn.2072-1439.2014.04.22
Citations Scopus - 10Web of Science - 9
Co-authors Nicole Ryan
2014 Fu JJ, McDonald VM, Gibson PG, Simpson JL, 'Systemic inflammation in older adults with asthma-COPD overlap syndrome', Allergy, Asthma and Immunology Research, 6 316-324 (2014) [C1]

Purpose: The role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to id... [more]

Purpose: The role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to identify associations between clinical characteristics and inflammatory mediators in asthma-COPD overlap syndrome. Methods: In 108 adults older than 55 years comprising healthy controls (n=29), asthma (n=16), COPD (n=21) and asthma-COPD overlap syndrome (n=42), serum high sensitivity C-reactive protein and Interleukin 6 (IL-6) were assayed. Spirometry, induced sputum, quality of life, comorbidities and medications were assessed, and their associations with asthma-COPD overlap syndrome were analyzed using logistic regression. Associations between systemic inflammatory mediators and clinical characteristics were tested in multivariate linear regression models. Results: Patients with asthma-COPD overlap syndrome had significantly elevated IL-6 levels compared with healthy controls and asthmatics. Age, comorbidity index and IL-6 level were independently associated with asthma-COPD overlap syndrome. FEV1% predicted was inversely associated with IL-6 level, and cardiovascular disease was associated with an increased IL-6 level. Systemic markers were not associated with airway inflammation. Conclusions: Systemic inflammation is commonly present in asthma-COPD overlap syndrome, and asthma-COPD overlap syndrome resembled COPD in terms of systemic inflammation. IL-6 is a pivotal inflammatory mediator that may be involved in airflow obstruction and cardiovascular disease and may be an independent treatment target. © Copyright The Korean Academy of Asthma, Allergy and Clinical Immunology.

DOI 10.4168/aair.2014.6.4.316
Citations Scopus - 54Web of Science - 48
Co-authors Vanessa Mcdonald, Jodie Simpson
2014 Gunawardhana LP, Baines KJ, Mattes J, Murphy VE, Simpson JL, Gibson PG, 'Differential DNA methylation profiles of infants exposed to maternal asthma during pregnancy', Pediatric Pulmonology, 49 852-862 (2014) [C1]

Background Asthma is a complex disease that involves both genetic factors and environmental exposures. Aberrant epigenetic modifications, such as DNA methylation, may be important... [more]

Background Asthma is a complex disease that involves both genetic factors and environmental exposures. Aberrant epigenetic modifications, such as DNA methylation, may be important in asthma development. Fetal exposure to maternal asthma during critical periods of in utero development may lead to epigenetic alterations that predispose infants to a greater risk of developing asthma themselves. We investigated alterations in the DNA methylation profile of peripheral blood from infants exposed to maternal asthma during pregnancy. Methods Peripheral blood was collected from 12-month-old infants born to women with (n = 25) and without (n = 15) doctor diagnosed asthma during pregnancy. Genomic DNA was extracted, bisulfite converted, and hybridized to Infinium Methylation 27 arrays (Illumina), containing over27,000 CpGs from 14,495 genes. CpG loci in only autosomal genes were classified as differentially methylated at the 99% level (P < 0.01, |DiffScore| > 22 and delta beta >0.06). Results There were 70 CpG loci, corresponding to 67 genes that were significantly differentially methylated. Twelve CpG loci (11 genes) showed greater than 10% comparative difference in DNA methylation, including hyper-methylated loci of FAM181A, MRI1, PIWIL1, CHFR, DEFA1, MRPL28, AURKA, and hypo-methylated loci of NALP1L5, MAP8KIP3, ACAT2, and PM20D1 in maternal asthma. Methylation of MAPK8IP3 was significantly negatively correlated with maternal blood eosinophils (r = -0.38; P = 0.022), maternal eNO (r = -0.44; P = 0.005), and maternal serum total IgE (r = -0.39, P = 0.015). Methylation of AURKA negatively correlated with maternal hemoglobin (r = -0.43; P = 0.008), infants height (r = -0.51; P < 0.001) and weight (r = -0.36; P = 0.021). Methylation of PM20D1 was lower in infants born to mothers with asthma on inhaled corticosteroid treatment. Methylation of PM20D1 was lower and MRI1 was higher in infants born to atopic mothers without asthma. Conclusions In an Australian study population, exposure to maternal asthma during pregnancy is associated with differential methylation profiles of infants' peripheral blood DNA, which may act as risk factors for future asthma development. © 2013 Wiley Periodicals, Inc.

DOI 10.1002/ppul.22930
Citations Scopus - 19Web of Science - 19
Co-authors Jodie Simpson, Joerg Mattes, Katherine Baines, Vanessa Murphy
2014 Walters JAE, Tan DJ, White CJ, Gibson PG, Wood-Baker R, Walters EH, 'Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2014) [C1]
DOI 10.1002/14651858.CD001288.pub4
Citations Scopus - 55Web of Science - 19
2014 Simpson JL, Guest M, Boggess MM, Gibson PG, 'Occupational exposures, smoking and airway inflammation in refractory asthma', BMC PULMONARY MEDICINE, 14 (2014) [C1]
DOI 10.1186/1471-2466-14-207
Citations Scopus - 7Web of Science - 5
Co-authors Jodie Simpson
2014 Wang G, Murphy VE, Namazy J, Powell H, Schatz M, Chambers C, et al., 'The risk of maternal and placental complications in pregnant women with asthma: A systematic review and meta-analysis', Journal of Maternal-Fetal and Neonatal Medicine, 27 934-942 (2014) [C1]

Objective: To investigate if maternal asthma is associated with an increased risk of maternal and placental complications in pregnancy. Methods: Electronic databases were searched... [more]

Objective: To investigate if maternal asthma is associated with an increased risk of maternal and placental complications in pregnancy. Methods: Electronic databases were searched for the following terms: (asthma or wheeze) and (pregnan* or perinat* or obstet*). Cohort studies published between January 1975 and March 2012 were considered for inclusion. Forty publications met the inclusion criteria, reporting at least one maternal or placental complication in pregnant women with and without asthma. Relative risk (RR) with 95% confidence intervals (CIs) was calculated. Results: Maternal asthma was associated with a significantly increased risk of cesarean section (RR=1.31, 95%CI=[1.22-1.39]), gestational diabetes (RR=1.39, 95%CI=[1.17-1.66]), hemorrhage (antepartum: RR=1.25, 95%CI=[1.10-1.42]; postpartum: RR=1.29, 95%CI=[1.18-1.41]), placenta previa (RR=1.23, 95%CI=[1.07-1.40]), placental abruption (RR=1.29, 95%CI=[1.14-1.47]) and premature rupture of membranes (RR=1.21, 95%CI=1.07-1.37). Moderate to severe asthma significantly increased the risk of cesarean section (RR=1.19, 95%CI=[1.09-1.31]) and gestational diabetes (RR=1.19, 95%CI=[1.06-1.33]) compared to mild asthma. Bronchodilator use was associated with a significantly lowered risk of gestational diabetes (RR=0.64, 95%CI=[0.57-0.72]). Conclusions: Pregnant women with asthma are at increased risk of maternal and placental complications, and women with moderate/severe asthma may be at particular risk. Further studies are required to elucidate whether adequate control of asthma during pregnancy reduces these risks. © 2014 Informa UK Ltd. All rights reserved.

DOI 10.3109/14767058.2013.847080
Citations Scopus - 29Web of Science - 29
Co-authors Vanessa Murphy, John Attia
2014 Gibson PG, McDonald VM, 'Why is COPD phenotyping like sorting diamonds?', Eur Respir J, 44 277-279 (2014) [C3]
DOI 10.1183/09031936.00091214
Citations Scopus - 3Web of Science - 3
Co-authors Vanessa Mcdonald
2014 Irwin RS, French CT, Lewis SZ, Diekemper RL, Gold PM, Adams TM, et al., 'Overview of the management of cough CHEST guideline and expert panel report', Chest, 146 885-889 (2014) [C3]

© 2014 American College of Chest Physicians. This overview will demonstrate that cough is a common and potentially expensive healthcare problem. Improvement in the quality of care... [more]

© 2014 American College of Chest Physicians. This overview will demonstrate that cough is a common and potentially expensive healthcare problem. Improvement in the quality of care of those with cough has been the focus of study for a variety of disciplines in medicine. The purpose of the Cough Guideline and Expert Panel is to synthesize current knowledge in a form that will aid clinical decision-making for the diagnosis and management of cough across disciplines and also identify gaps in knowledge and treatment options.

DOI 10.1378/chest.14-1485
Citations Scopus - 37Web of Science - 27
2014 Baines KJ, Pavord ID, Gibson PG, 'The role of biomarkers in the management of airways disease.', Int J Tuberc Lung Dis, 18 1264-1268 (2014) [C1]
DOI 10.5588/ijtld.14.0226
Citations Scopus - 14Web of Science - 13
Co-authors Katherine Baines
2014 Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al., 'Erratum: International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma (European Respiratory Journal (2014) 43 (343-373))', European Respiratory Journal, 43 1216 (2014)
DOI 10.1183/09031936.50202013
Citations Scopus - 6Web of Science - 3
2014 Negewo NA, McDonald VM, Gibson PG, 'Comorbidity in chronic obstructive pulmonary disease', Respiratory Investigation, (2014) [C1]

© 2015 The Japanese Respiratory Society. Patients with chronic obstructive pulmonary diseases (COPD) often experience comorbid conditions. The most common comorbidities that have ... [more]

© 2015 The Japanese Respiratory Society. Patients with chronic obstructive pulmonary diseases (COPD) often experience comorbid conditions. The most common comorbidities that have been associated with COPD include cardiovascular diseases, lung cancer, metabolic disorder, osteoporosis, anxiety and depression, skeletal muscle dysfunction, cachexia, gastrointestinal diseases, and other respiratory conditions. Not only are comorbidities common but they also considerably influence disease prognosis and patients' health status, and are associated with poor clinical outcomes. However, perusal of literature indicates that little has been done so far to effectively assess, manage, and treat comorbidities in patients with COPD. The aim of this review is to comprehensively narrate the comorbid conditions that often coexist with COPD, along with their reported prevalence and their significant impacts in the disease management of COPD. A perspective on integrated disease management approaches for COPD is also discussed.

DOI 10.1016/j.resinv.2015.02.004
Citations Scopus - 18Web of Science - 18
Co-authors Vanessa Mcdonald, Netsanet Negewo
2013 Gibson PG, 'Induced Sputum', APSR Respiratory Updates, 5 1-7 (2013) [C3]
2013 Gibson PG, 'Obesity and asthma.', Ann Am Thorac Soc, 10 Suppl S138-S142 (2013) [C1]
DOI 10.1513/AnnalsATS.201302-038AW
Citations Scopus - 25
2013 Periyalil HA, Gibson PG, Wood LG, 'Immunometabolism in obese asthmatics: Are we there yet?', Nutrients, 5 3506-3530 (2013) [C1]

Obesity is now recognised as a worldwide epidemic. The recent International Association for the Study of Obesity/International Obesity Taskforce (IASO/IOTF) analysis estimates tha... [more]

Obesity is now recognised as a worldwide epidemic. The recent International Association for the Study of Obesity/International Obesity Taskforce (IASO/IOTF) analysis estimates that approximately 1.0 billion adults are currently overweight and a further 475 million are obese. Obesity has huge psychosocial impact with obese children and adolescents facing discrimination and stigmatization in many areas of their lives leading to body dissatisfaction, low self-esteem and depression. Indeed, obesity is recognised as an important risk factor for the development of several chronic diseases such as hypertension, cancer, asthma and metabolic syndrome. Chronic low grade systemic inflammation is considered as a hallmark of obesity and may possibly explain the link between obesity and chronic disease, in particular the increased incidence, prevalence and severity of asthma in obese individuals. There is now strong evidence for infiltration of immune and inflammatory cells into adipose tissue that drives systemic inflammation and subsequent end organ damage. In addition to adipocytes, the key adipose tissue resident immune cells are macrophages and mast cells. Immunometabolism, as an emerging field of investigation, explores the pivotal role of these immune cells in translating immunological changes to metabolic effects in obesity. Abundance of free fatty acids, along with other inflammatory cytokines shift the balance of metabolic homeostasis to pro-inflammatory status by influencing the development of inflammatory cell lineage, which, further exhibits distinct functional phenotypes. There is emerging evidence for macrophage activation and functional polarization of an anti-inflammatory M2 phenotype towards a pro-inflammatory M1 phenotype of macrophages in obese adipose tissue. Similarly, studies in both obese humans and murine models reveal the pathognomic presence of an increased number of mast cells in visceral adipose tissue. These suggest a possible contribution of mast cells to the unique metabolome of obese asthma. This review examines proposed multilevel interactions between metabolic and immune systems in obese asthmatics that underlie the negative effects of obesity and may offer significant therapeutic promise. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

DOI 10.3390/nu5093506
Citations Scopus - 17Web of Science - 17
Co-authors Lisa Wood
2013 Murphy VE, Powell H, Wark PAB, Gibson PG, 'A Prospective Study of Respiratory Viral Infection in Pregnant Women With and Without Asthma', CHEST, 144 420-427 (2013) [C1]
DOI 10.1378/chest.12-1956
Citations Scopus - 16Web of Science - 15
Co-authors Peter Wark, Vanessa Murphy
2013 McDonald V, Wood L, Baines P, Higgins I, Gibson P, 'Obesity and bone health in COPD', EUROPEAN RESPIRATORY JOURNAL, 42 (2013)
Co-authors Vanessa Mcdonald, Lisa Wood, Isabel Higgins
2013 Thorburn AN, Brown AC, Nair PM, Chevalier N, Foster PS, Gibson PG, Hansbro PM, 'Pneumococcal Components Induce Regulatory T Cells That Attenuate the Development of Allergic Airways Disease by Deviating and Suppressing the Immune Response to Allergen', JOURNAL OF IMMUNOLOGY, 191 4112-4120 (2013) [C1]
DOI 10.4049/jimmunol.1201232
Citations Scopus - 12Web of Science - 9
Co-authors Paul Foster, Philip Hansbro
2013 Vanders RL, Gibson PG, Murphy VE, Wark PAB, 'Plasmacytoid Dendritic Cells and CD8 T Cells From PregnantWomen Show Altered Phenotype and Function Following H1N1/09 Infection', JOURNAL OF INFECTIOUS DISEASES, 208 1062-1070 (2013) [C1]
DOI 10.1093/infdis/jit296
Citations Scopus - 11Web of Science - 11
Co-authors Rebecca Vanders, Vanessa Murphy, Peter Wark
2013 Gibson PG, 'Macrolides for yet another chronic airway disease: severe asthma?', THORAX, 68 313-314 (2013) [C3]
DOI 10.1136/thoraxjnl-2012-203055
Citations Scopus - 3Web of Science - 2
2013 McDonald VM, Higgins I, Wood LG, Gibson PG, 'Multidimensional assessment and tailored interventions for COPD: respiratory utopia or common sense?', THORAX, 68 691-694 (2013) [C1]
DOI 10.1136/thoraxjnl-2012-202646
Citations Scopus - 61Web of Science - 57
Co-authors Isabel Higgins, Lisa Wood, Vanessa Mcdonald
2013 Jia CE, Zhang HP, Lv Y, Liang R, Jiang YQ, Powell H, et al., 'The Asthma Control Test and Asthma Control Questionnaire for assessing asthma control: Systematic review and meta-analysis', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 131 695-703 (2013) [C1]
DOI 10.1016/j.jaci.2012.08.023
Citations Scopus - 105Web of Science - 99
2013 Ryan NM, Birring SS, Gibson PG, 'Gabapentin for refractory chronic cough Reply', LANCET, 381 624-625 (2013) [C3]
DOI 10.1016/S0140-6736(13)60340-2
Citations Scopus - 3Web of Science - 3
Co-authors Nicole Ryan
2013 Powell H, McCaffery K, Murphy VE, Hensley MJ, Clifton VL, Giles W, Gibson PG, 'Psychosocial Variables Are Related to Future Exacerbation Risk and Perinatal Outcomes in Pregnant Women with Asthma', JOURNAL OF ASTHMA, 50 383-389 (2013) [C1]
DOI 10.3109/02770903.2012.757777
Citations Scopus - 28Web of Science - 24
Co-authors Michael Hensley, Vanessa Murphy
2013 McDonald VM, Higgins I, Gibson PG, 'Insight into Older Peoples' Healthcare Experiences with Managing COPD, Asthma, and Asthma-COPD Overlap', JOURNAL OF ASTHMA, 50 497-504 (2013) [C1]
DOI 10.3109/02770903.2013.790415
Citations Scopus - 9Web of Science - 9
Co-authors Isabel Higgins, Vanessa Mcdonald
2013 Namazy JA, Murphy VE, Powell H, Gibson PG, Chambers C, Schatz M, 'Effects of asthma severity, exacerbations and oral corticosteroids on perinatal outcomes', EUROPEAN RESPIRATORY JOURNAL, 41 1082-1090 (2013) [C1]
DOI 10.1183/09031936.00195111
Citations Scopus - 56Web of Science - 51
Co-authors Vanessa Murphy
2013 Gibson PG, 'Why inflammatory phenotyping is necessary for successful drug evaluation in asthma and COPD', EUROPEAN RESPIRATORY JOURNAL, 42 891-892 (2013) [C3]
DOI 10.1183/09031936.00038713
Citations Scopus - 4Web of Science - 4
2013 Jensen ME, Gibson PG, Collins CE, Wood LG, 'Airway and systemic inflammation in obese children with asthma', EUROPEAN RESPIRATORY JOURNAL, 42 1012-1019 (2013) [C1]
DOI 10.1183/09031936.00124912
Citations Scopus - 51Web of Science - 45
Co-authors Lisa Wood, Clare Collins, Megan Jensen
2013 Simpson JL, Gibson PG, Yang IA, Upham J, James A, Reynolds PN, Hodge S, 'Impaired macrophage phagocytosis in non-eosinophilic asthma', CLINICAL AND EXPERIMENTAL ALLERGY, 43 29-35 (2013) [C1]
DOI 10.1111/j.1365-2222.2012.04075.x
Citations Scopus - 63Web of Science - 59
Co-authors Jodie Simpson
2013 Jensen ME, Gibson PG, Collins CE, Hilton JM, Wood LG, 'Diet-induced weight loss in obese children with asthma: a randomized controlled trial', CLINICAL AND EXPERIMENTAL ALLERGY, 43 775-784 (2013) [C1]
DOI 10.1111/cea.12115
Citations Scopus - 59Web of Science - 58
Co-authors Lisa Wood, Clare Collins, Megan Jensen
2013 Simpson JL, McDonald VM, Baines KJ, Oreo KM, Wang F, Hansbro PM, Gibson PG, 'Influence of Age, Past Smoking, and Disease Severity on TLR2, Neutrophilic Inflammation, and MMP-9 Levels in COPD', MEDIATORS OF INFLAMMATION, (2013) [C1]
DOI 10.1155/2013/462934
Citations Scopus - 26Web of Science - 22
Co-authors Vanessa Mcdonald, Katherine Baines, Philip Hansbro, Nicole Hansbro, Jodie Simpson
2013 McDonald VM, Higgins I, Gibson PG, 'Managing Older Patients with Coexistent Asthma and Chronic Obstructive Pulmonary Disease Diagnostic and Therapeutic Challenges', DRUGS & AGING, 30 1-17 (2013) [C1]
DOI 10.1007/s40266-012-0042-z
Citations Scopus - 23Web of Science - 20
Co-authors Vanessa Mcdonald, Isabel Higgins
2013 Berthon BS, Macdonald-Wicks LK, Gibson PG, Wood LG, 'Investigation of the association between dietary intake, disease severity and airway inflammation in asthma', RESPIROLOGY, 18 447-454 (2013) [C1]
DOI 10.1111/resp.12015
Citations Scopus - 36Web of Science - 35
Co-authors Lisa Wood, Lesley Wicks
2013 Vanders RL, Gibson PG, Wark PAB, Murphy VE, 'Alterations in inflammatory, antiviral and regulatory cytokine responses in peripheral blood mononuclear cells from pregnant women with asthma', RESPIROLOGY, 18 827-833 (2013) [C1]
DOI 10.1111/resp.12068
Citations Scopus - 12Web of Science - 11
Co-authors Rebecca Vanders, Peter Wark, Vanessa Murphy
2013 Brooks CR, Gibson PG, Douwes J, Van Dalen CJ, Simpson JL, 'Relationship between airway neutrophilia and ageing in asthmatics and non-asthmatics', RESPIROLOGY, 18 857-865 (2013) [C1]
DOI 10.1111/resp.12079
Citations Scopus - 26Web of Science - 26
Co-authors Jodie Simpson
2013 Vertigan AE, Bone SL, Gibson PG, 'Laryngeal sensory dysfunction in laryngeal hypersensitivity syndrome', RESPIROLOGY, 18 948-956 (2013) [C1]
DOI 10.1111/resp.12103
Citations Scopus - 39Web of Science - 31
2013 Porsbjerg CM, Gibson PG, Pretto JJ, Salome CM, Brown NJ, Berend N, King GG, 'Relationship between airway pathophysiology and airway inflammation in older asthmatics', RESPIROLOGY, 18 1128-1134 (2013) [C1]
DOI 10.1111/resp.12142
Citations Scopus - 18Web of Science - 17
2013 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Dietary restriction and exercise improve airway inflammation and clinical outcomes in overweight and obese asthma: a randomized trial', Clinical and Experimental Allergy, 43 36-49 (2013) [C1]
DOI 10.1111/cea.12004
Citations Scopus - 97Web of Science - 96
Co-authors Lisa Wood, Philip Morgan, Manohar Garg, Robin Callister, Hayley Scott
2013 Baines KJ, Hsu AC-Y, Tooze M, Gunawardhana LP, Gibson PG, Wark PAB, 'Novel immune genes associated with excessive inflammatory and antiviral responses to rhinovirus in COPD', RESPIRATORY RESEARCH, 14 (2013) [C1]
DOI 10.1186/1465-9921-14-15
Citations Scopus - 20Web of Science - 21
Co-authors Alan Hsu, Katherine Baines, Peter Wark
2013 Gao P, Simpson JL, Zhang J, Gibson PG, 'Galectin-3: its role in asthma and potential as an anti-inflammatory target', RESPIRATORY RESEARCH, 14 (2013) [C1]
DOI 10.1186/1465-9921-14-136
Citations Scopus - 33Web of Science - 29
Co-authors Jodie Simpson
2013 Murphy VE, Wang G, Namazy JA, Powell H, Gibson PG, Chambers C, Schatz M, 'The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta-analysis', BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 120 812-822 (2013) [C1]
DOI 10.1111/1471-0528.12224
Citations Scopus - 49Web of Science - 50
Co-authors Vanessa Murphy
2013 Jensen ME, Gibson PG, Collins CE, Hilton JM, Latham-Smith F, Wood LG, 'Increased sleep latency and reduced sleep duration in children with asthma', SLEEP AND BREATHING, 17 281-287 (2013) [C1]
DOI 10.1007/s11325-012-0687-1
Citations Scopus - 13Web of Science - 11
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2013 Fu J-J, Baines KJ, Wood LG, Gibson PG, 'Systemic Inflammation Is Associated with Differential Gene Expression and Airway Neutrophilia in Asthma', OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY, 17 187-199 (2013) [C1]
DOI 10.1089/omi.2012.0104
Citations Scopus - 37Web of Science - 33
Co-authors Lisa Wood, Katherine Baines
2013 Gao P, Gibson PG, Zhang J, He X, Hao Y, Li P, Liu H, 'The safety of sputum induction in adults with acute exacerbation of COPD', CLINICAL RESPIRATORY JOURNAL, 7 101-109 (2013) [C1]
DOI 10.1111/j.1752-699X.2012.00291.x
Citations Scopus - 8Web of Science - 7
2013 Mcdonald VM, Simpson JL, Mcelduff P, Gibson PG, 'Older peoples' perception of tests used in the assessment and management of COPD and asthma', Clinical Respiratory Journal, 7 367-374 (2013) [C1]

Objectives: Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the... [more]

Objectives: Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the patient perception of tests used for the assessment of airways disease in older people. Data Source: Older adults (>55 years) with obstructive airway disease and healthy controls (N=56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration. Results: Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P=0.001), associated with more discomfort (mean 1.3, P<0.001), more painful (0.46, P=0.019), longer test duration (0.84, P<0.001) and worsening symptoms (0.55, P=0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment. Conclusions: Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care. © 2013 John Wiley & Sons Ltd.

DOI 10.1111/crj.12017
Co-authors Vanessa Mcdonald, Jodie Simpson, Patrick Mcelduff
2013 Gao P, Zhang J, He X, Hao Y, Wang K, Gibson PG, 'Sputum Inflammatory Cell-Based Classification of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease', PLOS ONE, 8 (2013) [C1]
DOI 10.1371/journal.pone.0057678
Citations Scopus - 28Web of Science - 23
2012 Wood LG, Garg ML, Smart JM, Scott HA, Barker D, Gibson PG, 'Manipulating antioxidant intake in asthma: A randomized controlled trial', American Journal of Clinical Nutrition, 96 534-543 (2012) [C1]
DOI 10.3945/ajcn.111.032623
Citations Scopus - 92Web of Science - 82
Co-authors Daniel Barker, Lisa Wood, Hayley Scott, Manohar Garg
2012 Wood LG, Baines KJ, Fu J, Scott HA, Gibson PG, 'The neutrophilic inflammatory phenotype is associated with systemic inflammation in asthma', Chest, 142 86-93 (2012) [C1]
Citations Scopus - 142Web of Science - 131
Co-authors Lisa Wood, Hayley Scott, Katherine Baines
2012 Thorburn AN, Foster PS, Gibson PG, Hansbro PM, 'Components of streptococcus pneumoniae suppress allergic airways disease and NKT cells by inducing regulatory T cells', The Journal of Immunology, 188 4611-4620 (2012) [C1]
Citations Scopus - 46Web of Science - 43
Co-authors Philip Hansbro, Paul Foster
2012 Vanders RL, Wark PA, Murphy VE, Gibson PG, 'Pregnant women have attenuated innate interferon responses to 2009 pandemic influenza a virus subtype H1N1', Journal of Infectious Diseases, 206 646-653 (2012) [C1]
Citations Scopus - 30Web of Science - 31
Co-authors Vanessa Murphy, Peter Wark, Rebecca Vanders
2012 Chang AB, Yerkovich ST, Gibson PG, Anderson-James S, Petsky HL, Carroll ML, et al., 'Pulmonary innate immunity in children with protracted bacterial bronchitis', Journal of Pediatrics, 161 621-625 (2012) [C1]
Citations Scopus - 27Web of Science - 21
2012 Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia J, Gibson PG, 'A Meta-Analysis of Adverse Perinatal Outcomes in Women With Asthma EDITORIAL COMMENT', OBSTETRICAL & GYNECOLOGICAL SURVEY, 67 77-78 (2012) [C3]
DOI 10.1097/OGX.0b013e318247c54d
Co-authors John Attia
2012 Pavord ID, Gibson PG, 'Inflammometry: The current state of play', Thorax, 67 191-192 (2012) [C3]
Citations Scopus - 25Web of Science - 22
2012 Pavord ID, Gibson PG, 'Use of sputum eosinophil counts to guide management in children with severe asthma [response]', Thorax, 67 1016 (2012) [C3]
Citations Scopus - 1Web of Science - 1
2012 Essilfie A-T, Simpson JL, Dunkley ML, Morgan LC, Oliver BG, Gibson PG, et al., 'Combined haemophilus influenzae respiratory infection and allergic airways disease drives chronic infection and features of neutrophilic asthma', Thorax, 67 588-599 (2012) [C1]
DOI 10.1136/thoraxjnl-2011-200160
Citations Scopus - 77Web of Science - 67
Co-authors Margaret Dunkley, Philip Hansbro, Paul Foster, Jodie Simpson
2012 Vanders RL, Gibson PG, Murphy VE, Wark PAB, 'Impaired type I and III interferon response to rhinovirus infection during pregnancy and asthma', Thorax, 67 209-214 (2012) [C1]
DOI 10.1136/thoraxjnl-2011-200708
Citations Scopus - 39Web of Science - 37
Co-authors Rebecca Vanders, Peter Wark, Vanessa Murphy
2012 Powell H, Gibson PG, 'Exhaled nitric oxide as a guide to management of asthma in pregnancy Reply', LANCET, 379 708-709 (2012) [C3]
DOI 10.1016/S0140-6736(12)60301-8
2012 Powell H, Gibson PG, 'Reply: Exhaled nitric oxide as a guide to management of asthma in pregnancy', Lancet, 379 708-709 (2012) [C3]
2012 Powell H, Gibson PG, 'Management of asthma in pregnancy - Authors' reply', The Lancet, 379 e43 (2012) [C3]
2012 Ryan NM, Birring SS, Gibson PG, 'Gabapentin for refractory chronic cough: a randomised, double-blind, placebo-controlled trial', The Lancet, 380 1583-1589 (2012) [C1]
DOI 10.1016/S0140-6736(12)60776-4
Citations Scopus - 174Web of Science - 150
Co-authors Nicole Ryan
2012 Vertigan AE, Gibson PG, 'The role of speech pathology in the management of patients with chronic refractory cough', Lung, 190 35-40 (2012) [C1]
Citations Scopus - 19Web of Science - 16
2012 Sukkar MB, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Soluble RAGE is deficient in neutrophilic asthma and COPD', European Respiratory Journal, 39 721-729 (2012) [C1]
Co-authors Peter Wark, Vanessa Mcdonald, Lisa Wood, Jodie Simpson
2012 Wark PA, Tooze M, Cheese L, Whitehead BF, Gibson PG, Wark K, McDonald VM, 'Viral infections trigger exacerbations of cystic fibrosis in adults and children', European Respiratory Journal, 40 510-512 (2012) [C1]
DOI 10.1183/09031936.00202311
Citations Scopus - 19Web of Science - 23
Co-authors Vanessa Mcdonald, Peter Wark
2012 Ryan NM, Vertigan AE, Ferguson JK, Wark PA, Gibson PG, 'Clinical and physiological features of postinfectious chronic cough associated with H1N1 infection', Respiratory Medicine, 106 138-144 (2012) [C1]
DOI 10.1016/j.rmed.2011.10.007
Citations Scopus - 15Web of Science - 12
Co-authors Nicole Ryan, Peter Wark, John Ferguson
2012 McDonald VM, Gibson PG, 'Exacerbations of severe asthma', Clinical and Experimental Allergy, 42 670-677 (2012) [C1]
DOI 10.1111/j.1365-2222.2012.03981.x
Citations Scopus - 37Web of Science - 38
Co-authors Vanessa Mcdonald
2012 Wood LG, Gibson PG, 'Adiponectin: The link between obesity and asthma in women?', American Journal of Respiratory and Critical Care Medicine, 186 1-2 (2012) [C3]
Citations Scopus - 6Web of Science - 5
Co-authors Lisa Wood
2012 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Relationship between body composition, inflammation and lung function in overweight and obese asthma', Respiratory Research, 13 1-10 (2012) [C1]
Citations Scopus - 27Web of Science - 27
Co-authors Robin Callister, Philip Morgan, Hayley Scott, Manohar Garg, Lisa Wood
2012 Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia JR, Gibson PG, 'Severity of asthma in pregnancy affects perinatal outcomes - Authors' Reply', BJOG - An International Journal of Obstetrics and Gynaecology, 119 508-509 (2012) [C3]
DOI 10.1111/j.1471-0528.2011.03258.x
Citations Scopus - 1Web of Science - 1
Co-authors John Attia, Vanessa Murphy
2012 Jensen ME, Wood LG, Gibson PG, 'Obesity and childhood asthma - Mechanisms and manifestations', Current Opinion in Allergy and Clinical Immunology, 12 186-192 (2012) [C1]
Citations Scopus - 48Web of Science - 43
Co-authors Lisa Wood, Megan Jensen
2011 Gibson PG, 'Simple clinical score', Clinical Medicine, 11 96 (2011) [C3]
2011 McDonald VM, Higgins I, Simpson JL, Gibson PG, 'The importance of clinical management problems in older people with COPD and asthma: Do patients and physicians agree?', Primary Care Respiratory Journal, 20 389-395 (2011) [C1]

Background: COPD and asthma in older people are complex conditions associated with multiple clinical problems. The relative importance of these problems to both patients and physi... [more]

Background: COPD and asthma in older people are complex conditions associated with multiple clinical problems. The relative importance of these problems to both patients and physicians and the level of agreement between them is largely unknown. Methods: Older people with asthma and COPD underwent a multidimensional assessment to characterise the prevalence of clinical problems. Each individual's problems were then summarised and presented separately to the patient and physician to rate problem importance. Problems were scored using a 5-point Likert scale from unimportant to very important. Results: The highest-rated problems were dyspnoea, activity limitation and airway inflammation, and these areas had good patientphysician concordance. Poor concordance was found for inhaler technique adequacy, airflow obstruction and obesity. Good concordance was found for written action plans, but this was less important to both patients and physicians. Conclusions: In asthma and COPD, patients and their physicians agree about the importance of managing activity limitation, dyspnoea, and airway inflammation. Other areas of management had little concordance or were viewed as less important. Self-management skills were not rated as important by patients and this may hinder successful management. Eliciting problems and addressing their importance to treatment goals may improve care in COPD and asthma. © 2011 Primary Care Respiratory Society UK. All rights reserved.

DOI 10.4104/pcrj.2011.00025
Citations Scopus - 23Web of Science - 22
Co-authors Vanessa Mcdonald, Jodie Simpson, Isabel Higgins
2011 Gibson PG, 'Asthma phenotypes in childhood', Paediatric Respiratory Reviews, 12 151 (2011) [C3]
DOI 10.1016/j.prrv.2011.02.006
Citations Scopus - 1Web of Science - 1
2011 Jensen ME, Collins CE, Gibson PG, Wood LG, 'The obesity phenotype in children with asthma', Paediatric Respiratory Reviews, 12 152-159 (2011) [C1]
DOI 10.1016/j.prrv.2011.01.009
Citations Scopus - 30Web of Science - 30
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2011 Essilfie A-T, Simpson JL, Horvat JC, Preston JA, Dunkley ML, Foster PS, et al., 'Haemophilus influenzae infection drives IL-17-mediated neutrophilic allergic airways disease', PLoS Pathogens, 7 e1002244 (2011) [C1]
Co-authors Philip Hansbro, Jay Horvat, Paul Foster, Jodie Simpson, Margaret Dunkley
2011 Baines KJ, Simpson JL, Gibson PG, 'Innate immune responses are increased in chronic obstructive pulmonary disease', PLoS ONE, 36 (2011) [C1]
DOI 10.1371/journal.pone.0018426
Citations Scopus - 49Web of Science - 41
Co-authors Katherine Baines, Jodie Simpson
2011 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'Multidimensional assessment of older people with asthma and COPD: Clinical management and health status', Age and Ageing, 40 42-49 (2011) [C1]
DOI 10.1093/ageing/afq134
Citations Scopus - 45Web of Science - 42
Co-authors Jodie Simpson, Isabel Higgins, Vanessa Mcdonald
2011 Chang AB, Gibson PG, Willis C, Petsky HL, Widdicombe JG, Masters IB, Robertson CF, 'Do sex and atopy influence cough outcome measurements in children?', Chest, 140 324-330 (2011) [C1]
DOI 10.1378/chest.10-2507
Citations Scopus - 13Web of Science - 11
2011 Baines KJ, Simpson JL, Wood LG, Scott R, Gibson PG, 'Systemic upregulation of neutrophil a-defensins and serine proteases in neutrophilic asthma', Thorax, 66 942-947 (2011) [C1]
Citations Scopus - 44Web of Science - 39
Co-authors Jodie Simpson, Rodney Scott, Lisa Wood, Katherine Baines
2011 Wood LG, Garg ML, Gibson PG, 'A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma', Journal of Allergy and Clinical Immunology, 127 1133-1140 (2011) [C1]
DOI 10.1016/j.jaci.2011.01.036
Citations Scopus - 128Web of Science - 117
Co-authors Lisa Wood, Manohar Garg
2011 Baines KJ, Simpson JL, Wood LG, Scott R, Gibson PG, 'Transcriptional phenotypes of asthma defined by gene expression profiling of induced sputum samples', Journal of Allergy and Clinical Immunology, 127 153.e9-160.e9 (2011) [C1]
DOI 10.1016/j.jaci.2010.10.024
Citations Scopus - 142Web of Science - 127
Co-authors Jodie Simpson, Katherine Baines, Lisa Wood, Rodney Scott
2011 Powell GH, Murphy VE, Taylor DR, Hensley MJ, McCaffery K, Giles W, et al., 'Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: A double-blind, randomised controlled trial', The Lancet, 378 983-990 (2011) [C1]
DOI 10.1016/s0140-6736(11)60971-9
Citations Scopus - 180Web of Science - 167
Co-authors Vanessa Murphy, Michael Hensley
2011 Murphy VE, Gibson PG, 'Asthma in pregnancy', Clinics in Chest Medicine, 32 93-110 (2011) [C1]
Citations Scopus - 46Web of Science - 41
Co-authors Vanessa Murphy
2011 Powell H, McCaffery K, Murphy VE, Hensley MJ, Clifton VL, Giles WB, Gibson PG, 'Psychosocial outcomes are related to asthma control and quality of life in pregnant women with asthma', Journal of Asthma, 48 1032-1040 (2011) [C1]
DOI 10.3109/02770903.2011.631239
Citations Scopus - 35Web of Science - 36
Co-authors Michael Hensley, Vanessa Murphy
2011 Vertigan AE, Gibson PG, 'Chronic refractory cough as a sensory neuropathy: Evidence from a reinterpretation of cough triggers', Journal of Voice, 25 596-601 (2011) [C1]
DOI 10.1016/j.jvoice.2010.07.009
Citations Scopus - 71Web of Science - 62
2011 Wang F, He XY, Baines KJ, Gunawardhana LP, Simpson JL, Li F, Gibson PG, 'Different inflammatory phenotypes in adults and children with acute asthma', European Respiratory Journal, 38 567-574 (2011) [C1]
DOI 10.1183/09031936.00170110
Citations Scopus - 58Web of Science - 55
Co-authors Jodie Simpson, Katherine Baines
2011 Wang F, Gibson PG, 'Respiratory Chlamydophyla pneumoniae resides primarily in the lower airway', European Respiratory Journal, 38 995 (2011) [C3]
DOI 10.1183/09031936.00076011
2011 Scott HA, Gibson PG, Garg ML, Wood LG, 'Airway inflammation is augmented by obesity and fatty acids in asthma', European Respiratory Journal, 38 594-602 (2011) [C1]
DOI 10.1183/09031936.00139810
Citations Scopus - 139Web of Science - 129
Co-authors Lisa Wood, Manohar Garg, Hayley Scott
2011 Wood LG, Simpson JL, Wark PA, Powell H, Gibson PG, 'Characterization of innate immune signalling receptors in virus-induced acute asthma', Clinical and Experimental Allergy, 41 640-648 (2011) [C1]
DOI 10.1111/j.1365-2222.2010.03669.x
Citations Scopus - 25Web of Science - 23
Co-authors Lisa Wood, Peter Wark, Jodie Simpson
2011 Preston JA, Thorburn AN, Starkey MR, Beckett EL, Horvat JC, Wade MA, et al., 'Streptococcus pneumoniae infection suppresses allergic airways disease by inducing regulatory T-cells', European Respiratory Journal, 37 53-64 (2011) [C1]
DOI 10.1183/09031936.00049510
Citations Scopus - 55Web of Science - 49
Co-authors Paul Foster, Jay Horvat, Philip Hansbro, Malcolm Starkey, Emma Beckett
2011 Verrills NM, Irwin JA, He XY, Wood LG, Powell H, Simpson JL, et al., 'Identification of novel diagnostic biomarkers for asthma and chronic obstructive pulmonary disease', American Journal of Respiratory and Critical Care Medicine, 183 1633-1643 (2011) [C1]
DOI 10.1164/rccm.201010-1623OC
Citations Scopus - 66Web of Science - 62
Co-authors Jodie Simpson, Alistair Sim, Nikki Verrills, Lisa Wood, Jennifer Irwin, Vanessa Mcdonald
2011 Hodyl NA, Stark MJ, Osei-Kumah A, Bowman M, Gibson PG, Clifton VL, 'Fetal glucocorticoid-regulated pathways are not affected by inhaled corticosteroid use for asthma during pregnancy', American Journal of Respiratory and Critical Care Medicine, 183 716-722 (2011) [C1]
DOI 10.1164/rccm.201007-1188oc
Citations Scopus - 29Web of Science - 24
Co-authors Maria Bowman
2011 Wood LG, Powell H, Grissell TV, Davies BL, Shafren DR, Whitehead BF, et al., 'Persistence of rhinovirus RNA and IP-10 gene expression after acute asthma', Respirology, 16 291-299 (2011) [C1]
DOI 10.1111/j.1440-1843.2010.01897.x
Citations Scopus - 14Web of Science - 13
Co-authors Michael Hensley, Lisa Wood
2011 McDonald VM, Vertigan AE, Gibson PG, 'How to set up a severe asthma service', Respirology, 16 900-911 (2011) [C1]
DOI 10.1111/j.1440-1843.2011.02012.x
Citations Scopus - 21Web of Science - 19
Co-authors Vanessa Mcdonald
2011 Thomas R, Ferguson JK, Coombs G, Gibson PG, 'Community-acquired methicillin-resistant Staphylococcus aureus pneumonia: A clinical audit', Respirology, 16 926-931 (2011) [C1]
Citations Scopus - 13Web of Science - 17
Co-authors John Ferguson
2011 Vertigan AE, Gibson PG, 'Urge to cough and its application to the behavioural treatment of cough', Bratislavske Lekarske Listy, 112 102-108 (2011) [C1]
Citations Scopus - 4Web of Science - 4
2011 Gibson PG, Ryan NM, 'Cough pharmacotherapy: Current and future status', Expert Opinion on Pharmacotherapy, 12 1745-1755 (2011) [C1]
Citations Scopus - 21Web of Science - 18
Co-authors Nicole Ryan
2011 Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia JR, Gibson PG, 'A meta-analysis of adverse perinatal outcomes in women with asthma', BJOG: An International Journal of Obstetrics and Gynaecology, 118 1314-1323 (2011) [C1]
DOI 10.1111/j.1471-0528.2011.03055.x
Citations Scopus - 150Web of Science - 140
Co-authors John Attia, Vanessa Murphy
2010 Ryan NM, Vertigan AE, Bone S, Gibson PG, 'Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough', Cough, 6 1-8 (2010) [C1]
Citations Scopus - 50
Co-authors Nicole Ryan
2010 Wood LG, Gibson PG, 'Reduced circulating antioxidant defences are associated with airway hyper-responsiveness, poor control and severe disease pattern in asthma', British Journal of Nutrition, 103 735-741 (2010) [C1]
DOI 10.1017/s0007114509992376
Citations Scopus - 19Web of Science - 19
Co-authors Lisa Wood
2010 Barnes PJ, Dweik RA, Gelb AF, Gibson PG, George SC, Grasemann H, et al., 'Exhaled nitric oxide in pulmonary diseases: A comprehensive review', Chest, 138 682-692 (2010) [C1]
DOI 10.1378/chest.09-2090
Citations Scopus - 258Web of Science - 241
2010 Horvat JC, Starkey MR, Kim RY, Beagley KW, Preston JA, Gibson PG, et al., 'Chlamydial respiratory infection during allergen sensitization drives neutrophilic allergic airways disease', Journal of Immunology, 184 4159-4169 (2010) [C1]
DOI 10.4049/jimmunol.0902287
Citations Scopus - 60Web of Science - 54
Co-authors Paul Foster, Philip Hansbro, Malcolm Starkey, Jay Horvat
2010 Li J, Wang W, Baines KJ, Bowden NA, Hansbro PM, Gibson PG, et al., 'IL-27/IFN-y induce MyD88-dependent steroid-resistant airway hyperresponsiveness by inhibiting glucocorticoid signaling in macrophages', Journal of Immunology, 185 4401-4409 (2010) [C1]
DOI 10.4049/jimmunol.1001039
Citations Scopus - 71Web of Science - 65
Co-authors Nikola Bowden, Katherine Baines, Philip Hansbro, Ming Yang, Paul Foster
2010 Gibson PG, Chang AB, Glasgow NJ, Holmes PW, Katelaris P, Kemp AS, et al., 'CICADA: Cough in children and adults: Diagnosis and assessment. Australian Cough Guidelines summary statement', Medical Journal of Australia, 192 265-271 (2010) [C2]
Citations Scopus - 81Web of Science - 67
2010 Gibson PG, Chang AB, Kemp AS, 'CICADA: Cough in Children and Adults: Diagnosis and Assessment. Australian Cough Guidelines summary statement REPLY', Medical Journal of Australia, 192 672 (2010) [C3]
Citations Scopus - 2Web of Science - 1
2010 Thorburn AN, O'Sullivan BJ, Thomas R, Kumar RK, Foster PS, Gibson PG, Hansbro PM, 'Pneumococcal conjugate vaccine-induced regulatory T cells suppress the development of allergic airways disease', Thorax, 65 1053-1060 (2010) [C1]
DOI 10.1136/thx.2009.131508
Citations Scopus - 44Web of Science - 43
Co-authors Paul Foster, Philip Hansbro
2010 Murphy VE, Clifton VL, Gibson PG, 'The effect of cigarette smoking on asthma control during exacerbations in pregnant women', Thorax, 65 739-744 (2010) [C1]
DOI 10.1136/thx.2009.124941
Citations Scopus - 50Web of Science - 43
Co-authors Vanessa Murphy
2010 Hodyl NA, Wyper HJ, Osei-Kumah A, Scott NM, Murphy VE, Gibson PG, et al., 'Sex-specific associations between cortisol and birth weight in pregnancies complicated by asthma are not due to differential glucocorticoid receptor expression', Thorax, 65 677-683 (2010) [C1]
DOI 10.1136/thx.2009.123091
Citations Scopus - 27Web of Science - 25
Co-authors Roger Smith, Vanessa Murphy
2010 Horvat JC, Starkey MR, Kim RY, Phipps S, Gibson PG, Beagley KW, et al., 'Early-life chlamydial lung infection enhances allergic airways disease through age-dependent differences in immunopathology', Journal of Allergy and Clinical Immunology, 125 617-625 (2010) [C1]
DOI 10.1016/j.jaci.2009.10.018
Co-authors Jay Horvat, Philip Hansbro, Malcolm Starkey, Paul Foster
2010 Gibson PG, McDonald VM, Marks GB, 'Asthma in older adults', The Lancet, 376 803-813 (2010) [C1]
DOI 10.1016/S0140-6736(10)61087-2
Citations Scopus - 233Web of Science - 215
Co-authors Vanessa Mcdonald
2010 Thorburn A, Foster P, Gibson P, Hansbro P, 'Induction of regulatory T cells by a novel immunoregulatory therapy suppresses the development of allergic airways disease', JOURNAL OF IMMUNOLOGY, 184 (2010)
Co-authors Paul Foster, Philip Hansbro
2010 Baines KJ, Simpson JL, Bowden NA, Scott R, Gibson PG, 'Differential gene expression and cytokine production from neutrophils in asthma phenotypes', European Respiratory Journal, 35 522-531 (2010) [C1]
DOI 10.1183/09031936.00027409
Citations Scopus - 59Web of Science - 53
Co-authors Katherine Baines, Jodie Simpson, Rodney Scott, Nikola Bowden
2010 Wood LG, Attia JR, McElduff P, McEvoy MA, Gibson PG, 'Assessment of dietary fat intake and innate immune activation as risk factors for impaired lung function', European Journal of Clinical Nutrition, 64 818-825 (2010) [C1]
DOI 10.1038/ejcn.2010.68
Citations Scopus - 11Web of Science - 11
Co-authors Lisa Wood, John Attia, Patrick Mcelduff, Mark Mcevoy
2010 Reddel HK, Gibson PG, Peters MJ, Wark PA, Sand IB, Hoyos CM, Jenkins CR, 'Down-titration from high-dose combination therapy in asthma: Removal of long-acting b2-agonist', Respiratory Medicine, 104 1110-1120 (2010) [C1]
DOI 10.1016/j.rmed.2010.04.003
Citations Scopus - 50Web of Science - 43
Co-authors Peter Wark
2010 Wood LG, Simpson JL, Hansbro PM, Gibson PG, 'Potentially pathogenic bacteria cultured from the sputum of stable asthmatics are associated with increased 8-isoprostane and airway neutrophilia', Free Radical Research, 44 146-154 (2010) [C1]
DOI 10.3109/10715760903362576
Citations Scopus - 60Web of Science - 52
Co-authors Philip Hansbro, Jodie Simpson, Lisa Wood
2010 Wood LG, Powell HG, Gibson PG, 'Mannitol challenge for assessment of airway responsiveness, airway inflammation and inflammatory phenotype in asthma', Clinical & Experimental Allergy, 40 232-241 (2010) [C1]
DOI 10.1111/j.1365-2222.2009.03371.x
Citations Scopus - 29Web of Science - 32
Co-authors Lisa Wood
2009 Walters JAE, Gibson PG, Wood-Baker R, Hannay M, Walters EH, 'Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease', Cochrane Database of Systematic Reviews, - CD001288 (2009) [C1]
DOI 10.1002/14651858.cd001288.pub3
Citations Scopus - 113Web of Science - 226
2009 Thorburn AN, Hansbro PM, Gibson PG, 'Pneumococcal vaccines for allergic airways diseases', Expert Opinion on Biological Therapy, 9 621-629 (2009) [C1]
DOI 10.1517/14712590902916999
Citations Scopus - 16Web of Science - 14
Co-authors Philip Hansbro
2009 Baines KJ, Wood LG, Gibson PG, 'The nutrigenomics of asthma: Molecular mechanisms of airway neutrophilia following dietary antioxidant withdrawal', OMICS: A Journal of Integrative Biology, 13 355-365 (2009) [C1]
DOI 10.1089/omi.2009.0042
Citations Scopus - 19Web of Science - 18
Co-authors Katherine Baines, Lisa Wood
2009 Ryan NM, Vertigan AE, Gibson PG, 'Chronic cough and laryngeal dysfunction improve with specific treatment of cough and paradoxical vocal fold movement', Cough, 5 1-8 (2009) [C1]
DOI 10.1186/1745-9974-5-4
Citations Scopus - 31
Co-authors Nicole Ryan
2009 Gibson PG, Simpson JL, 'The overlap syndrome of asthma and COPD: What are its features and how important is it?', Thorax, 64 728-735 (2009) [C1]
DOI 10.1136/thx.2008.108027
Citations Scopus - 386Web of Science - 343
Co-authors Jodie Simpson
2009 Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M, 'Interventions for educating children who are at risk of asthma-related emergency department attendance', Cochrane Database of Systematic Reviews, - CD001290 (2009) [C1]
DOI 10.1002/14651858.cd001290.pub2
Citations Scopus - 116Web of Science - 68
2009 Gibson PG, 'Inflammatory phenotypes in adult asthma: clinical applications', CLINICAL RESPIRATORY JOURNAL, 3 198-206 (2009) [C3]
DOI 10.1111/j.1752-699X.2009.00162.x
Citations Scopus - 71Web of Science - 63
2009 Krishnan JA, Davis SQ, Naureckas ET, Gibson PG, Rowe BH, 'An umbrella review: Corticosteroid therapy for adults with acute asthma', American Journal of Medicine, 122 977-991 (2009) [C1]
DOI 10.1016/j.amjmed.2009.02.013
Citations Scopus - 38Web of Science - 30
2009 Clifton VL, Engel PJ, Smith R, Gibson PG, Brinsmead MW, Giles WB, 'Maternal and neonatal outcomes of pregnancies complicated by asthma in an Australian population', Australian and New Zealand Journal of Obstetrics and Gynaecology, 49 619-626 (2009) [C1]
DOI 10.1111/j.1479-828x.2009.01077.x
Citations Scopus - 43Web of Science - 41
Co-authors Roger Smith
2009 Saedi Some Olia A, Wood LG, Garg ML, Gibson PG, Wark PA, 'Anti-inflammatory effects of long-chain n-3 PUFA in rhinovirus-infected cultured airway epithelial cells', British Journal of Nutrition, 101 533-540 (2009) [C1]
DOI 10.1017/s0007114508025798
Citations Scopus - 17Web of Science - 351
Co-authors Manohar Garg, Lisa Wood, Peter Wark
2009 Ryan NM, Gibson PG, 'Characterization of laryngeal dysfunction in chronic persistent cough', Laryngoscope, 119 640-645 (2009) [C1]
DOI 10.1002/lary.20114
Citations Scopus - 25Web of Science - 20
Co-authors Nicole Ryan
2009 Marks GB, Poulos LM, Jenkins CR, Gibson PG, 'Asthma in older adults: A holistic, person-centred and problem-oriented approach', Medical Journal of Australia, 191 197-199 (2009) [C3]
Citations Scopus - 9Web of Science - 9
2009 Simpson JL, McElduff P, Gibson PG, 'Assessment and reproducibility of non-eosinophilic asthma using induced sputum', Respiration, 79 147-151 (2009) [C1]
DOI 10.1159/000245899
Citations Scopus - 56Web of Science - 53
Co-authors Jodie Simpson, Patrick Mcelduff
2009 Gibson PG, 'Tackling asthma phenotypes in community studies', Thorax, 64 369-370 (2009) [C3]
DOI 10.1136/thx.2008.109710
Citations Scopus - 8Web of Science - 8
2009 Wood LG, Gibson PG, 'Dietary factors lead to innate immune activation in asthma', Pharmacology and Therapeutics, 123 37-53 (2009) [C1]
DOI 10.1016/j.pharmthera.2009.03.015
Citations Scopus - 50Web of Science - 48
Co-authors Lisa Wood
2009 Simpson JL, Phipps S, Gibson PG, 'Inflammatory mechanisms and treatment of obstructive airway diseases with neutrophilic bronchitis', Pharmacology and Therapeutics, 124 86-95 (2009) [C1]
DOI 10.1016/j.pharmthera.2009.06.004
Citations Scopus - 54Web of Science - 52
Co-authors Jodie Simpson
2009 Wood LG, Scott HA, Garg ML, Gibson PG, 'Innate immune mechanisms linking non-esterified fatty acids and respiratory disease', Progress in Lipid Research, 48 27-43 (2009) [C1]
DOI 10.1016/j.plipres.2008.10.001
Citations Scopus - 35Web of Science - 34
Co-authors Manohar Garg, Lisa Wood, Hayley Scott
2009 Baines KJ, Simpson JL, Scott R, Gibson PG, 'Immune responses of airway neutrophils are impaired in asthma', Experimental Lung Research, 35 554-569 (2009) [C1]
DOI 10.1080/01902140902777490
Citations Scopus - 25Web of Science - 24
Co-authors Katherine Baines, Jodie Simpson, Rodney Scott
2009 Simpson JL, Baines KJ, Boyle MJ, Scott R, Gibson PG, 'Oncostatin M (OSM) is increased in asthma with incompletely reversible airflow obstruction', Experimental Lung Research, 35 781-794 (2009) [C1]
DOI 10.3109/01902140902906412
Citations Scopus - 25Web of Science - 28
Co-authors Rodney Scott, Katherine Baines, Jodie Simpson
2009 Simpson JL, Milne DG, Gibson PG, 'Neutrophilic asthma has different radiographic features to COPD and smokers', Respiratory Medicine, 103 881-887 (2009) [C1]
DOI 10.1016/j.rmed.2008.12.013
Citations Scopus - 23Web of Science - 21
Co-authors Jodie Simpson
2009 Gibson PG, 'Using fractional exhaled nitric oxide to guide asthma therapy: Design and methodological issues for ASthma TReatment ALgorithm studies', Clinical and Experimental Allergy, 39 478-490 (2009) [C1]
DOI 10.1111/j.1365-2222.2009.03226.x
Citations Scopus - 80Web of Science - 75
2009 Saedi Some Olia A, Wood LG, Garg ML, Gibson PG, Wark PA, 'Lycopene enrichment of cultured airway epithelial cells decreases the inflammation induced by rhinovirus infection and lipopolysaccharide', Journal of Nutritional Biochemistry, 20 577-585 (2009) [C1]
DOI 10.1016/j.jnutbio.2008.06.001
Citations Scopus - 36Web of Science - 32
Co-authors Manohar Garg, Peter Wark, Lisa Wood
2009 Reddel HK, Taylor DR, Bateman ED, Boulet L-P, Boushey HA, Busse WW, et al., 'An official American Thoracic Society/European Respiratory Society Statement: Asthma control and exacerbations standardising endpoints for clinical asthma trials and clinical practice', American Journal of Respiratory and Critical Care Medicine, 180 59-99 (2009) [C1]
DOI 10.1164/rccm.200801-060st
Citations Scopus - 1029Web of Science - 962
2009 Vandemheen KL, O'Connor A, Bell SC, Freitag A, Bye P, Jeanneret A, et al., 'Randomized trial of a decision aid for patients with cystic fibrosis considering lung transplantation', American Journal of Respiratory and Critical Care Medicine, 180 761-768 (2009) [C1]
DOI 10.1164/rccm.200903-0421oc
Citations Scopus - 40Web of Science - 39
2009 Gibson PG, Vertigan AE, 'Speech pathology for chronic cough: A new approach', Pulmonary Pharmacology & Therapeutics, 22 159-162 (2009) [C1]
DOI 10.1016/j.pupt.2008.11.005
Citations Scopus - 36Web of Science - 31
2009 Widdicombe J, Fontana G, Gibson PG, 'Workshop - Cough: Exercise, speech and music', Pulmonary Pharmacology & Therapeutics, 22 143-147 (2009) [C3]
DOI 10.1016/j.pupt.2008.12.009
Citations Scopus - 11Web of Science - 9
2009 Walters JA, Gibson PG, Wood-Baker R, Hannay M, Walters EH, 'Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease.', Cochrane database of systematic reviews (Online), (2009)

BACKGROUND: COPD is a common condition, mainly related to smoking. Acute exacerbations of COPD, usually related to superimposed infection, occur commonly and systemic corticostero... [more]

BACKGROUND: COPD is a common condition, mainly related to smoking. Acute exacerbations of COPD, usually related to superimposed infection, occur commonly and systemic corticosteroids are widely used in their management in combination with other treatments including antibiotics, oxygen supplementation and bronchodilators. OBJECTIVES: To determine the efficacy of corticosteroids, administered either parenterally or orally, on the outcomes of acute exacerbations of COPD. SEARCH STRATEGY: Searches were carried out using the Cochrane Airways Group COPD RCT register with additional studies sought in the bibliographies of randomised controlled trials and review articles. Authors of identified randomised controlled trials were contacted for other published and unpublished studies. The last search was carried out in August 2008. SELECTION CRITERIA: Randomised controlled trials comparing corticosteroids, administered either parenterally or orally, with appropriate placebo control. Other interventions e.g. bronchodilators and antibiotics were standardised. Clinical studies of acute asthma were excluded. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. Data measured but not reported were sought from authors of included studies. Trials were combined using Review Manager for analyses. MAIN RESULTS: Eleven studies (n=1081) fulfilled the inclusion criteria and 10 studies contributed data for analyses (n=1051). There were significantly fewer treatment failures within thirty days in patients given corticosteroid treatment, Odds Ratio (OR) 0.50; 95% confidence interval (CI) 0.36 to 0.69 and Hazard Ratio 0.78; 95% CI 0.63 to 0.97. It would have been necessary to treat 10 patients (95%CI 7 to 16) with corticosteroids to avoid one treatment failure in this time period. Duration of hospitalisation was significantly shorter with corticosteroid treatment, mean difference -1.22 days; 95% CI -2.26 to -0.18. For FEV1 there were significant treatment benefits with mean differences at the early time point (to 72 hours), 140 ml; 95% CI 90 to 190 ml and at end of treatment (up to 15 days) 80 ml; 95% confidence interval 10 to 160. There was a significant improvement in breathlessness and blood gases at both time points. There was no significant effect on mortality but an increased likelihood of an adverse event associated with corticosteroid treatment, OR 2.33; 95% CI 1.60 to 3.40. Overall one extra adverse effect occurred for every 5 people treated (95% CI 4 to 9). The risk of hyperglycaemia was significantly increased, OR 4.95; 95% CI 2.47 to 9.91. AUTHORS' CONCLUSIONS: Treatment of an exacerbation of COPD with oral or parenteral corticosteroids significantly reduces treatment failure and the need for additional medical treatment and shortens hospital stay. It increases the rate of improvement in lung function and dyspnoea and the improvement continues during treatment, but there is a significantly increase in the risk of an adverse drug event occurring. The optimal dose and length of treatment regime needs to be better defined.

Citations Scopus - 28
2009 Boyd M, Lasserson TJ, McKean MC, Gibson PG, Ducharme FM, Haby M, 'Interventions for educating children who are at risk of asthma-related emergency department attendance.', Cochrane database of systematic reviews (Online), (2009)

BACKGROUND: Asthma is the most common chronic childhood illness and is a leading cause for paediatric admission to hospital. Asthma management for children results in substantial ... [more]

BACKGROUND: Asthma is the most common chronic childhood illness and is a leading cause for paediatric admission to hospital. Asthma management for children results in substantial costs. There is evidence to suggest that hospital admissions could be reduced with effective education for parents and children about asthma and its management. OBJECTIVES: To conduct a systematic review of the literature and update the previous review as to whether asthma education leads to improved health outcomes in children who have attended the emergency room for asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group Trials Register, including the MEDLINE, EMBASE and CINAHL databases, and reference lists of trials and review articles (last search May 2008). SELECTION CRITERIA: We included randomised controlled trials of asthma education for children who had attended the emergency department for asthma, with or without hospitalisation, within the previous 12 months. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We pooled dichotomous data with a fixed-effect risk ratio. We used a random-effects risk ratio for sensitivity analysis of heterogenous data. MAIN RESULTS: A total of 38 studies involving 7843 children were included. Following educational intervention delivered to children, their parents or both, there was a significantly reduced risk of subsequent emergency department visits (RR 0.73, 95% CI 0.65 to 0.81, N = 3008) and hospital admissions (RR 0.79, 95% CI 0.69 to 0.92, N = 4019) compared with control. There were also fewer unscheduled doctor visits (RR 0.68, 95% CI 0.57 to 0.81, N = 1009). Very few data were available for other outcomes (FEV1, PEF, rescue medication use, quality of life or symptoms) and there was no statistically significant difference between education and control. AUTHORS' CONCLUSIONS: Asthma education aimed at children and their carers who present to the emergency department for acute exacerbations can result in lower risk of future emergency department presentation and hospital admission. There remains uncertainty as to the long-term effect of education on other markers of asthma morbidity such as quality of life, symptoms and lung function. It remains unclear as to what type, duration and intensity of educational packages are the most effective in reducing acute care utilisation.

Citations Scopus - 47
2009 Wark PA, Grissell TV, Davies BL, See HV, Gibson PG, 'Diversity in the bronchial epithelial cell response to infection with different rhinovirus strains', Respirology, 14 180-186 (2009) [C1]
DOI 10.1111/j.1440-1843.2009.01480.x
Citations Scopus - 59Web of Science - 57
Co-authors Peter Wark
2008 Saedi Some Olia A, Wood LG, Garg ML, Gibson PG, Wark PA, 'Supplementation of long chain N-3 polyunsaturated fatty acids increases the utilization of lycopene in cultured airway epithelial cells', Journal of Food Lipids, 15 421-432 (2008) [C1]
DOI 10.1111/j.1745-4522.2008.00130.x
Citations Scopus - 10Web of Science - 8
Co-authors Peter Wark, Manohar Garg, Lisa Wood
2008 Wood LG, Garg ML, Powell H, Gibson PG, 'Lycopene-rich treatments modify noneosinophilic airway inflammation in asthma: Proof of concept', Free Radical Research, 42 94-102 (2008) [C1]
DOI 10.1080/10715760701767307
Citations Scopus - 65Web of Science - 56
Co-authors Lisa Wood, Manohar Garg
2008 Simpson JL, Powell H, Boyle MJ, Scott R, Gibson PG, 'Clarithromycin targets neutrophilic airway inflammation in refractory asthma', American Journal of Respiratory and Critical Care Medicine, 177 148-155 (2008) [C1]
DOI 10.1164/rccm.200707-1134oc
Citations Scopus - 336Web of Science - 294
Co-authors Rodney Scott, Jodie Simpson
2008 Wlodarczyk JH, Gibson PG, Caeser M, 'Impact of inhaled corticosteroids on cortisol suppression in adults with asthma: A quantitative review', Annals of Allergy, Asthma and Immunology, 100 23-30 (2008) [C1]
DOI 10.1016/S1081-1206(10)60400-0
Citations Scopus - 22Web of Science - 19
2008 Murphy VE, Gibson PG, 'Premenstrual asthma: Prevalence, cycle-to-cycle variability and relationship to oral contraceptive use and menstrual symptoms', Journal of Asthma, 45 696-704 (2008) [C1]
DOI 10.1080/02770900802207279
Citations Scopus - 26Web of Science - 25
Co-authors Vanessa Murphy
2008 McDonald VM, Gibson PG, 'Asthma mortality and management in older Australians: Time for a new approach?', Australasian Journal on Ageing, 27 215 (2008) [C3]
DOI 10.1111/j.1741-6612.2008.00322.x
Citations Scopus - 6Web of Science - 4
Co-authors Vanessa Mcdonald
2008 Manning P, Gibson PG, Lasserson TJ, 'Ciclesonide versus other inhaled steroids for chronic asthma in children and adults', Cochrane Database of Systematic Reviews, CD007031 (2008) [C1]
DOI 10.1002/14651858.cd007031
Citations Scopus - 30Web of Science - 18
2008 Manning P, Gibson PG, Lasserson TJ, 'Ciclesonide versus placebo for chronic asthma in adults and children', Cochrane Database of Systematic Reviews, CD006217 (2008) [C1]
DOI 10.1002/14651858.cd006217.pub2
Citations Scopus - 10Web of Science - 11
2008 Ryan NM, Gibson PG, 'Extrathoracic airway hyperresponsiveness as a mechanism of post infectious cough: Case report', Cough, 4 1-4 (2008) [C3]
DOI 10.1186/1745-9974-4-7
Citations Scopus - 11
Co-authors Nicole Ryan
2008 Vertigan AE, Gibson PG, Theodoros DG, Winkworth AL, 'The role of sensory dysfunction in the development of voice disorders, chronic cough and paradoxical vocal fold movement', International Journal of Speech-Language Pathology, 10 231-244 (2008) [C1]
DOI 10.1080/17549500801932089
Citations Scopus - 12Web of Science - 10
2008 Powell H, Smart JM, Wood LG, Grissell TV, Shafren DR, Hensley MJ, Gibson PG, 'Validity of the common cold questionnaire (CCQ) in asthma exacerbations', PLoS ONE, 3 e1802 (2008) [C1]
DOI 10.1371/journal.pone.0001802
Co-authors Lisa Wood, Michael Hensley
2008 Marchant JM, Gibson PG, Grissell TV, Timmins NL, Masters IB, Chang AB, 'Prospective assessment of protracted bacterial bronchitis: Airway inflammation and innate immune activation', Pediatric Pulmonology, 43 1092-1099 (2008) [C1]
DOI 10.1002/ppul.20906
Citations Scopus - 62Web of Science - 50
2008 Taylor DR, Bateman ED, Boulet LP, Boushey HA, Busse WW, Casale TB, et al., 'A new perspective on concepts of asthma severity and control', European Respiratory Journal, 32 545-554 (2008) [C1]
DOI 10.1183/09031936.00155307
Citations Scopus - 280Web of Science - 258
2008 Gibson PG, 'A light at the end of the tunnel of inflammation in obstructive airway diseases?', Chest, 134 475-476 (2008) [C3]
DOI 10.1378/chest.08-1478
Citations Scopus - 3Web of Science - 3
2008 Manning P, Gibson PG, Lasserson TJ, 'Ciclesonide versus other inhaled steroids for chronic asthma in children and adults.', Cochrane database of systematic reviews (Online), (2008)

BACKGROUND: Inhaled corticosteroids (ICS) are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer both sig... [more]

BACKGROUND: Inhaled corticosteroids (ICS) are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer both significant benefit in terms of symptom management and improvement in lung function, but may also cause harm in terms of local and systemic side-effects. Ciclesonide is a novel steroid that is metabolised to its active component in the lung, making it a potentially useful for reducing local side effects. OBJECTIVES: To assess the efficacy and adverse effects of ciclesonide relative to those of other inhaled corticosteroids in the management of chronic asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group register of trials with pre-defined terms. Additional searches of PubMed and Clinicalstudyresults.org were undertaken. The literature searches for this review are current up to June 2007. SELECTION CRITERIA: Randomised parallel or crossover studies were eligible for the review. We included studies comparing ciclesonide with other steroids both at nominally equivalent dose or lower doses of ciclesonide. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. MAIN RESULTS: Twenty one trials involving 7243 participants were included. Equal daily doses of ciclesonide and beclomethasone (BDP) or budesonide (BUD) gave similar results for peak expiratory flow rates (PEF), although forced vital capacity (FVC) was higher with ciclesonide. Data on forced expired volume in one second (FEV1) were inconsistent. Withdrawal data and symptoms were similar between treatments. Compared with the same dose of fluticasone (FP), data on lung function parameters (FEV1, FVC and PEF) did not differ significantly. Paediatric quality of life score favoured ciclesonide. Candidiasis was less frequent with ciclesonide, although other side-effect outcomes did not give significant differences in favour of either treatment. When lower doses of ciclesonide were compared to BDP or BUD, the difference in FEV1 did not reach significance but we cannot exclude a significant effect in favour of BDP/BUD. Other lung function outcomes did not give significant differences between treatments. Paediatric quality of life scores did not differ between treatments. Adverse events occurred with similar frequency between ciclesonide and BDP/BUD. Comparison with FP at half the nominal dose was undertaken in three studies, which indicated that FEV1 was not significantly different, but was not equivalent between the treatments (per protocol: -0.05 L 95% confidence intervals -0.11 to 0.01). AUTHORS' CONCLUSIONS: The results of this review give some support to ciclesonide as an equivalent therapy to other ICS at similar nominal doses. The studies assessed low doses of steroids, in patients whose asthma required treatment with low doses of steroids. At half the dose of FP and BDP/BUD, the effects of ciclesonide were more inconsistent The effect on candidiasis may be of importance to people who find this to be problematic. The role of ciclesonide in the management of asthma requires further study, especially in paediatric patients. Further assessment against FP at a dose ratio of 1:2 is a priority.

Citations Scopus - 9
2008 Manning P, Gibson PG, Lasserson TJ, 'Ciclesonide versus placebo for chronic asthma in adults and children.', Cochrane database of systematic reviews (Online), (2008)

BACKGROUND: Inhaled corticosteroids are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer significant be... [more]

BACKGROUND: Inhaled corticosteroids are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer significant benefit in terms of symptom management and improvement in lung function, but may also cause harm in terms of local and systemic side-effects. Ciclesonide is a novel steroid that has efficient distribution and release properties that mean it can be taken once daily, making it potentially useful in ongoing asthma management. OBJECTIVES: To assess the efficacy of inhaled ciclesonide in adults and children with chronic asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group register of trials with pre-defined terms. Additional searches of CENTRAL and PubMed were undertaken. The literature searches for this review are current up to June 2007. SELECTION CRITERIA: Randomised parallel or crossover studies were eligible for the review. We included studies comparing ciclesonide with placebo, and we also included studies comparing ciclesonide at different doses. DATA COLLECTION AND ANALYSIS: Two authors assessed studies for inclusion in the review, extracted data independently and checked each others' work. We contacted study investigators in order to obtain additional data. Extracted data were entered into RevMan 4.2 and analysed as fixed effect mean differences for continuous data, and fixed effect risk ratios for dichotomous data. MAIN RESULTS: Eighteen trials (reporting 20 study comparisons) met the review entry criteria. We report findings from 18 group comparisons where data were available (6343 participants, of whom 1692 were children).Ciclesonide versus placebo: The short duration of the included studies means that there is a lack of data with respect to the impact of ciclesonide on asthma exacerbations. At doses of 100 mcg/d or less up to 400 mcg/d in mild to moderate asthma, ciclesonide improved lung function, asthma symptoms and rescue inhaler use, compared with placebo.Dose response outcomes: Comparisons of 100 versus 200 mcg/d, 100 versus 400 mcg/d and 400 versus 800 mcg/d did not yield significant differences in lung function outcomes.Adverse event data were not available in sufficient detail to permit assessment of the safety profile of this drug. AUTHORS' CONCLUSIONS: Ciclesonide was more effective than placebo, in the short term, in improving lung function in patients with mild to moderate asthma previously treated with inhaled corticosteroids. There remain questions as to dose response, and the lack of data on the longer term impact on exacerbations and safety profile should be addressed in future studies.

Citations Scopus - 5
2008 Pavord ID, Shaw DE, Gibson PG, Taylor DR, 'Inflammometry to assess airway diseases', The Lancet, 372 1017-1019 (2008) [C3]
DOI 10.1016/s0140-6736(08)61421-x
Citations Scopus - 53Web of Science - 54
2008 Wood LG, Garg ML, Blake RJ, Simpson JL, Gibson PG, 'Oxidized vitamin E and glutathione as markers of clinical status in asthma', Clinical Nutrition, 27 579-586 (2008) [C1]
DOI 10.1016/j.clnu.2007.12.002
Citations Scopus - 28Web of Science - 25
Co-authors Lisa Wood, Manohar Garg, Jodie Simpson
2008 Vertigan AE, Theodoros DG, Winkworth AL, Gibson PG, 'A comparison of two approaches to the treatment of chronic cough: Perceptual, acoustic, and electroglottographic outcomes', Journal of Voice, 22 581-589 (2008) [C1]
DOI 10.1016/j.jvoice.2007.01.001
Citations Scopus - 19Web of Science - 16
2008 Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, Fitzgerald M, et al., 'Global strategy for asthma management and prevention: GINA executive summary', European Respiratory Journal, 31 143-178 (2008) [C1]
DOI 10.1183/09031936.00138707
Citations Scopus - 1806Web of Science - 1663
2008 Vertigan AE, Theodoros DG, Winkworth AL, Gibson PG, 'Acoustic and electroglottographic voice characteristics in chronic cough and paradoxical vocal fold movement', Folia Phoniatrica et Logopaedica, 60 210-216 (2008) [C1]
DOI 10.1159/000136902
Citations Scopus - 10Web of Science - 11
2007 Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL, 'Voice and Upper Airway Symptoms in People With Chronic Cough and Paradoxical Vocal Fold Movement', Journal of Voice, 21 361-383 (2007) [C1]
DOI 10.1016/j.jvoice.2005.12.008
Citations Scopus - 41Web of Science - 32
2007 Chang AB, Gibson PG, Ardill J, McGarvey LPA, 'Calcitonin gene-related peptide relates to cough sensitivity in children with chronic cough', European Respiratory Journal, 30 66-72 (2007) [C1]
DOI 10.1183/09031936.00150006
Citations Scopus - 26Web of Science - 22
2007 Lovett CJ, Whitehead BF, Gibson PG, 'Eosinophilic airway inflammation and the prognosis of childhood asthma', Clinical and Experimental Allergy, 37 1594-1601 (2007) [C1]
DOI 10.1111/j.1365-2222.2007.02839.x
Citations Scopus - 24Web of Science - 20
2007 Vertigan AE, Theodoros DG, Winkworth AL, Gibson PG, 'Perceptual voice characteristics in chronic cough and paradoxical vocal fold movement', Folia Phoniatrica et Logopaedica, 59 256-267 (2007) [C1]
DOI 10.1159/000104464
Citations Scopus - 25Web of Science - 21
2007 Vertigan AE, Theodoros DG, Winkworth AL, Gibson PG, 'Chronic cough: A tutorial for speech-language pathologists', Journal of Medical Speech-Language Pathology, 15 189-206 (2007) [C1]
Citations Scopus - 17Web of Science - 13
2007 Horvat JC, Beagley KW, Wade MA, Preston JA, Hansbro NG, Hickey DK, et al., 'Neonatal chlamydial infection induces mixed T-cell responses that drive allergic airway disease', American Journal of Respiratory and Critical Care Medicine, 176 556-564 (2007) [C1]
DOI 10.1164/rccm.200607-1005OC
Citations Scopus - 69Web of Science - 71
Co-authors Gerard Kaiko, Paul Foster, Jay Horvat, Philip Hansbro, Nicole Hansbro
2007 Weckmann M, Collison A, Simpson JL, Kopp MV, Wark PA, Smyth MJ, et al., 'Critical link between TRAIL and CCL20 for the activation of T(H)2 cells and the expression of allergic airway disease', Nature Medicine, 13 1308-1315 (2007) [C1]
DOI 10.1038/nm1660
Citations Scopus - 86Web of Science - 85
Co-authors Adam Collison, Paul Foster, Nicole Hansbro, Jodie Simpson, Joerg Mattes, Peter Wark
2007 Gibson PG, Taramarcaz P, McDonald VM, 'Use of omalizumab in a severe asthma clinic', Respirology, 12 S35-S44 (2007) [C1]
DOI 10.1111/j.1440-1843.2007.01047.x
Citations Scopus - 8Web of Science - 7
Co-authors Vanessa Mcdonald
2007 Grissell TV, Chang AB, Gibson PG, 'Reduced toll-like receptor 4 and substance P gene expression is associated with airway bacterial colonization in children', Pediatric Pulmonology, 42 380-385 (2007) [C1]
DOI 10.1002/ppul.20592
Citations Scopus - 29
2007 Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL, 'Behaviour modification therapies for chronic cough', Chronic Respiratory Disease, 4 89-97 (2007) [C1]
DOI 10.1177/1479972307078099
Citations Scopus - 17
2007 Gibson PG, Abramson M, Wood-Baker R, Volmink J, Hensley M, Costabel U, 'Evidence-based Respiratory Medicine', Evidence-based Respiratory Medicine, 1-593 (2007)

First major evidence-based text in adult respiratory medicine. Comprehensive, authoritative summary of the best treatments for the major respiratory diseases. Compiled by speciali... [more]

First major evidence-based text in adult respiratory medicine. Comprehensive, authoritative summary of the best treatments for the major respiratory diseases. Compiled by specialists from the Cochrane Airways Management Group. Easy-to-use format, with key clinical implications summarised in each chapter. Kept up-to-date online: Compiled by specialists from the Cochrane Collaboration Airways Management Group, Evidence-based Respiratory Medicine is the first major evidence-based text in adult respiratory medicine. Providing a comprehensive summary of the best treatments for the most important respiratory diseases, some of the world's leading physicians review the evidence for a broad range of treatments using evidence-based principles. Essential information is presented in an easy-to-understand format, with the most important clinical implications summarised in each chapter. Evidence-based Respiratory Medicine tackles the big clinical questions in diagnosis and treatment, presenting treatment options which take into account the individual patient's needs. Evidence-Based Series:Evidence-based Respiratory Medicine, part of the acclaimed series BMJ Evidence-based medicine textbooks that have revolutionised clinical medicine literature, comes with a fully searchable CD-ROM of the whole text. Note: CD-ROM/DVD and other supplementary materials are not included as part of eBook file. © 2005 by Blackwell Publishing Ltd.

DOI 10.1002/9780470987377
Co-authors Michael Hensley
2007 Vertigan AE, Gibson PG, Theodoros DG, Winkworth AL, 'A review of voice and upper airway function in chronic cough and paradoxical vocal cord movement', Current Opinion in Allergy and Clinical Immunology, 7 37-42 (2007) [C1]
DOI 10.1097/ACI.0b013e328012c587
Citations Scopus - 16Web of Science - 11
2007 Gibson PG, 'Long-Term Oxygen Therapy for Chronic Respiratory Failure in Chronic Obstructive Pulmonary Disease 463-471 (2007)
DOI 10.1002/9780470987377.ch35
Citations Scopus - 1
2007 Gibson PG, Powell H, 'Asthma Education 183-191 (2007)
DOI 10.1002/9780470987377.ch14
2007 Tee AKH, Koh MS, Gibson PG, Lasserson TJ, Wilson AJ, Irving LB, 'Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma', Cochrane Database of Systematic Reviews, (2007)

Background: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent dif... [more]

Background: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. Objectives: To assess the comparative efficacy, safety and side-effects of long-acting beta-2 agonists and theophylline in the maintenance treatment of adults and adolescents with asthma. Search strategy: We searched the Cochrane Airways Group trials register and reference lists of articles. We also contacted authors of identified RCTs for other relevant published and unpublished studies and pharmaceutical manufacturers. Most recent search: November 2006. Selection criteria: All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-2 agonist. Data collection and analysis: In original review, two reviewers independently assessed trial quality and extracted data, similarly in this update two reviewers undertook this. Study authors were contacted for additional information. Main results: Thirteen studies with a total of 1344 participants met the inclusion criteria of the review. They were of varying quality. There was no significant difference between salmeterol and theophylline in FEV1 predicted (6.5%; 95% CI -0.84 to 13.83). However, salmeterol treatment led to significantly better morning PEF (mean difference 16.71 L/min, 95% CI 8.91 to 24.51) and evening PEF (mean difference 15.58 L/min, 95% CI 8.33 to 22.83). Salmeterol also reduced the use of rescue medication. Formoterol, used in two studies was reported to be as effective as theophylline. Bitolterol, used in only one study, was reported to be less effective than theophylline. Participants taking salmeterol experienced fewer adverse events than those using theophylline (Parallel studies: Relative Risk 0.44; 95% CI 0.30 to 0.63, Risk Difference -0.11; 95% CI -0.16 to -0.07, Numbers Needed to Treat (NNT) 9; 95% CI 6 to 14). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.50; 95% CI 0.29 to 0.86, Risk Difference -0.07; 95% CI -0.12 to -0.02, NNT 14; 95% CI 8 to 50) and gastrointestinal adverse events (Relative Risk 0.30; 95% CI 0.17 to 0.55, Risk Difference -0.11; 95% CI -0.16 to -0.06, NNT 9; 95% CI 6 to 16). Authors' conclusions: Long-acting beta-2 agonists, particularly salmeterol, are more effective than theophylline in improving morning and evening PEF, but are not significantly different in their effect on FEV1. There is evidence of decreased daytime and nighttime short-acting beta-2 agonist requirement with salmeterol. Fewer adverse events occurred in participants using long-acting beta-2 agonists (salmeterol and formoterol) as compared to theophylline. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

DOI 10.1002/14651858.CD001281.pub2
Citations Scopus - 23
Co-authors Amanda Wilson
2007 Tee AK, Koh MS, Gibson PG, Lasserson TJ, Wilson AJ, Irving LB, 'Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma.', Cochrane database of systematic reviews (Online), (2007)

BACKGROUND: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent dif... [more]

BACKGROUND: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. OBJECTIVES: To assess the comparative efficacy, safety and side-effects of long-acting beta-2 agonists and theophylline in the maintenance treatment of adults and adolescents with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. We also contacted authors of identified RCTs for other relevant published and unpublished studies and pharmaceutical manufacturers. Most recent search: November 2006. SELECTION CRITERIA: All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-2 agonist. DATA COLLECTION AND ANALYSIS: In original review, two reviewers independently assessed trial quality and extracted data, similarly in this update two reviewers undertook this. Study authors were contacted for additional information. MAIN RESULTS: Thirteen studies with a total of 1344 participants met the inclusion criteria of the review. They were of varying quality. There was no significant difference between salmeterol and theophylline in FEV(1) predicted (6.5%; 95% CI -0.84 to 13.83). However, salmeterol treatment led to significantly better morning PEF (mean difference 16.71 L/min, 95% CI 8.91 to 24.51) and evening PEF (mean difference 15.58 L/min, 95% CI 8.33 to 22.83). Salmeterol also reduced the use of rescue medication. Formoterol, used in two studies was reported to be as effective as theophylline. Bitolterol, used in only one study, was reported to be less effective than theophylline. Participants taking salmeterol experienced fewer adverse events than those using theophylline (Parallel studies: Relative Risk 0.44; 95% CI 0.30 to 0.63, Risk Difference -0.11; 95% CI -0.16 to -0.07, Numbers Needed to Treat (NNT) 9; 95% CI 6 to 14). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.50; 95% CI 0.29 to 0.86, Risk Difference -0.07; 95% CI -0.12 to -0.02, NNT 14; 95% CI 8 to 50) and gastrointestinal adverse events (Relative Risk 0.30; 95% CI 0.17 to 0.55, Risk Difference -0.11; 95% CI -0.16 to -0.06, NNT 9; 95% CI 6 to 16). AUTHORS' CONCLUSIONS: Long-acting beta-2 agonists, particularly salmeterol, are more effective than theophylline in improving morning and evening PEF, but are not significantly different in their effect on FEV1. There is evidence of decreased daytime and nighttime short-acting beta-2 agonist requirement with salmeterol. Fewer adverse events occurred in participants using long-acting beta-2 agonists (salmeterol and formoterol) as compared to theophylline.

Citations Scopus - 9
Co-authors Amanda Wilson
2007 Walters EH, Gibson PG, Lasserson TJ, Walters JAE, 'Long-acting beta2-agonists for chronic asthma in adults and children where background therapy contains varied or no inhaled corticosteroid', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2007)
DOI 10.1002/14651858.CD001385.pub2
Citations Scopus - 23Web of Science - 57
2007 Tee AKH, Koh MS, Gibson PG, Lasserson TJ, Wilson AJ, Irving LB, 'Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2007)
DOI 10.1002/14651858.CD001281.pub2
Citations Scopus - 35Web of Science - 16
Co-authors Amanda Wilson
2007 Grissell TV, Chang AB, Gibson PG, 'Reduced toll-like receptor 4 and substance P gene expression is associated with airway bacterial colonization in children', PEDIATRIC PULMONOLOGY, 42 380-385 (2007)
DOI 10.1002/pput.20592
Citations Web of Science - 27
2007 Walters EH, Gibson PG, Lasserson TJ, Walters JAE, 'Long-acting beta2-agonists for chronic asthma in adults and children where background therapy contains varied or no inhaled corticosteroid', Cochrane Database of Systematic Reviews, (2007)

Background: Asthma is a common respiratory disease among both adults and children and short acting inhaled beta-2 agonists are used widely for &apos;reliever&apos; bronchodilator ... [more]

Background: Asthma is a common respiratory disease among both adults and children and short acting inhaled beta-2 agonists are used widely for 'reliever' bronchodilator therapy. Long acting beta-2 agonists (LABA) were introduced as prospective 'symptom controllers' in addition to inhaled corticosteroid 'preventer' therapy (ICS). In this updated review we have included studies in which patients were either not on ICS as a group, or in which some patients, but not all, were on ICS to complement previous systematic reviews of studies where LABA was given in patients uniformly receiving ICS. We have focussed particularly on serious adverse events, given previous concerns about potential risks, especially of death, from regular beta-2 agonist use. Objectives: This review aimed to determine the benefit or detriment on the primary outcome of asthma control with the regular use of LABA compared with placebo, in mixed populations in which only some were taking ICS and in populations not using ICS therapy. Search strategy: We carried out searches using the Cochrane Airways Group trial register, most recently in October 2005. We searched bibliographies of identified RCTs for additional relevant RCTs and contacted authors of identified RCTs for other published and unpublished studies. Selection criteria: All randomised studies of at least four weeks duration, comparing a LABA given twice daily with a placebo, in chronic asthma. Selection criteria to this updated review have been altered to accommodate recently published Cochrane reviews on combination and addition of LABA to ICS therapy. Studies in which all individuals were uniformly taking ICS were excluded from this review. Data collection and analysis: Two reviewers performed data extraction and study quality assessment independently. We contacted authors of studies for missing data. Main results: Sixty-seven studies (representing 68 experimental comparisons) randomising 42,333 participants met the inclusion criteria. Salmeterol was used as long-acting agent in 50 studies and formoterol fumarate in 17. The treatment period was four to nine weeks in 29 studies, and 12 to 52 weeks in 38 studies. Twenty-four studies did not permit the use of ICS, and forty permitted either inhaled corticosteroid or cromones (in three studies this was unclear). In these studies between 22% and 92% were taking ICS, with a median of 62%. There were significant advantages to LABA treatment compared to placebo for a variety of measurements of airway calibre including morning peak expiratory flow (PEF), evening PEF and FEV1. They were associated with significantly fewer symptoms, less use of rescue medication and higher quality of life scores. This was true whether patients were taking LABA in combination with ICS or not. Findings from SMART (a recently published surveillance study) indicated significant increases in asthma related deaths, respiratory related deaths and combined asthma related deaths and life threatening experiences. The absolute increase in asthma-related mortality was consistent with an increase of around one per 1250 patients treated with LABA for six months, but the confidence intervals are wide (from 700 to 10,000). Post-hoc exploratory subgroups suggested that African-Americans and those not on inhaled corticosteroids were at particular risk for the primary end-point of death or life-threatening asthma event. There was also a suggestion of an increase in exacerbation rate in children. Pharmacologically predicted side effects such as headache, throat irritation, tremor and nervousness were more frequent with LABA treatment. Authors' conclusions: LABA are effective in the control of chronic asthma in the "real-life" subject groups included. However there are potential safety issues which call into question the safety of LABA, particularly in those asthmatics who are not taking ICS, and it is not clear why African-Americans were found to have...

DOI 10.1002/14651858.CD001385.pub2
Citations Scopus - 76
2007 Wood LG, Powell HG, Grissell TV, Nguyen TTD, Shafren D, Hensley MJ, Gibson PG, 'Persistent airway obstruction after virus infection is not associated with airway inflammation', Chest, 131 415-423 (2007) [C1]
DOI 10.1378/chest.06-1062
Citations Scopus - 9Web of Science - 8
Co-authors Michael Hensley, Lisa Wood
2007 Simpson JL, Grissell TV, Douwes J, Scott R, Boyle MJ, Gibson PG, 'Innate immune activation in neutrophilic asthma and bronchiectasis', Thorax, 62 211-218 (2007) [C1]
DOI 10.1136/thx.2006.061358
Citations Scopus - 208Web of Science - 201
Co-authors Rodney Scott, Jodie Simpson
2007 Gibson PG, 'What do non-eosinophilic asthma and airway remodelling tell us about persistent asthma?', Thorax, 62 1034-1036 (2007) [C3]
Citations Scopus - 7Web of Science - 6
2007 Gibson PG, Powell H, Ducharme FM, 'Differential effects of maintenance long-acting beta-agonist and inhaled corticosteroid on asthma control and asthma exacerbations', Journal of Allergy and Clinical Immunology, 119 344-350 (2007) [C1]
DOI 10.1016/j.jaci.2006.10.043
Citations Scopus - 70Web of Science - 66
2007 Gibson PG, Ducharme FM, Cates CJ, 'Reply', Journal of Allergy and Clinical Immunology, 120 726 (2007) [C3]
DOI 10.1016/j.jaci.2007.04.043
2007 Wark PA, Bucchieri F, Johnston SL, Gibson PG, Hamilton L, Mimica J, et al., 'IFN-gamma-induced protein 10 is a novel biomarker of rhinovirus-induced asthma exacerbations', Journal of Allergy and Clinical Immunology, 120 586-593 (2007) [C1]
DOI 10.1016/j.jaci.2007.04.046
Citations Scopus - 117Web of Science - 111
Co-authors John Attia, Peter Wark, Joanna Latter
2007 Yang Z, Yan WX, Cai H, Tedla N, Armishaw C, Di Girolamo N, et al., 'S100A12 provokes mast cell activation: A potential amplification pathway in asthma and innate immunity', Journal of Allergy and Clinical Immunology, 119 106-114 (2007) [C1]
DOI 10.1016/j.jaci.2006.08.021
Citations Scopus - 94Web of Science - 90
Co-authors Jodie Simpson
2007 Gibson PG, Ducharme FM, Cates CJ, 'Benefits of long-acting beta(2)-agonists - Reply', Journal of Allergy and Clinical Immunology, 120 726 (2007) [C3]
2007 Preston JA, Essilfie AT, Horvat JC, Wade MA, Beagley KW, Gibson PG, et al., 'Inhibition of allergic airways disease by immunomodulatory therapy with whole killed Streptococcus pneumoniae', Vaccine, 25 8154-8162 (2007) [C1]
DOI 10.1016/j.vaccine.2007.09.034
Citations Scopus - 43Web of Science - 43
Co-authors Jay Horvat, Philip Hansbro, Paul Foster
2006 Murphy VE, Clifton VL, Gibson PG, 'Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes', Thorax, 61 169-176 (2006) [C1]
DOI 10.1136/thx.2005.049718
Citations Scopus - 197Web of Science - 178
Co-authors Vanessa Murphy
2006 Wark PA, Gibson PG, 'Asthma exacerbations 3: Pathogenesis', Thorax, 61 909-915 (2006) [C1]
DOI 10.1136/thx.2005.045187
Citations Scopus - 89Web of Science - 80
Co-authors Peter Wark
2006 Fitzgerald JM, Gibson PG, 'Asthma exacerbations 4: Prevention', Thorax, 61 992-999 (2006) [C1]
DOI 10.1136/thx.2005.045195
Citations Scopus - 44Web of Science - 33
2006 Vertigan A, Theodoros D, Gibson PG, Winkworth A, 'Efficacy of Speech pathology management for chronic cough: a randomised placebo controllled trial of treatment efficacy', Thorax, 61 1065-1069 (2006) [C1]
DOI 10.1136/thx.2006.064337
Citations Scopus - 118Web of Science - 97
2006 Wood LG, Gibson PG, Garg ML, 'A review of the methodology for assessing in vivo antioxidant capacity', Journal of the Science of Food and Agriculture, 86 2057-2066 (2006) [C1]
DOI 10.1002/jsfa.2604
Citations Scopus - 68Web of Science - 55
Co-authors Manohar Garg, Lisa Wood
2006 Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL, 'The Relationship Between Chronic Cough and Paradoxical Vocal Fold Movement: A Review of the Literature', Journal of Voice, 20 466-480 (2006) [C1]
DOI 10.1016/j.jvoice.2005.08.001
Citations Scopus - 40Web of Science - 31
2006 Simpson JL, Scott R, Boyle MJ, Gibson PG, 'Inflammatory subtypes in asthma: Assessment and identification using induced sputum', Respirology, 11 54-61 (2006) [C1]
DOI 10.1111/j.1440-1843.2006.00784.x
Citations Scopus - 471Web of Science - 445
Co-authors Jodie Simpson, Rodney Scott
2006 Murphy VE, Johnson RF, Wang YC, Akinsanya K, Gibson PG, Smith R, Clifton VL, 'Proteomic study of plasma proteins in pregnant women with asthma', Respirology, 11 41-48 (2006) [C1]
DOI 10.1111/j.1440-1843.2006.00782.x
Citations Scopus - 20Web of Science - 18
Co-authors Roger Smith, Vanessa Murphy
2006 Vm M, Gibson PG, 'Asthma self-management education', Chronic Respiratory Disease, 3 29-37 (2006) [C1]
DOI 10.1191/1479972306cd090ra
Citations Scopus - 36
Co-authors Vanessa Mcdonald
2006 Vertigan AE, Gibson PG, Theodoros DG, Winkworth AL, Borgas T, Reid C, 'Involuntary glottal closure during inspiration in muscle tension dysphonia', Laryngoscope, 116 643-649 (2006) [C1]
DOI 10.1097/01.MLG.0000201906.41316.FC
Citations Scopus - 9Web of Science - 9
2006 Johnston S, Blasi F, Black P, Martin R, Farrell D, Nieman R, et al., 'The effect of telithromycin in acute exacerbations of asthma', The New England Journal of Medicine, 354 1589-1600 (2006) [C1]
DOI 10.1056/NEJMoa044080
2006 Tiong LU, Davies R, Gibson PG, Hensley MJ, Hepworth R, Lasserson TJ, Smith B, 'Lung volume reduction surgery for diffuse emphysema.', Cochrane database of systematic reviews (Online), (2006)

BACKGROUND: Lung volume reduction surgery (LVRS) has been re-introduced for treating patients with severe diffuse emphysema. It is a procedure that aims to improve long-term daily... [more]

BACKGROUND: Lung volume reduction surgery (LVRS) has been re-introduced for treating patients with severe diffuse emphysema. It is a procedure that aims to improve long-term daily functioning, although it is costly and may also be associated with a high risk of mortality. OBJECTIVES: To assemble evidence from randomised controlled trials for the effectiveness of LVRS, and identify optimal surgical techniques. SEARCH STRATEGY: Randomised controlled trials were identified using the Cochrane Airways Group Chronic Obstructive Pulmonary Disease (COPD) register. Searches are current to September 2005. SELECTION CRITERIA: Randomised controlled trials that studied the safety and efficacy of LVRS in patients with diffuse emphysema were included. Studies were excluded if they investigated giant or bullous emphysema. DATA COLLECTION AND ANALYSIS: Two independent review authors assessed trials for inclusion and extracted data. Where possible, data from more than one study were combined using RevMan 4.2 software. MAIN RESULTS: Eight studies (1663 participants) met the entry criteria of the review. One study accounted for 73% of the participants recruited. Study quality was high, although blinding in studies was not possible. Ninety day mortality was significantly greater in all those who underwent LVRS (odds ratio 6.57 (95% CI 3.34 to 12.95), four studies, N = 1415). A subgroup analysis by risk status suggested that there was a subgroup of participants who were consistently at a significant risk of death, although this was only measured in one large study. The ninety day mortality data indicated that death was more likely with LVRS irrespective of risk status identified in one large study. Improvements in lung function, quality of life and exercise capacity were more likely with LVRS than with usual follow-up. AUTHORS' CONCLUSIONS: The evidence summarised in this review is drawn from one large study, and several smaller trials. The findings from the large study indicated that in patients who survive up to three months post-surgery, there were significantly better health status and lung function outcomes in favour of surgery compared with usual medical care. Patients identified post hoc as being of high risk of death from surgery were those with particularly impaired lung function and poor diffusing capacity and/or homogenous emphysema. Further research should address the effect of this intervention on exacerbations and rate of decline in lung function and health status.

Citations Scopus - 41
Co-authors Michael Hensley
2006 Tiong LU, Davies HRHR, Gibson PG, Hensley MJ, Hepworth R, Lasserson TJ, Smith B, 'Lung volume reduction surgery for diffuse emphysema', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2006)
DOI 10.1002/14651858.CD0010001.pub2
Citations Scopus - 2Web of Science - 16
Co-authors Michael Hensley
2006 Gibson PG, 'Allergic bronchopulmonary aspergillosis', Seminars in Respiratory and Critical Care Medicine, 27 185-191 (2006) [C1]
DOI 10.1055/s-2006-939521
Citations Scopus - 45Web of Science - 38
2006 Gibson PG, Powell H, 'Initial corticosteroid therapy for asthma', Current Opinion in Pulmonary Medicine, 12 48-53 (2006) [C1]
DOI 10.1097/01.mcp.0000199808.64882.12
Citations Scopus - 4Web of Science - 2
2006 Manning P, Gibson P, 'Ciclesonide for chronic asthma in adults and children', Cochrane Database of Systematic Reviews, (2006)

This is the protocol for a review and there is no abstract. The objectives are as follows: The objectives are as follows: 1). to determine the effectiveness of ciclesonide in clin... [more]

This is the protocol for a review and there is no abstract. The objectives are as follows: The objectives are as follows: 1). to determine the effectiveness of ciclesonide in clinical studies and 2). the comparative efficacy of ciclesonide when compared to other inhaled corticosteroids, as well as 3) the safety of the once daily inhaled corticosteroid Ciclesonide in adults (aged 18 years and older) and children (less than 18 years) who have persistent asthma of any severity compared with either placebo therapy or another inhaled corticosteroid therapy. Copyright © 2006 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

DOI 10.1002/14651858.CD006217
Citations Scopus - 2
2005 Thakkinstian A, McEvoy MA, Minelli C, Gibson PG, Hancox B, Duffy D, et al., 'Systematic review and meta-analysis of the association between beta(2)-adrenoceptor polymorphisms and asthma: A HuGE review', American Journal of Epidemiology, 162 201-211 (2005) [C1]
DOI 10.1093/aje/kwi184
Citations Scopus - 301Web of Science - 296
Co-authors Mark Mcevoy, John Attia
2005 Wood LG, Gibson PG, Garg ML, 'Circulating markers to assess nutritional therapy in cystic fibrosis', Clinica Chimica Acta, 353 13-29 (2005) [C1]
DOI 10.1016/j.cccn.2004.11.002
Citations Scopus - 8Web of Science - 7
Co-authors Manohar Garg, Lisa Wood
2005 Douwes J, LeGros G, Gibson P, Pearce N, 'On the hygiene hypothesis: Regulation down, up, or sideways? Reply', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 115 1326-1326 (2005)
DOI 10.1016/j.jaci.2005.01.061
Citations Web of Science - 1
2005 Thomas PS, Gibson PG, Wang H, Shah S, Henry RL, 'The relationship of exhaled nitric oxide to airway inflammation and responsiveness in children', Journal of Asthma, 42 291-295 (2005) [C1]
DOI 10.1081/JAS-200057908
Citations Scopus - 36Web of Science - 37
Co-authors He Wang
2005 Wood LG, Garg ML, Blake RJ, Garcia-Caraballo S, Gibson PG, 'Airway and Circulating Levels of Carotenoids in Asthma and Healthy Controls', Journal of the American College of Nutrition, 24 448-455 (2005) [C1]
Citations Scopus - 54Web of Science - 45
Co-authors Lisa Wood, Manohar Garg
2005 Gibson PG, 'Teaching old drugs new tricks: Asthma therapy adjusted by patient perception or noninvasive markers', EUROPEAN RESPIRATORY JOURNAL, 25 397-399 (2005)
DOI 10.1183/09031936.05.00002805
Citations Scopus - 17Web of Science - 12
2005 Murphy VE, Gibson PG, Smith R, Clifton VL, 'Asthma during pregnancy: mechanisms and treatment implications', European Respiratory Journal, 25 731-750 (2005) [C1]
DOI 10.1183/09031936.05.00085704
Citations Scopus - 107Web of Science - 95
Co-authors Vanessa Murphy, Roger Smith
2005 Murphy VE, Gibson PG, Talbot PI, Kessell CG, Clifton VL, 'Asthma self-management skills and the use of asthma education during pregnancy', European Respiratory Journal, 26 435-441 (2005) [C1]
DOI 10.1183/09031936.05.00135604
Citations Scopus - 63Web of Science - 52
Co-authors Vanessa Murphy
2005 Clifton VL, Crompton R, Read MA, Gibson PG, Smith R, Wright IM, 'Microvascular Effects of Corticotropin-Releasing Hormone in Human Skin Vary in Relation to Estrogen Concentration During the Menstrual Cycle', Journal of Endocrinology, 186 69-76 (2005) [C1]
DOI 10.1677/joe.1.06030
Citations Scopus - 14Web of Science - 12
Co-authors Roger Smith, Ian Wright
2005 Grissell TV, Powell H, Shafren DR, Boyle MJ, Hensley MJ, Jones PD, et al., 'Interleukin-10 gene expression in acute virus-induced asthma', American Journal of Respiratory and Critical Care Medicine, 172 433-439 (2005) [C1]
DOI 10.1164/rccm.200412-1621OC
Citations Scopus - 145Web of Science - 138
Co-authors Michael Hensley
2005 Murphy VE, Johnson RF, Wang Y-C, Akinsanya K, Gibson PG, Smith R, Clifton VL, 'The Effect of Maternal Asthma on Placental and Cord Blood Protein Profiles', Society for Gynecological Investigation Journal, 12 349-355 (2005) [C1]
DOI 10.1016/j.jsgi.2005.01.024
Citations Scopus - 18Web of Science - 18
Co-authors Vanessa Murphy, Roger Smith
2005 McDonald VM, Gibson PG, 'Inhalation-device polypharmacy in asthma', Medical Journal of Australia, 182 250-251 (2005) [C3]
Citations Scopus - 11Web of Science - 9
Co-authors Vanessa Mcdonald
2005 Simpson JL, Wood LG, Gibson PG, 'Inflammatory mediators in exhaled breath, induced sputum and saliva', Clinical & Experimental Allergy, 35 1180-1185 (2005) [C1]
DOI 10.1111/j.1365-2222.2005.02327.x
Citations Scopus - 43Web of Science - 45
Co-authors Jodie Simpson, Lisa Wood
2005 Simpson JL, Scott R, Boyle MJ, Gibson PG, 'Differential proteolytic enzyme activity in eosinophilic and neutrophilic asthma', American Journal of Respiratory and Critical Care Medicine, 172 559-565 (2005) [C1]
DOI 10.1164/rccm.200503-369OC
Citations Scopus - 119Web of Science - 108
Co-authors Jodie Simpson, Rodney Scott
2005 Wood LG, Garg ML, Simpson JL, Mori TA, Croft KD, Wark PA, Gibson PG, 'Induced sputum 8-isoprostane concentrations in inflammatory airway diseases', American Journal of Respiratory and Critical Care Medicine, 171 426-430 (2005) [C1]
DOI 10.1164/rccm.200408-1010OC
Citations Scopus - 76Web of Science - 66
Co-authors Peter Wark, Lisa Wood, Manohar Garg, Jodie Simpson
2005 Sigsgaard T, Heederik D, 'On the hygiene hypothesis: Regulation down, up, or sideways?', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 115 1325-1326 (2005)
DOI 10.1016/j.jaci.2005.01.060
Citations Scopus - 3Web of Science - 2
2005 Brannan JD, Anderson SD, Perry CP, Freed-Martens R, Lassig AR, Charlton B, 'The safety and efficacy of inhaled dry powder mannitol as a bronchial provocation test for airway hyperresponsiveness: a phase 3 comparison study with hypertonic (4.5%) saline', RESPIRATORY RESEARCH, 6 (2005)
DOI 10.1186/1465-9921-6-144
Citations Scopus - 148Web of Science - 147
2005 Murphy VE, Gibson PG, Talbot PI, Clifton VL, 'Severe asthma exacerbations during pregnancy', Obstetrics and Gynecology, 106 1046-1054 (2005) [C1]
Co-authors Vanessa Murphy
2005 Gibson PG, Powell H, Ducharme F, 'Long-acting beta2-agonists as an inhaled corticosteroid-sparing agent for chronic asthma in adults and children', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2005)
DOI 10.1002/14651858.CD005076.pub2
Citations Scopus - 37Web of Science - 21
2005 Jenkins CR, Thompson PJ, Gibson PG, Wood-Baker R, 'Distinguishing asthma and chronic obstructive pulmonary disease: why, why not and how?', The Medical journal of Australia, 183 (2005)

WHAT WE NEED TO KNOW: What are the essential differences in the inflammatory process that lead to different pathological outcomes in asthma and chronic obstructive pulmonary disea... [more]

WHAT WE NEED TO KNOW: What are the essential differences in the inflammatory process that lead to different pathological outcomes in asthma and chronic obstructive pulmonary disease (COPD)? What factors cause some patients with asthma to have clinical features indistinguishable from COPD, and should these patients be treated differently from those with early-onset, atopic asthma? What should be added to FEV(1) improvement after bronchodilator to enhance the ability of spirometry to distinguish between asthma and COPD? Why is disturbed gas exchange characteristic of stable COPD but rare in asthma? Why and when does COPD become a systemic disease with multiorgan dysfunction, while asthma generally does not? Does the response to bronchodilators in asthma and COPD predict prognosis and response to other interventions? Do people with asthma (airway obstruction, hyper-responsiveness and atopy) and COPD (fixed airflow limitation) have different natural histories, responses to treatment and prognoses? WHAT WE NEED TO DO: Evaluate new diagnostic tools (eg, indirect markers of inflammation) for asthma and COPD. Target older people in epidemiological studies to identify and describe the extent of asthma. Initiate community awareness programs to help older people with dyspnoea recognise they may have symptoms of asthma or COPD that should be assessed by a doctor. Define the clinical and physiological features of asthma and COPD in older people that indicate when and which treatments will achieve maximum benefit with least harm. Develop strategies for better, patient-focused care of people with severe airway disease, concentrating on device use, action plans, side effects, end-of-life decisions, exercise and independence in activities of daily living. Maintain research into new drugs and targets for preventing progressive loss of lung function in asthma and COPD.

Citations Scopus - 17
2005 Wood-Baker RR, Gibson PG, Hannay M, Walters EH, Walters JA, 'Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease.', Cochrane database of systematic reviews (Online), (2005)

BACKGROUND: COPD is a common condition, mainly related to smoking. The burden of the disease is increasing and it is projected to rank fifth in 2020 for the world-wide burden of d... [more]

BACKGROUND: COPD is a common condition, mainly related to smoking. The burden of the disease is increasing and it is projected to rank fifth in 2020 for the world-wide burden of disease. Acute exacerbations of COPD, usually related to superimposed infection occur commonly and systemic corticosteroids are widely used in their management in combination with other treatments including antibiotics, oxygen supplementation and bronchodilators. OBJECTIVES: To determine the efficacy of corticosteroids, administered either parenterally or orally, on the outcome in patients with acute exacerbations of COPD. SEARCH STRATEGY: Searches were carried out using the Cochrane Airways Group COPD RCT register with additional studies sought in the bibliographies of randomised controlled trials and review articles. Authors of identified randomised controlled trials were contacted for other published and unpublished studies. The last search was carried out in August 2004. SELECTION CRITERIA: Randomised controlled trials comparing corticosteroids, administered either parenterally or orally, with appropriate placebo. Other interventions e.g. bronchodilators and antibiotics were standardised. Clinical studies of acute asthma were excluded. DATA COLLECTION AND ANALYSIS: Data was extracted independently by two reviewers. Outcome data was sent to authors for verification. All trials were combined using Review Manager (version 4.2.4) for analyses. MAIN RESULTS: Ten studies were identified that fulfilled the inclusion criteria. There were significantly fewer treatment failures within thirty days in patients given corticosteroid treatment, odds ratio 0.48; 95% confidence interval 0.34 to 0.68 and Hazard Ratio 0.78; 95% confidence interval 0.63 to 0.97. It would have been necessary to treat 9 patients (95%CI 6 to 14) with systemic corticosteroids to avoid one treatment failure in this time period. There was no significant difference in mortality. The early FEV1, up to 72 hours, showed a significant treatment benefit, weighted mean difference 140 mls (95% confidence interval 80-200 mls), although this benefit was not found for later time points. There was a significant improvement in breathlessness and blood gases between 6 - 72 hours after treatment. There was an increased likelihood of an adverse drug reaction with corticosteroid treatment, odds ratio 2.29; 95% confidence interval 1.55 to 3.38. Overall one extra adverse effect occurred for every 6 people treated (95% CI 4 to 10). The risk of hyperglycaemia was significantly increased, odds ratio 5.48; 95% confidence interval 1.58 to 18.96. AUTHORS' CONCLUSIONS: Treatment of an exacerbation of COPD with oral or parenteral corticosteroids significantly reduces treatment failure and the need for additional medical treatment . It increases the rate of improvement in lung function and dyspnoea over the first 72 hours, but at a significantly increased risk of an adverse drug reaction.

Citations Scopus - 52
2005 Richeldi L, Ferrara G, Fabbri LM, Lasserson TJ, Gibson PG, 'Macrolides for chronic asthma.', Cochrane database of systematic reviews (Online), (2005)

BACKGROUND: Asthma is a chronic disease of the airways in which inflammation of the respiratory mucosa plays a crucial role. The mechanisms responsible for the maintaining of this... [more]

BACKGROUND: Asthma is a chronic disease of the airways in which inflammation of the respiratory mucosa plays a crucial role. The mechanisms responsible for the maintaining of this inflammatory response are only partially known and there is evidence that a role could be paid by chronic infection by intracellular pathogens (such as Chlamydia pneumoniae). Macrolides are antibiotics with both antimicrobic and antiinflammatory activities and thus their use in asthmatic patients could lead to reduction of the airways inflammation and therefore improvement of symptoms and pulmonary function. OBJECTIVES: To determine whether macrolides are effective in the management of patients with chronic asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group Specialised Register of trials up to May 2004. This was also supplemented by manually searching bibliographies of previously published reviews, conference proceedings, and contacting study authors. All languages were included in the initial search. SELECTION CRITERIA: Randomised, controlled clinical trials involving both children and adult patients with chronic asthma treated with macrolides for more than 4 weeks, versus placebo. DATA COLLECTION AND ANALYSIS: Two reviewers independently examined all identified articles. The full text of any potentially relevant article was reviewed independently by two reviewers. MAIN RESULTS: Seven studies recruiting a total of 416 participants met the inclusion criteria. The quality of reporting of study methodology was generally low. We assembled findings from studies comparing macrolide treatment for at least 4 weeks in adult and pediatric patients treated for chronic asthma. Four studies showed a positive effect on symptoms of macrolides in different types of asthmatic patients. There were limited data available for meta-analysis. There was no significant difference in FEV1 for either parallel or crossover trials. However, there were significant differences in eosinophilic inflammation and symptoms. One large parallel group trial reported significant differences in peak flow but these differences abated within six months of treatment. AUTHORS' CONCLUSIONS: Considering the small number of patients studied, there is insufficient evidence to support or to refute the use of macrolides in patients with chronic asthma. Further studies are needed in particular to clarify the potential role of macrolides in some subgroups of asthmatics such as those with evidence of chronic bacterial infection.

Citations Scopus - 30
2004 Wark P, Gibson PG, Wilson A, 'Azoles for allergic bronchopulmonary aspergillosis associated with asthma', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2004)
DOI 10.1002/14651858.CD001108.pub2
Citations Scopus - 28Web of Science - 29
Co-authors Amanda Wilson, Peter Wark
2004 Powell HG, Gibson PG, 'Initial starting dose of inhaled corticosteroids in adults with asthma: a systematic review', Thorax, 59 1041-1045 (2004) [C1]
DOI 10.1136/thx.2004.023754
Citations Scopus - 32Web of Science - 27
2004 Gibson PG, Powell HG, 'Written action plans for asthma: an evidence-based review of the key components', Thorax, 59 94-99 (2004) [C1]
DOI 10.1136/thorax.2003.011858
Citations Scopus - 285Web of Science - 230
2004 Gibson PG, 'Atopic cough', Thorax, 59 449 (2004) [C3]
Citations Scopus - 3Web of Science - 4
2004 Douwes J, Le Gros G, Gibson PG, Pearce N, 'Can bacterial endotoxin exposure reverse atopy and atopic disease?', Journal of Allergy and Clinical Immunology, 114 1051-1054 (2004) [C1]
DOI 10.1016/j.jaci.2004.08.004
Citations Scopus - 55Web of Science - 43
2004 Taramarcaz P, Grissell TV, Borgas T, Gibson PG, 'Transient postviral vocal cord dysfunction', The Journal of Allergy and Clinical Immunology, 114 1471-1472 (2004) [C1]
DOI 10.1016/j.jaci.2004.08.038
Citations Scopus - 29Web of Science - 23
2004 Hansbro PM, Beagley KW, Horvat JC, Gibson PG, 'Role of atypical bacterial infection of the lung in predisposition/protection of asthma', Pharmacology and Therapeutics, 101 193-210 (2004) [C1]
DOI 10.1016/j.pharmthera.2003.10.007
Citations Scopus - 76Web of Science - 68
Co-authors Jay Horvat, Philip Hansbro
2004 Powell H, Gibson PG, 'High dose versus low dose inhaled corticosteroid as initial starting dose for asthma in adults and children', Praxis, 93 1557-1558 (2004)
DOI 10.1024/0369-8394.93.38.1557
2004 Henry RL, Gibson PG, Vimpani GV, Francis JL, Hazell J, 'Randomized Controlled Trial of a Teacher-Led Asthma Education Program', Pediatric Pulmonology, 38 434-442 (2004) [C1]
DOI 10.1002/ppul.20095
Citations Scopus - 35Web of Science - 27
2004 Preston JA, Beagley KW, Gibson PG, Hansbro PM, 'Genetic background affects susceptibility in nonfatal pneumococcal bronchopneumonia', Eur Respir J, 23 224-231 (2004) [C1]
DOI 10.1183/09031936.03.00081403
Citations Scopus - 23Web of Science - 21
Co-authors Philip Hansbro
2004 Gibson PG, Simpson JL, Holgate ST, Dahlén S-E, Reid DW, Champion A, et al., 'The European Network For Understanding Mechanisms Of Severe Asthma study; Host response to transmissible
DOI 10.1183/09031936.04.00132904
Co-authors Jodie Simpson
2004 Simpson JL, Timmins N, Fakes K, Talbot P, Gibson PG, 'Effect of saliva contamination on induced sputum cell counts, IL-8 and eosinophil cationic protein levels', European Respiratory Journal, 23 759-762 (2004) [C1]
DOI 10.1183/09031936.04.00043104a
Citations Scopus - 18Web of Science - 18
Co-authors Jodie Simpson
2004 Gibson PG, Simpson JL, 'The European Network For Understanding Mechanisms Of Severe Asthma study', European Respiratory Journal, 23 492-495 (2004) [C1]
DOI 10.1183/09031936.04.00132904a
Citations Scopus - 2Web of Science - 2
Co-authors Jodie Simpson
2004 Taramarcaz P, Gibson PG, 'The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndrome', Clinical and Experimental Allergy, 34 1883-1889 (2004) [C1]
DOI 10.1111/j.1365-2222.2004.02130.x
Citations Scopus - 37Web of Science - 30
2004 Wark P, Gibson PG, Wilson A, 'Azoles for allergic bronchopulmonary aspergillosis associated with asthma', Cochrane Database of Systematic Reviews, 2017 (2004)

© 2017 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd. Background: Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fum... [more]

© 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background: Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fumigatus that complicates patients with asthma and cystic fibrosis. The mainstay of treatment for allergic bronchopulmonary aspergillosis remains oral corticosteroids, though this does not completely prevent exacerbations and may not prevent the decline in lung function. Objectives: The purpose of this review was to determine the efficacy of azoles in the treatment of allergic bronchopulmonary aspergillosis. Search methods: We searched the Cochrane Airways Group Asthma trials register, CENTRAL, MEDLINE and EMBASE. Searches are current as of May 2008. Selection criteria: All controlled trials that assessed the effect of azole antifungal agents compared to placebo or other standard therapy for allergic bronchopulmonary aspergillosis were reviewed. Patients with cystic fibrosis were not included. Data collection and analysis: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. Main results: Twelve trials were identified, but only three were prospective, randomised and controlled. A total of 94 participants were included. One demonstrated a reduction in immunological markers of disease activity and symptom scores using ketoconazole 400 mg daily for 12 months. There was no significant improvement in lung function. The other two examined the use of itraconazole for 16 weeks. In one there was a reduction in sputum eosinophils by 35% compared to 19% with placebo (p < 0.01). In the same trial, the number of exacerbations requiring oral corticosteroids was 0.4 per patient with itraconazole compared with 1.3 per patient with placebo (p < 0.03). Meta-analysis of data from both trials showed that itraconazole treated patients were more likely to have decline in serum IgE over 25% or more (Peto OR 3.30; 95% confidence intervals 1.30 to 8.15). Authors' conclusions: Itraconazole modifies the immunologic activation associated with allergic bronchopulmonary aspergillosis and improves clinical outcome, at least over the period of 16 weeks. Adrenal suppression with inhaled corticosteroids and itraconazole is a potential concern.

DOI 10.1002/14651858.CD001108.pub2
Citations Scopus - 77
Co-authors Peter Wark, Amanda Wilson
2004 Gibson PG, 'Review: Regular inhaled short acting B[sub2]- agonistimprove lung function in stable chronic obstructive pulmonary disease: commentary', ACP Journal Club, 140 12 (2004) [C3]
2004 Gibson PG, 'Cough is an airway itch?', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 169 1-2 (2004)
DOI 10.1164/rccm.2310009
Citations Scopus - 15Web of Science - 16
2004 Gibson PG, 'Cough is an Airway Itch', American Journal of Respiratory and Critical Care Medicine, 169 1-9 (2004) [C3]
2004 Westby MJ, Benson MK, Gibson PG, 'Anticholinergic agents for chronic asthma in adults', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2004)
DOI 10.1002/14651858.CD003269.pub2
Citations Scopus - 79Web of Science - 28
2004 Gibson PG, 'Smokers and ex-smokers with chronic stable asthma did not respond to high dose oral corticosteroids', Evidence Based Medicine, 9 115 (2004) [C3]
2004 Powell H, Gibson PG, Thien F, 'Review: Adults who require inhaled corticosteroids benefit from a moderate starting dose', Evidence-Based Medicine, 9 178 (2004)
DOI 10.1136/ebm.9.6.178
2004 Gibson PG, 'Asthma action plans: use it or lose it', Primary Care Respiratory Journal, 13 17-18 (2004) [C3]
Citations Scopus - 11
2004 Taramarcaz P, Gibson PG, 'Intranasal corticosteroids for asthma control in people with coexisting asthma and rhinitis', Praxis, 93 471 (2004)
DOI 10.1024/0369-8394.93.12.471
2003 Powell H, Gibson PG, 'Review: Regular medical review is equivalent to written self management plans for optimising asthma control in adults', Evidence-Based Medicine, 8 115 (2003)
DOI 10.1136/ebm.8.4.115
2003 Simpson JL, Moric I, Wark PA, Johnston S, Gibson PG, 'Use of induced sputum for the diagnosis of influenza and infections in asthma: a comparison of diagnostic techniques', Journal of Clinical Virology, 339-346 (2003) [C1]
DOI 10.1016/S1386-6532(02)00084-7
Citations Scopus - 36Web of Science - 31
Co-authors Jodie Simpson, Peter Wark
2003 Hensley MJ, Chalmers AC, Clover K, Gibson PG, Toneguzzi R, Lewis PR, 'Symptoms of Asthma: Comparison of a Parent-Completed Retrospective Questionnaire With a Prospective Daily Symptom Diary', Pediatric Pulmonology, 36 509-513 (2003) [C1]
DOI 10.1002/ppul.10360
Citations Scopus - 22Web of Science - 21
Co-authors Michael Hensley, Anita Chalmers
2003 Gibson PG, Henry RL, Shah S, Powell H, Wang H, 'Migration to a Western Country Increases Asthma Symptoms But Not Eosinophilic Airway Inflammation', Pediatric Pulmonology, 36 209-215 (2003) [C1]
DOI 10.1002/ppul.10323
Citations Scopus - 43Web of Science - 41
Co-authors He Wang
2003 Powell H, Gibson PG, 'Options for self-management education for adults with asthma.', Cochrane database of systematic reviews (Online), (2003)

BACKGROUND: Asthma education and self-management are key recommendations of asthma management guidelines because they improve health outcomes. There are several different modaliti... [more]

BACKGROUND: Asthma education and self-management are key recommendations of asthma management guidelines because they improve health outcomes. There are several different modalities for the delivery of asthma self-management education. OBJECTIVES: We evaluated programmes that: 1) Optimised asthma control through inhaled corticosteroid use by regular medical review or optimised asthma control by individualised written action plans 2) Used written self-management plans based on peak expiratory flow self-monitoring compared with symptom self-monitoring 3) Compared different options for the delivery of optimal self-management programmes. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised trials of asthma self-management education interventions in adults over 16 years of age with asthma. DATA COLLECTION AND ANALYSIS: Fifteen trials met the inclusion criteria. Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. MAIN RESULTS: 1) Six studies compared optimal self-management allowing self-adjustment of medications according to an individualised written action plan to adjustment of medications by a doctor. These two styles of asthma management gave equivalent effects for hospitalisation, ER visits, unscheduled doctor visits and nocturnal asthma. 2) Self-management using a written action plan based on PEF was found to be equivalent to self-management using a symptoms based written action plan in the six studies which compared these interventions. 3) Three studies compared self-management options. In one, that provided optimal therapy but tested the omission of regular review, the latter was associated with more health centre visits and sickness days. In another, comparing high and low intensity education, the latter was associated with more unscheduled doctor visits. In a third, no difference in health care utilisation or lung function was reported between verbal instruction and written action plans. REVIEWER'S CONCLUSIONS: Optimal self-management allowing for optimisation of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review. Individualised written action plans based on peak expiratory flow are equivalent to action plans based on symptoms. Reducing the intensity of self-management education or level of clinical review may reduce its effectiveness.

Citations Scopus - 190
2003 Shah L, Wilson AJ, Gibson PG, Coughlan J, 'Long acting beta-agonists versus theophylline for maintenance treatment of asthma.', Cochrane database of systematic reviews (Online), (2003)

BACKGROUND: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent dif... [more]

BACKGROUND: Theophylline and long acting beta-2 agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. OBJECTIVES: To assess the comparative efficacy, safety and side-effects of long-acting beta-2 agonists and theophylline in the maintenance treatment of asthma. SEARCH STRATEGY: Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or bitolterol. Date of last search was April 2003.Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. SELECTION CRITERIA: All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-2 agonist. DATA COLLECTION AND ANALYSIS: Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decide whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party.Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. MAIN RESULTS: Six trials originally met the inclusion criteria. Five used salmeterol and one, bitolterol. In an updated version of the review, six more trials were included. Four trials used salmeterol and two used formoterol. They were of varying quality. Salmeterol improved FEV1 significantly more than theophylline in five studies and salmeterol use was associated with significantly more symptom free nights in all the studies comparing these agents. Formoterol, used in two studies was reported to be as effective as theophylline. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Parallel studies: Relative Risk 0.44; 95% CI: 0.30 to 0.63), Risk Difference -0.11 (95%CI: -0.16 to -0.07), NNT 9 (6, 14). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.50; 95%Confidence Intervals 0.29, 0.86), Risk Difference -0.07(95% CI -0.12, -0.02), NNT 14(8, 50) and gastrointestinal adverse events (Relative Risk 0.30; 95%Confidence Intervals 0.17, 0.55), Risk Difference -0.11(-0.16, -0.06), NNT 9(6, 16). REVIEWER'S CONCLUSIONS: Long-acting beta-2 agonists are at least as effective than theophylline in reducing asthma symptoms including night waking and improving lung function. Fewer adverse events occurred in subjects using long-acting beta-2 agonists(salmeterol and formoterol) as compared to theophylline.

Citations Scopus - 42
Co-authors Amanda Wilson
2003 Wark PA, Gibson PG, Wilson AJ, 'Azoles for allergic bronchopulmonary aspergillosis associated with asthma.', Cochrane database of systematic reviews (Online), (2003)

BACKGROUND: Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fumigatus that complicates patients with asthma and cystic fibrosis. The mainstay... [more]

BACKGROUND: Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fumigatus that complicates patients with asthma and cystic fibrosis. The mainstay of treatment for allergic bronchopulmonary aspergillosis remains oral corticosteroids, though this does not completely prevent exacerbations and may not prevent the decline in lung function. OBJECTIVES: The purpose of this review was to determine the efficacy of azoles in the treatment of allergic bronchopulmonary aspergillosis. SEARCH STRATEGY: We searched the Cochrane Airways Group Asthma trials register using the terms: (allergic bronchopulmonary aspergillosis OR aspergillosis OR allergic pulmonary aspergillosis OR allergic fungal and disease OR allergic mycotic and disease) AND (azole OR triazole OR itraconazole OR ketoconazole). Date of last search January 2003. SELECTION CRITERIA: All controlled trials that assessed the effect of azole antifungal agents compared to placebo or other standard therapy for allergic bronchopulmonary aspergillosis were reviewed. Patients with cystic fibrosis were not included. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials. MAIN RESULTS: Twelve trials were identified, but only three were prospective, randomised and controlled. A total of 94 participants were included. One demonstrated a reduction in immunological markers of disease activity and symptom scores using ketoconazole 400 mg daily for 12 months. There was no significant improvement in lung function. The other two examined the use of itraconazole for 16 weeks. In one there was a reduction in sputum eosinophils by 35% compared to 19% with placebo (p < 0.01). In the same trial, the number of exacerbations requiring oral corticosteroids was 0.4 per patient with itraconazole compared with 1.3 per patient with placebo (p < 0.03). Meta-analysis of data from both trials showed that itraconazole treated patients were more likely to have decline in serum IgE over 25% or more (Peto OR 3.30; 95% confidence intervals 1.30 to 8.15). REVIEWER'S CONCLUSIONS: Itraconazole modifies the immunologic activation associated with allergic bronchopulmonary aspergillosis and improves clinical outcome, at least over the period of 16 weeks. Adrenal suppression with inhaled corticosteroids and itraconazole is a potential concern.

Citations Scopus - 24
Co-authors Amanda Wilson, Peter Wark
2003 Powell H, Gibson PG, 'Inhaled corticosteroid doses in asthma: an evidence-based approach', The Medical Journal of Australia, 178 223-225 (2003) [C1]
Citations Scopus - 94Web of Science - 87
2003 Gibson PG, Simpson JL, Hankin RG, Powell HG, Henry RL, 'Relationship between included sputum eosinophils and clinical pattern of childhood asthma', Thorax, 58 116-121 (2003) [C1]
DOI 10.1136/thorax.58.2.116
Citations Scopus - 85Web of Science - 73
Co-authors Jodie Simpson
2003 Wark PA, Hensley MJ, Saltos N, Boyle MJ, Toneguzzi R, Simpson JL, et al., 'Anti-inflammatory effect of itraconazole in stable allergic bronchopulmonary aspergillosis: A randomized controlled trial', The Journal of Allergy and Clinical Immunology, 111 952-957 (2003) [C1]
DOI 10.1067/mai.2003.1388
Citations Scopus - 209Web of Science - 171
Co-authors Jodie Simpson, Michael Hensley, Peter Wark, Patrick Mcelduff
2003 Chang AB, Gibson PG, Masters I, Dash P, Hills B, 'The Relationship Between Inflammation and Dipalmitoyl Phosphatidycholine in Induced Sputum of Children with Asthma', Journal of Asthma, 40 63-70 (2003) [C1]
DOI 10.1081/JAS-120017208
Citations Scopus - 5Web of Science - 5
2003 Gibson PG, Wark PA, Simpson JL, Meldrum CJ, Meldrum S, Saltos N, Boyle MJ, 'Induced sputum IL-8 gene expression, neutrophil influx and MMP-9 in allergic bronchopulmonary aspergillosis', European Respiratory Journal, 21 582-588 (2003) [C1]
DOI 10.1183/09031936.03.00001803
Citations Scopus - 48Web of Science - 38
Co-authors Jodie Simpson, Peter Wark
2003 Wood LG, Gibson PG, Garg ML, 'Exhaled breath condensate contains more than only volatiles', The European Respiratory Journal, 22 1 (2003) [C3]
Citations Web of Science - 5
Co-authors Manohar Garg, Lisa Wood
2003 Gibson PG, Ram FSF, Powell H, 'Asthma Education', Respiratory Medicine, 97 1036-1044 (2003) [C1]
DOI 10.1016/S0954-6111(03)00134-3
Citations Scopus - 47Web of Science - 37
2003 Gibson PG, 'Respiratory rehabilitation improves health-related quality of life in chronic obstructive pulmonary disease', ACP Journal Club, 138 43 (2003) [C3]
2003 Murphy VE, Gibson PG, Giles WB, Zakar T, Smith R, Bisits AM, et al., 'Maternal Asthma Is Associated with Reduced Female Fetal Growth', American Journal of Respiratory & Critical Care Medicine, 168 1317-1323 (2003) [C1]
DOI 10.1164/rccm.200303-374OC
Citations Scopus - 168Web of Science - 159
Co-authors Vanessa Murphy, Roger Smith
2003 Wark PAB, Gibson PG, 'Clinical Usefulness of Inflammatory Markers in Asthma', American Journal of Respiratory & Critical Care Medicine, 2 11-19 (2003) [C1]
Citations Scopus - 25
Co-authors Peter Wark
2003 Rutherford C, Mills R, Gibson PG, Price MJ, 'Improvement in health-related quality of life with fluticasone propionate compared with budesonide or beclomethasone dipropionate in adults with severe asthma', Respirology, 8 371-375 (2003) [C1]
DOI 10.1046/j.1440-1843.2003.00488.x
Citations Scopus - 11Web of Science - 11
2002 Murphy VE, Zakar T, Smith R, Giles WB, Gibson PG, Clifton VL, 'Reduced 11 -Hydroxysteroid Dehydrogenase Type 2 Activity Is Associated with Decreased Birth Weight Centile in Pregnancies Complicated by Asthma', The Journal of Clinical Endocrinology & Metabolism, 87(4) 1660-1668 (2002) [C1]
Citations Scopus - 110Web of Science - 108
Co-authors Roger Smith, Vanessa Murphy
2002 Gibson PG, 'Comment: Should we still give our asthmatic patients written individualised management plans?', The Medical Journal of Australia, 177(8) 460 (2002) [C3]
2002 Douwes J, Gibson PG, Pekkanen J, Pearce N, 'Non-eosinophilic asthma: importance and possible mechanisms', Thorax, 57 643-648 (2002) [C1]
Citations Scopus - 414Web of Science - 380
2002 Gibson PG, Fujimura M, Niimi A, 'Eosinophilic bronchitis: clinical manifestations and implications for treatment', Thorax, 57(2) 178-182 (2002) [C1]
Citations Scopus - 142Web of Science - 100
2002 Wood LG, Fitzgerald DA, Gibson PG, Cooper DM, Collins CE, Garg ML, 'Oxidative stress in cystic fibrosis: Dietary and metabolic factors. (Vol 20, pg 157, 2001)', JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION, 21 363-363 (2002)
Co-authors Clare Collins, Lisa Wood, Manohar Garg
2002 Wark PA, Johnston S, Simpson JL, Hensley MJ, Gibson PG, 'Chlamydia pneumoniae immunoglobulin A reactivation and airway inflammation in acute asthma', The European Respiratory Journal, 20 834-840 (2002) [C1]
Citations Scopus - 63Web of Science - 59
Co-authors Jodie Simpson, Peter Wark, Michael Hensley
2002 Wark PA, Johnston S, Moric I, Simpson JL, Hensley MJ, Gibson PG, 'Neutrophil degranulation and cell lysis is associated with clinical severity in virus-induced asthma', The European Respiratory Journal, 19 68-75 (2002) [C1]
Citations Scopus - 262Web of Science - 237
Co-authors Michael Hensley, Peter Wark, Jodie Simpson
2002 Gibson PG, Grootendor D, Henry R, Pin I, Rytila P, Wark P, et al., 'Sputum induction in children', European Respiratory Journal, 37 44s-46s (2002) [C3]
Citations Scopus - 38Web of Science - 29
Co-authors Peter Wark
2002 Wark PA, Simpson JL, Hensley MJ, Gibson PG, 'Airway inflammation in thunderstorm asthma', Clinical and Experimental Allergy, 32 1750-1756 (2002) [C1]
Citations Scopus - 38Web of Science - 33
Co-authors Jodie Simpson, Michael Hensley, Peter Wark
2002 Mamoon H, Henry R, Stuart JE, Gibson PG, 'House dust mite allergen levels in carpeted sleeping accommodation are higher in private houses than public places', Journal of Paediatrics and Child Health, 38 568-570 (2002) [C1]
Citations Scopus - 7Web of Science - 4
Co-authors John Stuart
2002 Gibson PG, Coughlan J, Wilson A, Hensley MJ, Abramson M, Bauman A, Walters E, 'Limited (information only) patient education programs for adults with asthma', The Cochrane Library, 2 CD001005 (2002) [C3]
Citations Scopus - 17
Co-authors Amanda Wilson, Michael Hensley
2002 Richeldi L, Ferrara G, Fabbri L, Gibson PG, 'Macrolides for chronic asthma', The Cochrane Library, 1 CD002997 (2002) [C3]
Citations Scopus - 143
2002 Haby M, Waters E, Robertson C, Gibson PG, Ducharme F, 'Interventions for educating children who have attended the emergency room for asthma', The Cochrane Library, 1 CD001290 (2002) [C3]
Citations Scopus - 61
2002 Walters E, Walters J, Gibson PG, 'Regular treatment with long acting beta agonists versus daily regular treatment with short acting beta agonists in adults and children with stable asthma', The Cochrane Library, 4 CD003901 (2002) [C3]
Citations Scopus - 36
2002 Gibson PG, 'Outpatient monitoring of asthma', Current Opinion in Allergy and Clinical Immunology, 2 161-166 (2002) [C1]
Citations Scopus - 7Web of Science - 3
2002 Preston JA, Beagley KW, Gibson PG, Hansbro PM, 'Development of a Pneumococcal Pneumonia Recovery Model in Mice', 3rd International Symposium on Pneumococci and Pneumococcal Diseases, n/a 91 (2002) [C3]
Co-authors Philip Hansbro
2002 Gibson PG, Powell H, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, et al., 'Limited (information only) patient education programs for adults with asthma.', Cochrane database of systematic reviews (Online), (2002)

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education. OBJECTIVES: The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and two reviewers extracted data independently. Study authors were contacted for missing information. MAIN RESULTS: Twelve trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no significant effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but in two studies, perceived asthma symptoms did improve after limited asthma education (odds ratio 0.44, 95% confidence interval 0.26 to 0.74). In one study, limited asthma education was associated with reduced emergency department visits (reduction of -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18). REVIEWER'S CONCLUSIONS: Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma although perceived symptoms may improve. Provision of information in the emergency department may be effective, but this needs to be confirmed.

Citations Scopus - 132
Co-authors Amanda Wilson, Michael Hensley
2002 Chang A, Gibson PG, 'Relationship between Cough, Cough Receptor Sensitivity and Asthma in Children', Pulmonary Pharmacology & Therapeutics, 15 287-291 (2002) [C1]
Citations Scopus - 12Web of Science - 5
2002 Thornett AM, Newbury JW, Duszynski AJ, 'Should we still give our asthmatic patients written individualised management plans?', MEDICAL JOURNAL OF AUSTRALIA, 177 459-460 (2002)
Citations Scopus - 1
2002 Simpson JL, Gibson PG, Wark PA, 'Optimization of sputum-processing methods for the measurement of interleukin-5: Effects of protease inhibition', Respirology, 7 111-116 (2002) [C1]
Citations Scopus - 8Web of Science - 11
Co-authors Jodie Simpson, Peter Wark
2002 Richeldi L, Ferrara G, Fabbri LM, Gibson PG, 'Macrolides for chronic asthma.', Cochrane database of systematic reviews (Online), (2002)

BACKGROUND: Asthma is a chronic disease of the airways in which inflammation of the respiratory mucosa plays a crucial role. The mechanisms responsible for the maintaining of this... [more]

BACKGROUND: Asthma is a chronic disease of the airways in which inflammation of the respiratory mucosa plays a crucial role. The mechanisms responsible for the maintaining of this inflammatory response are only partially known and there is evidence that a role could be paid by chronic infection by intracellular pathogens (such as Chlamydia pneumoniae). Macrolides are antibiotics with both antimicrobial and anti-inflammatory activities and thus their use in asthmatic patients could lead to reduction of the airways inflammation and therefore improvement of symptoms and pulmonary function. OBJECTIVES: To determine whether macrolides are effective in the management of patients with chronic asthma. SEARCH STRATEGY: We searched MEDLINE, EMBASE and CINAHL up to May 2001. This was also supplemented by manually searching bibliographies of previously published reviews, conference proceedings, and contacting study authors. All languages were included in the initial search. SELECTION CRITERIA: Randomised, controlled clinical trials involving both children and adult patients with chronic asthma treated with macrolides for more than 4 weeks, versus placebo. DATA COLLECTION AND ANALYSIS: Two reviewers independently examined all identified articles. Two reviewers reviewed the full text of any potentially relevant article independently. MAIN RESULTS: The initial search retrieved 95 studies. Preliminary evaluation identified 20 studies that were potentially eligible. Five (357 patients) met the entry criteria. The entry criteria for the primary trials differed, but all recruited a specific subgroup of patients (eg severe oral steroid dependent, aspirin intolerant or evidence of Chlamydia pnuemoniae infection). There was a positive effect on symptoms (Standardised Mean Difference -1.25, 95% Confidence Intervals (CI) -1.80, -0.70) and markers of eosinophilic inflammation; eg sputum eosinophils Weighted Mean difference -78.5, 95%CI -90.8, -66.1). Tests of oral corticosteroid-sparing effects have not yet been performed on the newer agents such as roxithromycin and clarithromycin. REVIEWER'S CONCLUSIONS: Considering the small number of patients studied, there is insufficient evidence to support or to refute the use of macrolides in patients with chronic asthma. Further studies are needed in particular to clarify the potential role of macrolides in some subgroups of asthmatics such as those with evidence of chronic bacterial infection.

Citations Scopus - 19
2002 Singh M, Bara A, Gibson P, 'Humidity control for chronic asthma.', Cochrane database of systematic reviews (Online), (2002)

BACKGROUND: Humidity control measures in the home environment of patients with asthma have been recommended, however there is no consensus about the usefulness of these measures. ... [more]

BACKGROUND: Humidity control measures in the home environment of patients with asthma have been recommended, however there is no consensus about the usefulness of these measures. OBJECTIVES: To study the effect of dehumidification of the home environment on asthma control. SEARCH STRATEGY: A search of the clinical trials registers of the Cochrane Collaboration and Cochrane Airways Group using search terms for asthma and [humid* OR water vapour OR water vapor* OR water-vapour* OR water-vapor*]. SELECTION CRITERIA: Randomized controlled trials on the use of humidity control measures in the home environment of patients with asthma were evaluated for inclusion. Only one trial could be included. DATA COLLECTION AND ANALYSIS: Data was extracted using a predesigned data extraction form. No data was available for entering into RevMan for analysis. MAIN RESULTS: The included trial using mechanical ventilation with or without high efficiency vacuum cleaners did not show any clinical benefit to asthma patients. There was a decline in the house dust mite count and the antigen level. This open trial had a low sample size. REVIEWER'S CONCLUSIONS: There is a need for studying the health benefits of dehumidification by a double blind randomized controlled trial with adequate sample size measuring clinical outcomes in patients of asthma.

Citations Scopus - 19
2002 Wood LG, Fitzgerald DA, Gibson PG, Cooper DM, Collins CE, Garg ML, 'Erratum: Oxidative stress in cystic fibrosis: Dietary and metabolic factors (Journal of the American College of Nutrition (2001) 20:2 (157-165))', Journal of the American College of Nutrition, 21 363 (2002)
Co-authors Lisa Wood, Manohar Garg, Clare Collins
2002 Wood LG, Fitzgerald DA, Gibson PG, Cooper DM, Garg ML, 'Increased plasma fatty acid concentrations after respiratory exacerbations are associated with elevated oxidative stress in cystic fibrosis patients (vol 75, pg 668, 2002)', AMERICAN JOURNAL OF CLINICAL NUTRITION, 76 907-907 (2002)
Citations Scopus - 1
Co-authors Manohar Garg, Lisa Wood
2002 Wood LG, Fitzgerald DA, Gibson PG, Cooper DM, Garg ML, 'Increased plasma fatty acid concentrations after respiratory exacerbations are associated with elevated oxidative stress in cystic fibrosis patients', American Journal of Clinical Nutrition: a journal reporting the practical application of our world-wide knowledge of nutrition, 75 668-675 (2002) [C1]
Citations Scopus - 42Web of Science - 37
Co-authors Lisa Wood, Manohar Garg
2002 Chang A, Harrhy V, Simpson JL, Masters I, Gibson PG, 'Cough, airway inflammation, and mild asthma exacerbation', Archives of Disease in Childhood, 86 270-275 (2002) [C1]
Citations Scopus - 30Web of Science - 24
Co-authors Jodie Simpson
2002 Powell H, Gibson PG, 'Teaching People about Asthma: the evidence', International Review of Asthma, 4(4) 88-101 (2002) [C3]
2001 Gibson PG, Simpson J, Saltos N, 'Heterogeneity of Airway Inflammation in Persistant Asthma Evidence of Neturophilic Inflammation and Increased Sputum Interleukin-8', Chest, 119 1329-1336 (2001) [C1]
Citations Scopus - 400Web of Science - 370
Co-authors Jodie Simpson
2001 Field SK, Sutherland LR, Gibson P, 'Gastro-oesophageal reflux and asthma [9] (multiple letters)', Thorax, 56 898 (2001)
DOI 10.1136/thorax.56.11.898
2001 Gibson PO, Simpson JL, 'IL-8 gene expression is increased in allergic bronchopulmonary aspergillosis', Respirology, 6 (2001)

Airway inflammation is allergic aspergillosis (ABPA) is typically characterised by increased eosinophils. We have recently reported increased sputum neutrophils in ABPA that corre... [more]

Airway inflammation is allergic aspergillosis (ABPA) is typically characterised by increased eosinophils. We have recently reported increased sputum neutrophils in ABPA that correlates with the extent of bronchiectasis on HRCT. In this study we sought to evaluate the role of the neutrophil chemoattractant IL-8 in ABPA. 29 adults with ABPA (20 with central bronchiectasis, ABPA-CB; 9 with serological ABPA, ABPA-S) were compared with 21 normal controls, and 9 asthmatics without Af sensitisation. Induced sputum was examined for cellular differential, IL-8 protein by ELISA and immunocytocheraistry, and IL-8 gene expression by semi-quantitative RTPCR. Sputum supernatant IL-8 was 66ng/mL in ABPA-CB, 65 in ABPA-S, 3.5ng/mL in controls and 3.6ng/mL in asthma (p<0.001 ). Sputum IL-8 correlated with sputum neutrophils (r=0.63) and FEV| % predicted (r=-0.7). IL-8 containing cells were predominantly neutrophils. IL-8mRNA levels were 108 and 24ag/mL in the ABPA groups, compared to 1.2 and 2.4ag/mL in asthma and controls (p<0.05). Conclusion: In ABPA there is elevated IL-8 gene expression and protein release, that correlates with the degree of airflow obstruction and neutrophil influx. IL-8 may be an important cytokine mediating inflammation and lung damage in ABPA.

Co-authors Jodie Simpson
2001 Gibson PG, 'Implementing evidence-based guidelines', Medical Journal of Australia, 174 337-338 (2001) [C2]
Citations Scopus - 8Web of Science - 6
2001 Coughlan JD, Gibson PG, Henry R, 'Medical treatment for reflux oesophagitis does not consistently improve asthma control: a systematic review', Thorax, 56 198-204 (2001) [C1]
Citations Scopus - 75Web of Science - 60
2001 Gibson PG, 'Gastro-oesophageal reflux and asthma - author's reply', Thorax, 56(11) 898 (2001) [C3]
2001 Jujimura M, Gibson PG, 'Eosinophilic airway diseases with isolated cough except for asthma', Japanese Journal of Clinical Medicine, 59 2031-2038 (2001) [C3]
2001 Gibson PG, 'Management of chronic obstructive pulmonary disease (COPD)', Australian Prescriber, 24 152-155 (2001)

The expiratory airflow obstruction that characterises chronic obstructive pulmonary disease is usually progressive over time and caused by emphysema, obliterative bronchiolitis, a... [more]

The expiratory airflow obstruction that characterises chronic obstructive pulmonary disease is usually progressive over time and caused by emphysema, obliterative bronchiolitis, and mucus hypersecretion. Stopping smoking is the only measure that slows the progression of chronic obstructive pulmonary disease, and smokers should be encouraged to stop at all stages of the disease. The effects of medication are limited, and need to be balanced against cost and adverse effects. Bronchodilators, given by puffer and spacer rather than by nebuliser, are effective. Avoid inhaled corticosteroids unless there is associated asthma. Pulmonary rehabilitation leads to important improvements in quality of life. Influenza vaccination is helpful. Comorbidity from cardiac disease and sleep disordered breathing are common and can be effectively treated. New therapies under evaluation include lung volume reduction surgery, non-invasive ventilation, and anti-inflammatory drugs.

DOI 10.18773/austprescr.2001.158
2001 Gibson PG, 'Outcomes of the Cochrane Airways Group International Conference', Australian Prescriber, 24 78-79 (2001) [C3]
2001 Wood L, Fitzgerald D, Gibson PG, Cooper D, Collins C, Garg M, 'Oxidative Stress in Cystic Fibrosis: Dietary and Metabolic Factors', Journal of the American College of Nutrition, 20 157-165 (2001) [C1]
Citations Scopus - 73Web of Science - 58
Co-authors Clare Collins, Lisa Wood, Manohar Garg
2001 Wark PA, Simpson J, Hensley MJ, Gibson PG, 'Safety of sputum induction with isotonic saline in adults with acute severe asthma', Clinical and Experimental Allergy, 31 1745-1753 (2001) [C1]
Citations Scopus - 29Web of Science - 25
Co-authors Jodie Simpson, Peter Wark, Michael Hensley
2001 Shah S, Peat J, Mazurski E, Wang H, Sindhusake D, Bruce C, et al., 'Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial', BMJ, 322 1-5 (2001) [C1]
2001 Gibson PG, Shah S, Sindhausake D, Wang H, Peat J, Henry R, 'Peer led programme for athma education in adolescents - Author's Reply', BMJ, 323(7304) 110 (2001) [C3]
2001 Shah S, Peat JK, Mazurski EJ, Wang H, Sindhusake D, Bruce C, et al., 'Effect of peer led programme for asthma education in adolescents: cluster randomised controlled trial', BRITISH MEDICAL JOURNAL, 322 583-585 (2001)
DOI 10.1136/bmj.322.7286.583
Citations Scopus - 174Web of Science - 135
2001 Gibson PG, Shah S, Sindhusake D, Wang H, Peak JK, Henry RL, 'Peer led programme for asthma education in adolescents - Reply', BRITISH MEDICAL JOURNAL, 323 111-111 (2001)
2001 Jones PD, Hankin RG, Simpson J, Gibson PG, Henry R, 'The Tolerability, Safety, and Success of Sputum Induction and Combined Hypertonic Saline Challenge in Children', American Journal of Respiratory And Critical Care Medicine, 164 1146-1149 (2001) [C1]
Citations Scopus - 50Web of Science - 38
Co-authors Jodie Simpson
2001 Gibson PG, Saltos N, Fakes K, 'Acute Anti-Inflammatory Effects of Inhaled Budesonide in Asthma. A randomized controlled trial', American Journal of Respiratory and Critical Care Medicine, 163 32-36 (2001) [C1]
Citations Scopus - 129Web of Science - 116
2001 Gibson PG, Simpson J, Chalmers AC, Toneguzzi R, Wark PA, Wilson AJ, Hensley MJ, 'Airway Eosinophilia is associated with Wheeze but is uncommon in Children with Persistent Cough and Frequent Chest Colds', American Journal of Respiratory and Critical Care Medicine, 164 977-981 (2001) [C1]
Citations Scopus - 49Web of Science - 37
Co-authors Jodie Simpson, Michael Hensley, Peter Wark, Anita Chalmers, Amanda Wilson
2001 Clifton VL, Giles WB, Smith R, Bisits AM, Hempenstall P, Kessell C, Gibson PG, 'Alterations of Placental Vascular Function in Asthmatic Pregnancies', American Journal of Respiratory and Critical Care Medicine, 164 546-553 (2001) [C1]
Citations Scopus - 49Web of Science - 44
Co-authors Roger Smith
2001 Wark P, Wilson AJ, Gibson PG, 'Azoles for allergic bronchopulmonary aspergillosis', Praxis, 90 1780 (2001)
Co-authors Peter Wark, Amanda Wilson
2001 Wark PA, Gibson PG, Johnston S, 'Exacerbations of asthma: addressing the triggers and treatments', Monaldi Archives for Chest Disease, 56 429-435 (2001) [C1]
Citations Scopus - 11
Co-authors Peter Wark
2001 Arnold DJ, Gibson PG, 'Prevalence of long term oral corticosteroid use and treatment for osteoporosis in chronic obstructive pulmonary disease (copd) or asthma', Respirology, 6 (2001)

Aim: To determine the prevalence of long term (&gt;6 months) oral corticosteroid use and osteoporosis therapy (treatment or prevention) in patients hospitalised with COPD or asthm... [more]

Aim: To determine the prevalence of long term (>6 months) oral corticosteroid use and osteoporosis therapy (treatment or prevention) in patients hospitalised with COPD or asthma. Method: All patients admitted to hospital under the care of the respiratory service with a history of COPD or asthma were interviewed to assess their use of OCS, history of osteoporosis and therapy for osteoporosis. Results: 67 patients (mean±SD age 63±17) were enrolled, 48 with COPD and 19 with asthma. 19(28%) were on long term OCS and of these 7(10%) had a previous diagnosis of osteoporosis (5 had had a fracture and all were on osteoporosis therapy; 2 had had no fracture and 1 was on therapy). Of the 12( 18%) patients on long term OCS with no diagnosis of osteoporosis none were on preventative therapy. Of 48 patients not on long term OCS 8 had a previous diagnosis of osteoporosis but only 3 were on therapy. Overall 27 (40%) of 67 patients were on long term OCS or had a previous diagnosis of osteoporosis, 13 (19%) had had a fracture and 11 ( 16%) were on osteoporosis treatment. Conclusion: Amongst patients admitted to hospital with COPD or asthma use of long term OCS or history of osteoporosis is common, while therapy for prevention or treatment of osteoporosis is uncommon.

2001 Wark PA, Gibson PG, 'Allergic bronchopulmonary aspergillosis: New concepts of pathogenesis and treatment', Respirology, 6 1-7 (2001) [C2]
Citations Scopus - 61
Co-authors Peter Wark
2001 Berend N, Kellett B, Kent N, Sly P, Bowler S, Burdon J, et al., 'Improved safety with equivalent asthma control in adults with chronic severe asthma on high-dose fli\uticasone propionate', Respirology, 6 237-246 (2001) [C1]
2001 Preston JA, Beagley KW, Gibson PG, Hansbro PM, 'Effects of Infections by Streptococcus pneumoniae on Eosinophilic Immune Responses', Official Journal of the Australian Society for Microbiology, 22 A82 (2001) [C3]
Co-authors Philip Hansbro
2001 Gibson PG, Saltos N, Borgas T, 'Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma (vol 105, pg 752, 2000)', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 107 223-223 (2001)
Citations Web of Science - 2
2001 Peters TJ, Graham A, Salisbury C, Moore L, 'Peer led programme for asthma education in adolescents - Issues of design and analysis are crucial in cluster randomised trials', BRITISH MEDICAL JOURNAL, 323 110-110 (2001)
DOI 10.1136/bmj.323.7304.110
2001 Gibson PG, Saltos N, Borgas T, 'Erratum: Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma (Journal of Allergy and Clinical Immunology (April 2000) 105 (752-759))', Journal of Allergy and Clinical Immunology, 107 223 (2001)
2001 Wood-Baker R, Walters EH, Gibson P, 'Oral corticosteroids for acute exacerbations of chronic obstructive pulmonary disease.', Cochrane database of systematic reviews (Online), (2001)

BACKGROUND: Systemic corticosteroids are widely used in the management of patients with acute exacerbations of COPD, in combination with other treatments. OBJECTIVES: To determine... [more]

BACKGROUND: Systemic corticosteroids are widely used in the management of patients with acute exacerbations of COPD, in combination with other treatments. OBJECTIVES: To determine the effect of corticosteroids, administered either parenterally or orally, on the outcome in patients with acute exacerbations of COPD. SEARCH STRATEGY: An initial search was carried out using the Cochrane Airways Group COPD RCT register with additional studies sought in the bibliographies of randomised controlled trials and review articles. Authors of identified randomised controlled trials were contacted for other published and unpublished studies. SELECTION CRITERIA: Randomised controlled trials comparing corticosteroids, administered either parenterally or orally, with appropriate placebo. Other interventions were standardised e.g. bronchodilators, antibiotics. Clinical studies of acute asthma were excluded. DATA COLLECTION AND ANALYSIS: Data was extracted by one of the reviewers and sent to authors for verification. All trials were combined using Review Manager (version 4.1) for analysis. MAIN RESULTS: We have identified 7 studies that fulfilled the inclusion criteria. Outcomes were varied and few were common to all studies. The most commonly reported outcome, the FEV1 between 6 - 72 hours after treatment, showed a significant treatment benefit for corticosteroid over placebo treatment, weighted mean difference 120 ml 95% confidence intervals: 5, 190 ml. There were significantly fewer treatment failures in patients given corticosteroid treatment, but the number of studies reporting this outcome was smaller and there was significant heterogeneity between them. There was an increased likelihood of an adverse drug reaction with corticosteroid treatment. REVIEWER'S CONCLUSIONS: Treatment with oral or parenteral corticosteroids increases the rate of lung function improvement over the first 72 hours of an exacerbation of chronic obstructive pulmonary disease, but at a significantly increased risk of an adverse drug reaction. There is no evidence that this benefit is maintained after 72 hours, or that other outcomes are improved.

Citations Scopus - 49
2000 Gibson PG, Charpin D, 'Educating adolescents about asthma [1] (multiple letters)', Chest, 118 1514-1515 (2000)
Citations Scopus - 3
2000 Gibson PG, 'Educating Adolescents About Asthma', Chest, 118 1514-1515 (2000) [C3]
Citations Web of Science - 3
2000 Thorne R, Marshall J, Shafren D, Gibson PG, Hart I, Burns G, 'The Integrins a3B1 and a6B1 Physically and Functionally Associate with CD36 in Human Melanoma Cells', Journal of Biological Chemistry, 275 35264-35275 (2000) [C1]
Citations Scopus - 75Web of Science - 74
Co-authors Rick Thorne
2000 Wood LG, Fitzgerald DA, Gibson PG, Cooper DM, Garg ML, 'Lipid Peroxidation as Determined by Plasma Isoprostanes Is Related to Disease Severity in Mild Asthma', Lipids, 35;9 967-974 (2000) [C1]
Citations Scopus - 123Web of Science - 114
Co-authors Manohar Garg, Lisa Wood
2000 Gibson PG, 'Letter to the Editor', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 106 1-2 (2000) [C3]
2000 Gibson PG, 'Monitoring the patient with asthma: An evidence-based approach', Journal of Allergy and Clinical Immunology, 106 17-26 (2000) [C1]
Citations Scopus - 72Web of Science - 64
2000 Gibson PG, Saltos N, Borgas T, 'Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma', Journal of Allergy and clinical Immunology, 105 752-759 (2000) [C1]
Citations Scopus - 90Web of Science - 83
2000 Jones P, Gibson PG, Henry R, 'The prevalence of asthma appears to be inversely related to the incidence of typhoid and tuberculosis: hypothesis to explain the variation in asthma prevalence around the world', Medical Hypotheses, 55 40-42 (2000) [C1]
Citations Scopus - 19Web of Science - 17
2000 Gibson PG, Henry R, Thomas P, 'Noninvasive assessment of airway inflammation in children: induced sputum, exhaled nitric oxide, and breath condensate', European Respiratory Journal, 16 1008-1015 (2000) [C1]
Citations Scopus - 142Web of Science - 113
2000 Wark PA, Saltos N, Simpson J, Slater S, Hensley MJ, Gibson PG, 'Induced sputum easinophils and neutrophils and bronchiectasis severity in allergic bronchopulmonary aspergillosis', European Respiratory Journal, 16 1095-1101 (2000) [C1]
Citations Scopus - 61Web of Science - 48
Co-authors Jodie Simpson, Michael Hensley, Peter Wark
2000 Gibson PG, Henry R, Shah S, Toneguzzi R, Francis J, Norzila M, Davies H, 'Validation of the ISAAC video questionnaire (AVQ3.0) in adolescents from a mixed ethnic background', Clinical and Experiemental Allergy, 30 1181-1187 (2000) [C1]
Citations Scopus - 52Web of Science - 39
2000 Gibson PG, 'Commentary on "Glucocorticoids reduced short-term treatment failure in exacerbations of chronic obstructive pulmonary disease". Comment on: Niewoehner DE, Erbland ML, Deupree RH et al. Effect of systemic glucocorticoids on exacerbations of chronic obstruc', ACP JOURNAL CLUB, 132 14 (2000) [C3]
2000 Gibson PG, Henry R, Coughlan J, 'Review: Treatment of gastroesophageal reflux does not improve asthma outcomes', ACP Journal Club, 132 15 (2000) [C3]
2000 Norzila M, Fakes K, Henry R, Simpson J, Gibson PG, 'Interleukin-8 secretion and neutrophil recruitment accompanies induced sputum eosinophil activation in children with acute asthma', American Journal of respiratory and Critical Care Medicine, 161 769-774 (2000) [C1]
Citations Web of Science - 165
Co-authors Jodie Simpson
2000 Wark PA, Gibson PG, Fakes K, 'Induced sputum eosinophils in the assessment of asthma and chronic cough*', Respirology, 5 51-57 (2000) [C1]
Citations Scopus - 21
Co-authors Peter Wark
2000 Gibson PG, 'European Respiratory Society Annual Congress', I Drugs, 3 56-58 (2000) [C3]
2000 Wark PA, Wilson A, Gibson PG, 'Azoles for allergic bronchopulmonary aspergillosis', The Cochrane Library, 1-9 (2000) [C1]
Co-authors Peter Wark, Amanda Wilson
2000 Gibson PG, Coughlan J, Wilson AJ, Abramson M, Bauman A, Hensley MJ, Walters EH, 'Self-management education and regular practitioner review for adults with asthma.', Cochrane database of systematic reviews (Online : Update Software), CD001117 (2000)

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes. OBJECTIVES: The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised trials of self-management education in adults over 16 years of age with asthma. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. MAIN RESULTS: Twenty-five trials were included. Self-management education was compared with usual care in 22 studies. Self-management education reduced hospitalisations (odds ratio 0.57, 95% confidence interval 0.38 to 0.88); emergency room visits (odds ratio 0.71, 95% confidence interval (0.57 to 0.90); unscheduled visits to the doctor (odds ratio 0.57, 95% confidence interval 0.40 to 0.82); days off work or school (odds ratio 0.55, 95% confidence interval 0.38 to 0. 79); and nocturnal asthma (odds ratio 0.53, 95% confidence interval 0.39 to 0.72). Measures of lung function were little changed. Self-management programmes that involved a written action plan showed a greater reduction in hospitalisation than those that did not (odds ratio 0.35, 95% confidence interval 0.18 to 0.68). People who managed their asthma by self-adjustment of their medications using an individualised written plan had better lung function than those whose medications were adjusted by a doctor. REVIEWER'S CONCLUSIONS: Training in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan appears to improve health outcomes for adults with asthma. Training programmes which enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.

Citations Scopus - 62
Co-authors Michael Hensley, Amanda Wilson
2000 Gibson PG, Henry RL, Coughlan JL, 'Gastro-oesophageal reflux treatment for asthma in adults and children.', Cochrane database of systematic reviews (Online : Update Software), (2000)

BACKGROUND: Asthma and gastro-oesophageal reflux are both common medical conditions and often co-exist. Studies have shown conflicting results concerning the effects of lower oeso... [more]

BACKGROUND: Asthma and gastro-oesophageal reflux are both common medical conditions and often co-exist. Studies have shown conflicting results concerning the effects of lower oesophageal acidification as a trigger of asthma. Furthermore, asthma might precipitate gastro-oesophageal reflux. Thus a temporal association between the two does not establish that gastro-oesophageal reflux triggers asthma. Randomised trials of a number of treatments for gastro-oesophageal reflux in asthma have been conducted, with conflicting results. OBJECTIVES: The objective of this review was to evaluate the effectiveness of treatments for gastro-oesophageal reflux in terms of their benefit on asthma. SEARCH STRATEGY: The Cochrane Airways Group trials register, review articles and reference lists of articles were searched. SELECTION CRITERIA: Randomised controlled trials of treatment for oesophageal reflux in adults and children with a diagnosis of both asthma and gastro-oesophageal reflux. DATA COLLECTION AND ANALYSIS: Trial quality and data extraction were carried out by two independent reviewers. Authors were contacted for confirmation or more data. MAIN RESULTS: Nine trials met the inclusion criteria. Interventions included proton pump inhibitors (n=3), histamine antagonists (n=5), surgery (n=1) and conservative management (n=1). Treatment duration ranged from 1 week to 6 months. A temporal association between asthma and gastro-oesophageal reflux was investigated in 4 trials and found to be present in a proportion of participants in these trials. Anti-reflux treatment did not consistently improve lung function, asthma symptoms, nocturnal asthma or the use of asthma medications. REVIEWER'S CONCLUSIONS: In asthmatic subjects with gastro-oesophageal reflux, (but who were not recruited specifically on the basis of reflux-associated respiratory symptoms), there was no overall improvement in asthma following treatment for gastro-oesophageal reflux. Subgroups of patients may gain benefit, but it appears difficult to predict responders.

2000 Gibson PG, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, Walters EH, 'Limited (information only) patient education programs for adults with asthma.', Cochrane database of systematic reviews (Online : Update Software), (2000)

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education. OBJECTIVES: The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for missing information. MAIN RESULTS: Eleven trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but perceived asthma symptoms did improve after limited asthma education (odds ratio 0.40, 95% confidence interval 0.18 to 0.86). In one study, limited asthma education was associated with reduced emergency department visits (weighted mean difference -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18). REVIEWER'S CONCLUSIONS: Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma. However the use of information in the emergency department may be effective, but this needs to be confirmed.

Citations Scopus - 31
Co-authors Michael Hensley, Amanda Wilson
2000 Gibson PG, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, Walters EH, 'Limited (information only) patient education programs for adults with asthma.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education. OBJECTIVES: The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for missing information. MAIN RESULTS: Eleven trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but perceived asthma symptoms did improve after limited asthma education (odds ratio 0.40, 95% confidence interval 0.18 to 0.86). In one study, limited asthma education was associated with reduced emergency department visits (weighted mean difference -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18). REVIEWER'S CONCLUSIONS: Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma. However the use of information in the emergency department may be effective, but this needs to be confirmed.

Citations Scopus - 75
Co-authors Michael Hensley, Amanda Wilson
2000 Gibson PG, Coughlan J, Wilson AJ, Abramson M, Bauman A, Hensley MJ, Walters EH, 'Self-management education and regular practitioner review for adults with asthma.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes. OBJECTIVES: The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised trials of self-management education in adults over 16 years of age with asthma. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. MAIN RESULTS: Twenty-five trials were included. Self-management education was compared with usual care in 22 studies. Self-management education reduced hospitalisations (odds ratio 0.57, 95% confidence interval 0.38 to 0.88); emergency room visits (odds ratio 0.71, 95% confidence interval (0.57 to 0.90); unscheduled visits to the doctor (odds ratio 0.57, 95% confidence interval 0.40 to 0.82); days off work or school (odds ratio 0.55, 95% confidence interval 0.38 to 0. 79); and nocturnal asthma (odds ratio 0.53, 95% confidence interval 0.39 to 0.72). Measures of lung function were little changed. Self-management programmes that involved a written action plan showed a greater reduction in hospitalisation than those that did not (odds ratio 0.35, 95% confidence interval 0.18 to 0.68). People who managed their asthma by self-adjustment of their medications using an individualised written plan had better lung function than those whose medications were adjusted by a doctor. REVIEWER'S CONCLUSIONS: Training in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan appears to improve health outcomes for adults with asthma. Training programmes which enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.

Citations Scopus - 416
Co-authors Michael Hensley, Amanda Wilson
2000 Gibson PG, Henry RL, Coughlan JL, 'Gastro-oesophageal reflux treatment for asthma in adults and children.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: Asthma and gastro-oesophageal reflux are both common medical conditions and often co-exist. Studies have shown conflicting results concerning the effects of lower oeso... [more]

BACKGROUND: Asthma and gastro-oesophageal reflux are both common medical conditions and often co-exist. Studies have shown conflicting results concerning the effects of lower oesophageal acidification as a trigger of asthma. Furthermore, asthma might precipitate gastro-oesophageal reflux. Thus a temporal association between the two does not establish that gastro-oesophageal reflux triggers asthma. Randomised trials of a number of treatments for gastro-oesophageal reflux in asthma have been conducted, with conflicting results. OBJECTIVES: The objective of this review was to evaluate the effectiveness of treatments for gastro-oesophageal reflux in terms of their benefit on asthma. SEARCH STRATEGY: The Cochrane Airways Group trials register, review articles and reference lists of articles were searched. SELECTION CRITERIA: Randomised controlled trials of treatment for oesophageal reflux in adults and children with a diagnosis of both asthma and gastro-oesophageal reflux. DATA COLLECTION AND ANALYSIS: Trial quality and data extraction were carried out by two independent reviewers. Authors were contacted for confirmation or more data. MAIN RESULTS: Nine trials met the inclusion criteria. Interventions included proton pump inhibitors (n=3), histamine antagonists (n=5), surgery (n=1) and conservative management (n=1). Treatment duration ranged from 1 week to 6 months. A temporal association between asthma and gastro-oesophageal reflux was investigated in 4 trials and found to be present in a proportion of participants in these trials. Anti-reflux treatment did not consistently improve lung function, asthma symptoms, nocturnal asthma or the use of asthma medications. REVIEWER'S CONCLUSIONS: In asthmatic subjects with gastro-oesophageal reflux, (but who were not recruited specifically on the basis of reflux-associated respiratory symptoms), there was no overall improvement in asthma following treatment for gastro-oesophageal reflux. Subgroups of patients may gain benefit, but it appears difficult to predict responders.

Citations Scopus - 83
2000 Wark P, Wilson AW, Gibson PG, 'Azoles for allergic bronchopulmonary aspergillosis.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: Allergic Broncho-pulmonary Aspergillosis (ABPA) is hypersensitivity to the fungus Aspergillus Fumigatus that complicates patients with asthma and cystic fibrosis. The ... [more]

BACKGROUND: Allergic Broncho-pulmonary Aspergillosis (ABPA) is hypersensitivity to the fungus Aspergillus Fumigatus that complicates patients with asthma and cystic fibrosis. The condition usually results in an increase in symptoms, a greater reliance on corticosteroids to control the disease process and may lead to a progressive decline in lung function. The mainstay of treatment for ABPA remains oral corticosteroids, though this does not completely prevent exacerbations and may not prevent the decline in lung function. OBJECTIVES: The purpose of this review is to determine the efficacy of azoles in the treatment of ABPA SEARCH STRATEGY: An initial search was carried out using the Cochrane Airways Group Asthma RCT register. The register was searched using the following terms: (asthma or wheeze) and (allergic bronchopulmonary aspergillosis or aspergillosis or allergic pulmonary aspergillosis or allergic fungal and disease or allergic mycotic and disease) and (azole or triazole or itraconazole or ketoconazole). SELECTION CRITERIA: All controlled trials that assessed the effect of azole antifungal agents compared to placebo or other standard, for any duration or dose regimen in subjects with ABPA of any age or severity were reviewed. Studies in languages other than English were included. DATA COLLECTION AND ANALYSIS: All identified trials were independently reviewed by both reviewers & all data collected. Trial quality was scored by the Cochrane assessment of allocation concealment & the Jadad scale of methodological quality. MAIN RESULTS: A total of 11 trials were identified concerning the use of azoles in ABPA. Only two prospective controlled trials were identified. The first trial examined the use of Ketoconazole 400 mg daily for 12 months and demonstrated a reduction in immunological markers of disease activity and symptom scores, there was no significant improvement in lung function. The other trial examined the use of itraconazole for 16 weeks. This demonstrated a reduction in corticosteroid usage, an improvement in immunological markers, an improvement in pulmonary function and exercise tolerance. This study was only available as an abstract and limited details were available. REVIEWER'S CONCLUSIONS: There is insufficient information available to recommend the use of azole anti-fungal agents in the routine treatment of patients with ABPA.

Citations Scopus - 19
Co-authors Amanda Wilson, Peter Wark
2000 Davies H, Olson L, Gibson P, 'Methotrexate as a steroid sparing agent for asthma in adults.', Cochrane database of systematic reviews (Online : Update Software), (2000)

BACKGROUND: Sustained oral corticosteroid use can lead to complications, so there is interest in identifying agents that can reduce oral steroid use in people with asthma. Methotr... [more]

BACKGROUND: Sustained oral corticosteroid use can lead to complications, so there is interest in identifying agents that can reduce oral steroid use in people with asthma. Methotrexate has attracted attention as a possible steroid sparing agent in patients with chronic oral steroid dependent asthma. OBJECTIVES: The objective of this review was to assess the effects of adding methotrexate to oral corticosteroids in adults with stable asthma who are dependent on oral corticosteroids. SEARCH STRATEGY: The Cochrane Airways Group trials register and reference lists of identified articles were searched. SELECTION CRITERIA: Randomised trials of the addition of methotrexate compared with placebo in adult steroid dependent asthmatics. Duration of therapy needed to be at least 12 weeks. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data extraction was carried out by two reviewers independently. Study authors were contacted for missing information. MAIN RESULTS: Ten trials involving a total of 185 people were included. Study design and quality, corticosteroid dosages and outcomes varied widely. There was a reduction in oral corticosteroid dose favouring methotrexate in parallel trials (weighted mean difference -4.1 mg per day, 95% confidence interval -6.8 to -1.3) and also in cross-over trials (weighted mean difference -2.9 mg per day, 95% confidence interval -5.9 to -0.2). There was no difference between methotrexate and placebo for forced expiratory volume in one minute (weighted mean difference 0.12 litre, 95% confidence interval -0.21 to 0.45). Hepatotoxicity was a common adverse effect with methotrexate compared to placebo (odds ratio 6.9, 95% confidence interval 3.1 to 15.5). REVIEWER'S CONCLUSIONS: Methotrexate may have a small steroid sparing effect in adults with asthma who are dependent on oral corticosteroids. However, the overall reduction in daily steroid use is probably not large enough to reduce steroid-induced adverse effects. This small potential to reduce the impact of steroid side-effects is probably insufficient to offset the adverse effects of methotrexate.

2000 Hensley M, Coughlan JL, Gibson P, 'Lung volume reduction surgery for diffuse emphysema.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: Lung volume reduction surgery (LVRS) has been re-introduced for treating patients with severe diffuse emphysema. OBJECTIVES: To assemble evidence from randomised contr... [more]

BACKGROUND: Lung volume reduction surgery (LVRS) has been re-introduced for treating patients with severe diffuse emphysema. OBJECTIVES: To assemble evidence from randomised controlled trials for the effectiveness of LVRS, and identify optimal surgical techniques, those patients who benefit most and those for whom it should be avoided. SEARCH STRATEGY: Randomised controlled trials were identified using the Cochrane Airways Group COPD register using the terms: emphysema AND (emphysema surgery OR lung volume reduction surgery OR LVRS OR volume reduction surgery OR pneumectomy OR reduction pneumoplasty OR lung reduction surgery). The Cochrane Controlled Clinical Trials Register was also searched using these terms. SELECTION CRITERIA: Randomised controlled trials that studied the safety and efficacy of LVRS in patients with diffuse emphysema were included. Studies were excluded if they investigated giant or bullous emphysema. DATA COLLECTION AND ANALYSIS: Two independent reviewers assessed trials for inclusion and extracted data. MAIN RESULTS: Only one randomised trial of LVRS for diffuse emphysema was identified. This compared stapled unilateral thoracoscopic lung reduction coupled with bovine pericardium reinforcement with a unilateral neodymium:yttrium aluminium garnet laser contact reduction. A total of 72 patients were studied. Both arms included post-operative rehabilitation and appeared to be well matched at randomisation. Improvement in FEV1 & FVC at six months was significantly greater in the staple treated group (p < 0.01 & p < 0. 07 respectively), but absolute increases were small. Need for supplemental oxygen was reduced significantly more in the staple treated group; Peto Odds Ratio (OR) 4.05; 95% confidence interval (CI) 1.40, 11.71. Quality of life improved more in the staple treated group (OR 5.36; 95% CI 2.13,13.47). The rate of delayed pneumothorax in the laser treated group was significantly higher (OR 10.46; 95% CI 1.98, 55.30). REVIEWER'S CONCLUSIONS: There is no randomised controlled trial evidence concerning the efficacy of LVRS for diffuse emphysema compared to optimal conservative medical therapy. Stapling is more effective than laser resection and has a lower complication rate. LVRS should not be applied routinely until results of large trials currently underway become available.

Citations Scopus - 15
Co-authors Michael Hensley
2000 Wilson AJ, Gibson PG, Coughlan J, 'Long acting beta-agonist versus theophylline for maintenance treatment of asthma', Praxis, 89 1305-1305 (2000)
Co-authors Amanda Wilson
2000 Partridge MR, Hill SR, 'Enhancing care for people with asthma: the role of communication, education, training and self-management', EUROPEAN RESPIRATORY JOURNAL, 16 333-348 (2000)
DOI 10.1183/09031936.00.16233400
Citations Scopus - 96Web of Science - 64
2000 Norzila MZ, Fakes K, Henry RL, Simpson J, Gibson PG, 'Interleukin-8 secretion and neutrophil recruitment accompanies induced sputum eosinophil activation in children with acute asthma', American Journal of Respiratory and Critical Care Medicine, 161 769-774 (2000)

Although airway inflammation is recognized as a key feature of asthma, the characteristics of airway inflammation in children with acute severe asthma are not well defined. The ai... [more]

Although airway inflammation is recognized as a key feature of asthma, the characteristics of airway inflammation in children with acute severe asthma are not well defined. The aim of this study was to describe the characteristics of airway inflammation in children with an acute exacerbation of asthma using sputum cell counts and fluid-phase measurements and to examine the changes in these parameters upon resolution of the exacerbation. Children (n = 38) presenting to the Emergency Department with acute asthma underwent successful sputum induction using ultrasonically nebulized normal saline (n = 22), or expectorated sputum spontaneously (n = 16). Sputum induction was repeated at least 2 wk later when the children had recovered (n = 28). Sputum portions were selected, dispersed and total and differential cell counts performed. Neutrophil elastase and EG2-positive eosinophils were assessed and fluid-phase eosinophil cationic protein (ECP), myeloperoxidase (MPO), interleukin-8 (IL-8), and IL-5 were measured. During the acute exacerbation the median (range) total cell count was 8.4 x 106/ml (0.5 to 190.3), and fell significantly at resolution to 1.3 x 106/ml (p < 0.01). The inflammatory cell infiltrate was mixed and included eosinophils (0.8 x 106/ml), neutrophils (3.3 x 106/ml), and mast cells. EG2+ cells were high and correlated with the degree of airflow obstruction (r = -0.5, p = 0.02). They decreased significantly at resolution as did supernatant ECP (1,078 versus 272 ng/ml), suggesting that eosinophils were activated during the exacerbation. MPO was 220 ng/ml at exacerbation and fell significantly to 1 ng/ml at resolution. Levels of IL-8 and IL-5 were elevated during the acute exacerbation and IL-8 concentrations decreased at resolution. In conclusion, airway inflammation can be studied in children with acute asthma by sputum induction. Airway inflammation is present during an acute exacerbation of asthma, and is characterized by infiltration and activation of both eosinophils and neutrophils. The heterogeneity of airway inflammation in acute asthma may influence response to corticosteroid therapy.

DOI 10.1164/ajrccm.161.3.9809071
Citations Scopus - 184
Co-authors Jodie Simpson
2000 Hensley M, Coughlan JL, Gibson P, 'Lung volume reduction surgery for diffuse emphysema', Praxis, 89 1393 (2000)
Co-authors Michael Hensley
2000 Gibson PG, Henry RL, Coughlan JL, 'Gastro-oesophageal reflux treatment for asthma in adults and children', Praxis, 89 1306 (2000)
1999 McNamara T, Zeng XP, Faraguna LA, Gibson P, Scicchitano R, Holmes M, 'Defensin mRNA is expressed in cells from induced sputum in asthmatics', Respirology, 4 (1999)

Defensins are small antimicrobial peptides which in addition to their role in host defense, have a number of functions, including cytotoxicity which may contribute to airways epit... [more]

Defensins are small antimicrobial peptides which in addition to their role in host defense, have a number of functions, including cytotoxicity which may contribute to airways epithelial damage in asthma. As part of a large multicentre trial, we had the opportunity to examine induced sputum obtained from a group of asthmatic subjects. Hypothesis: Human defensin gene expression is a marker of airway inflammation and asthma severity. Methods: Induced sputum was collected from 11 asthmatics and processed using the plug selection method. Total and differential cell counts were determined before isolation of total RNA. Defensin mRNA expression was analysed using reverse transcription and competitive polymerase chain reaction. Data were analysed using regression analysis; significance p<0.05. Results: Induced sputum samples yielded an average cell viability of 84.5 ± 2.5%. The differential cell count was (mean % ±SEM) neutrophils 42.1 ± 6.0, macrophages 55.1 ±5.8, eosinophils 1.5±0.6, epithelial cells 0.7±0.2, lymphocytes 0.7±0.2, mast cells 0.1 ±0.0 and squamous cells 4.0±1.0. Human ct-defensins (Human Neutrophil Peptide 1-3; HNP1-3), human beta defensin-1 (hBD-1) and human beta defensin-2 (hBD-2) mRNA expression was detected in all samples. Defensin gene expression did not correlate significantly with % predicted FEVi, % predicted FVC, FEWFVC or PD to hypertonic saline. Defensin expression was not correlated significantly with the % of neutrophils or macrophages in sputum. Conclusions: Defensin mRNA expressed in sputum cells obtained from asthmatics and the relationship with parameters of asthma severity and airways inflammation needs further investigation.

1999 Shah S, Mazurski E, Wang H, Henry R, Bauman A, Peat JK, Gibson P, 'Asthma knowledge and morbidity in rural adolescents', Respirology, 4 (1999)

The burden of illness caused by asthma in rural adolescents is poorly defined. We sought to establish knowledge of asthma self-management and various aspects of asthma morbidity i... [more]

The burden of illness caused by asthma in rural adolescents is poorly defined. We sought to establish knowledge of asthma self-management and various aspects of asthma morbidity in high school students in rural NSW, prior to the implementation of a peer-led asthma educational program. Methods: Students from years 7 and 10 in six high schools (n =1379, 91% response rate) in Tamworth completed video questionnaires to measure asthma prevalence (ISAAC) and asthma self management behaviour'. Students who reported wheezing in the last year (n=280, 86% response rate) completed questionnaires for Quality of Life (QOL), asthma symptoms and performed spirometry. Results: Prevalence of recent wheeze was 20.5% in Year 7 and 26.6% in Year 10 students (p <.02). The higher prevalence of wheeze in year 10 compared to Year 7 students tended to be greater among girls (6.4%) than boys (5.6%). Of students who reported wheezing within the last year, self- reported school absenteeism was 9.2 days with 10% having an asthma attack at school. QOL impairment due to asthma was mild (mean 5.5, where 1 = severe and 7= no impairment), and females reported more limitation (5.3) than males (5.7, p =.001). Only 5% had severe impairment due to asthma. Inhaled corticosteroids were used by 27% (n=76). Conclusions: Asthma is common in high school students in rural NSW, with older girls reporting more asthma. Females also experienced more impairment of QOL. The frequent asthma attacks at school underscore the need for effective asthma educational programs for this population.

1999 Henry R, Gibson P, Coughlan J, 'Treatment of reflux does not consistently improve asthma', Respirology, 4 (1999)

Asthma and gastroesophageal reflux (GOR) commonly coexist. The Australian Asthma Management Plan advises that treatment of GOR in patients with asthma and reflux may improve asthm... [more]

Asthma and gastroesophageal reflux (GOR) commonly coexist. The Australian Asthma Management Plan advises that treatment of GOR in patients with asthma and reflux may improve asthma. We conducted a systematic review to establish whether high quality literature supports the recommendation. Methods: Relevant articles were identified by a search of the Cochrane Airways Group clinical trials database. Two reviewers independently assessed articles for inclusion, methodological quality, study characteristics, interventions and outcomes. RCT's reporting the effects of GOR treatment on asthma were included. Results: From 18 potentially relevant RCT's, 9 were included. Agreement between assessors was 100%. Interventions were proton pump inhibitors (n=3), H2 antagonists (n=5), surgery (n=1) and conservative management (n=1). Treatment-time ranged from 1 week to 6 months. Although 6/9 trials reported that treatment improved at least 1 asthma outcome, these outcomes differed between trials. Overall, anti-reflux treatment did not consistently benefit FEV1, peak expiratory flow rate, asthma symptoms, nocturnal asthma symptoms or asthma medications in unselected asthmatic subjects. Significant improvement in wheeze was reported in 2 studies. One study included only subjects with asthma that was triggered by GOR, however treatment was too brief (1 week) to observe an effect. Conclusion: The published literature does not consistently support the treatment of GOR as a means to control asthma. Trials in asthma proven to be triggered by GOR are needed.

1999 Wilson AJ, Gibson PG, Coughlan J, 'Comparative efficacy and safety of long-acting ß 2-agonists versus theophylline: A systematic review', Respirology, 4 (1999)

Both theophylline and long-acting ß 2-agonists are recommended as effective treatment for nocturnal asthma in Australian Asthma Management Plan. This review sought to assess the c... [more]

Both theophylline and long-acting ß 2-agonists are recommended as effective treatment for nocturnal asthma in Australian Asthma Management Plan. This review sought to assess the comparative efficacy and safety of long-acting s-agonists and theophylline in the maintenance treatment of asthma. Methods: The Cochrane Airways Group Clinical Trials Register was searched for relevant studies and randomised controlled trials (RCTs) reporting more than one asthma outcome were included. Interventions were defined as inhaled long-acting ß 2-agonists: salmeterol; eformoterol; bambuterol or bitolterol versus ingested sustained-release and/or doseadjusted theophylline. Data on methodological quality, study characteristics, interventions and outcomes were extracted by two independent reviewers and agreement was assessed. Results: Theophylline versus a long-acting ß 2-agonist was reviewed in 6 RCTs of varying quality conducted over a period of 8 years. There was a trend for salmeterol to improve FEV1 more than theophylline (3 studies). More symptom free nights also tended to occur with salmeterol. Bitolterol (1 study) was less efficacious than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (RR 0.37;95%CI 0.23,0.60). Significant reductions were reported for central nervous system adverse events (RR 0.54;95%CI 0.31,0.93) and gastrointestinal adverse events (RR 0.29;95%CI 0.14, 0.60). Conclusions: Salmeterol may be more effective than theophylline in reducing asthma symptoms, including night waking and the need for rescue medication. More adverse events occurred in patients using theophylline when compared to salmeterol.

Co-authors Amanda Wilson
1999 Gibson PG, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, Walters EH, 'Limited (information only) patient education programs for adults with asthma', Praxis, 88 1570 (1999)
Co-authors Michael Hensley, Amanda Wilson
1999 Gibson PG, Coughlan J, Wilson AJ, Abramson M, Bauman A, Hensley MJ, Walters EH, 'Self-management education and regular practitioner review for adults with asthma', Praxis, 88 1571-1572 (1999)
Co-authors Amanda Wilson, Michael Hensley
1999 Gibson PG, 'Asthma in general practice: action plans or planned actions', MEDICAL JOURNAL OF AUSTRALIA, 171 67-67 (1999)
DOI 10.5694/j.1326-5377.1999.tb123521.x
Citations Scopus - 5Web of Science - 3
1999 Gibson PG, 'Airway hyperresponsiveness in asthma', THORAX, 54 656-657 (1999)
Citations Web of Science - 2
1999 Gibson PG, Brusasco V, Crimi E, Pellegrino R, 'Airway hyperresponsiveness in asthma (multiple letters) [4]', Thorax, 54 656-657 (1999)
Citations Scopus - 2
1999 Gibson PG, Coughlan J, Abramson M, 'Self-management education for adults with asthma improves health outcomes', WESTERN JOURNAL OF MEDICINE, 170 266-266 (1999)
Citations Scopus - 13Web of Science - 6
1999 Wark P, Simpson J, Fakes K, Burgess H, Timmins N, Hensley M, Gibson PG, 'Airway inflammation in allergic bronchopulmonary aspergillosis', Respirology, 4 (1999)

Allergic bronchopulmonary aspergillosis (ABPA) is a serious complication of asthma. In uncomplicated asthma airway inflammation(ai) is characterised by sputum eosinophilia without... [more]

Allergic bronchopulmonary aspergillosis (ABPA) is a serious complication of asthma. In uncomplicated asthma airway inflammation(ai) is characterised by sputum eosinophilia without an increase in the total cell count (TCC). In bronchiectasis the intensity of ai increased and there is a neutrophil infiltrate. Airway inflammation in ABPA is not well defined. This study tested the hypothesis that ai in ABPA would be of increased intensity with a mixed eosinophil/neutrophil pattern. Methods: In subjects with asthma, ABPA was assessed by 5 criteria; 1. positive allergy skin test to Aspergillus Fumigatus (Af); 2. raised specific serum IgE to Af; 3. positive precipitating antibodies to Af; 4. total IgE > 10001U/ml and 5. bronchiectasis (CT scan). Subjects were classified as definite ABPA (n=13) with criteria 1, 2, 3 and either 4 or 5; or as probable ABPA (n=18) with 1 and 2 and either 3, 4 or 5 (n=13). These groups were combined for analysis. Af sensitised subjects (n=19 with positive skin testing alone), were compared to a matched group with asthma (negative to Af on skin test) (n=15) and healthy controls (n=8). Spirometry, saline challenge and sputum induction were performed, with results reported as medians and interquartile ranges. Results: Patients with ABPA had an increased TCC (4.6, 0.9-29.6) compared to: Af sensitised (3.6, 1.4-7.4), asthma (1.5, 0.8-3.2), and controls (1.35, 1.3-1.4) (p<0.05). Those with ABPA had increased sputum eosinophils (3.8, 0.3-16.3), compared to: Af sensitised (1.4, 0.1-6), asthma (1.6, 0.01-3), and controls (0.3, 0.3-0.31 ) (p=0.001). Those with ABPA had increased levels of eosinophil cationic protein(ng/ml) (5471, 311-42485) compared to: Af sensitised (1432, 338-6902), asthma (244, 78-857), and controls (110, 99-121 ) (p<0.001). Neutrophil counts were similar in all groups. Myeloperoxidase was similar in ABPA (232, 66-454) and asthma (177, 57-318) (p=0.3) but greater than in healthy controls (76, 76-89) Conclusion: Airway inflammation in ABPA is of increased intensity compared to that of chronic asthma. Unlike bronchiectasis, the cellular infiltrate is predominantly eosinophilic. The eosinophils demonstrate increased activation.

Co-authors Michael Hensley, Jodie Simpson, Peter Wark
1999 Simpson J, Wilson A, Fakes K, Burgess H, Saltos N, Gibson PG, 'Neutrophil activation in symptomatic asthma without eosinophilia', Respirology, 4 (1999)

In mild asthma there is typically an infiltrate with eosinophils, which improves with corticosteroid therapy. Asthma can persist despite high dose inhaled corticosteroid therapy (... [more]

In mild asthma there is typically an infiltrate with eosinophils, which improves with corticosteroid therapy. Asthma can persist despite high dose inhaled corticosteroid therapy (ICS). Aim: The aim of this study was to establish the characteristics of airway inflammation in asthma, which persists despite high dose inhaled corticosteroids. Method: Adults (n=73) with asthma and persistent symptoms who were taking =1000g ICS underwent hypertonic saline challenge and sputum induction. Sputum was dispersed using dithiothreitol and assayed for total cell count, cellular differential, supernatant eosinophil cationic protein (ECP ng/mL), myeloperoxidase (MPO ng/mL) and interleukin-8 (IL-8 ng/mL). Subjects were categorised into 4 groups based upon the presence or absence of airway hyperresponsiveness (AHR) and increased sputum eosinophils (E; being >5%). Results: Subjects with eosinophilic AHR (EAR n=16) had 22% E, compared to those with noneosinophilic AHR (NEAR, n=40) who had 1.5% E. Those with asthma in remission (normal AHR and E; n=14) had 1.2% E. Neutrophil % was similar in all 3 groups (p>0.05). ECP was highest in the EAR positive group (7572) compared with NEAR (2834) and remission (504; p = 0.001). MPO was elevated in NEAR (275) and EAR (253) compared with remission (189; p = 0.05). IL-8 levels were highest in NEAR (86.2) compared to EAR (36.5) and remission (12.9; p = 0.03). Conclusion: Asthma which remains symptomatic despite high dose ICS consists of 2 different inflammatory patterns. While some have typical eosinophil inflammation, the most common pattern is cellular (neutrophil and eosinophil) activation, with suppressed eosinophil counts. This may be mediated by IL-8 secretion. There is heterogeneity of airway inflammation in symptomatic asthma.

Co-authors Jodie Simpson, Amanda Wilson
1999 Gibson PG, Coughlan J, Abramson M, 'Review: Self-management education for adults with asthma improves health outcomes: Commentary', Evidence-Based Medicine, 4 15 (1999)
1999 Gibson PG, Norzila MZ, Fakes K, Simpson J, Henry RL, 'Pattern of airway inflammation and its determinants in children with acute severe asthma', PEDIATRIC PULMONOLOGY, 28 261-270 (1999)
DOI 10.1002/(SICI)1099-0496(199910)28:4&lt;261::AID-PPUL5&gt;3.0.CO;2-I
Citations Scopus - 67Web of Science - 47
Co-authors Jodie Simpson
1998 Pizzichini E, Pizzichini MMM, Gibson P, Parameswaran K, Gleich GJ, Berman L, et al., 'Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 158 1511-1517 (1998)
DOI 10.1164/ajrccm.158.5.9804028
Citations Web of Science - 215
1998 Cai Y, Carty K, Henry RL, Gibson PG, 'Persistence of sputum eosinophilia in children with controlled asthma when compared with healthy children', EUROPEAN RESPIRATORY JOURNAL, 11 848-853 (1998)
DOI 10.1183/09031936.98.11040848
Citations Scopus - 112Web of Science - 95
1998 Gibson PG, Woolley KL, Carty K, Murree-Allen K, Saltos N, 'Induced sputum eosinophil cationic protein (ECP) measurement in asthma and chronic obstructive airway disease (COAD)', CLINICAL AND EXPERIMENTAL ALLERGY, 28 1081-1088 (1998)
Citations Scopus - 44Web of Science - 41
1998 Gibson PG, Shah S, Mamoon HA, 'Peer-led asthma education for adolescents: Impact evaluation', JOURNAL OF ADOLESCENT HEALTH, 22 66-72 (1998)
DOI 10.1016/S1054-139X(97)00203-6
Citations Scopus - 53Web of Science - 49
1998 Gibson PG, 'How to measure airway inflammation: Induced sputum', Canadian Respiratory Journal, 5 (1998)

Induced sputum examination has emerged as an important investigative tool in airway diseases. Sputum can be easily induced by ultrasonic nebulization of Hypertonic saline. Inprove... [more]

Induced sputum examination has emerged as an important investigative tool in airway diseases. Sputum can be easily induced by ultrasonic nebulization of Hypertonic saline. Inprovements in sputum processing have established that sputum provides reproducible measurements of cell counts and fluid phase mediators. Adults and children with stable asthma demonstrate an infiltrate of eosinophils. With an exacerbation of asthma the eosinophil infiltrate increases and the cells become activated in response to cytokines including interleukin-5. A neutrophil infiltrate may accompany some exacerbations. Exacerbations resolve under the influence of corticosteroid therapy. Eosinophils undergo apoptosis and are removed by macrophages. Eosinophilic bronchitis is an important component in up to 20% of patients with chronic cough. Sputum examination promises to be an important technique to facilitate the understanding and management of asthma and cough in adults and children.

Citations Scopus - 9
1998 Gibson PG, 'Severe exacerbation of chronic obstructive airways disease: Health resource use in general practice and hospital', Journal of Quality in Clinical Practice, 18 125-133 (1998)

The objective of this study is to examine the treatment of exacerbations of chronic obstructive airways disease (COAD) in the hospital and in the community setting using a retrosp... [more]

The objective of this study is to examine the treatment of exacerbations of chronic obstructive airways disease (COAD) in the hospital and in the community setting using a retrospective study of patients admitted to a major teaching hospital combined with a general practice chart audit. The admission records for 248 admissions from 128 patients were reviewed. Most patients (70%) had visited their GP within 2 weeks of admission, antibiotics were prescribed for 30% of the exacerbations while 51% were treated with ingested corticosteroids. During hospitalization, features of infection were present in 64% (n = 159) of exacerbations and 79% (n = 196) received antibiotics. Patients were also treated with nebulized bronchodilators, oxygen and corticosteroids (82%). The median length of stay was 10 days (range 0-55). There was a high readmission rate (70%) at 1 year for exacerbation of COAD during the study period. Exacerbations of COAD frequently demonstrated the clinical features of infection. Treatment in general practice was less intensive than in hospital, and there is a need to reconcile these differences with studies of early therapy with antibiotics and corticosteroids. Although corticosteroids were used less often in general practice, the literature in this area is not conclusive and the evidence supporting guideline recommendations is not explicit. There are opportunities to examine the role of early therapy and early discharge programmes to minimize the cost burden from exacerbations of COAD.

Citations Scopus - 42
Co-authors Amanda Wilson
1998 Gibson PG, Coughlan J, Wilson AJ, Shekelle PG, 'Review: Limited asthma education reduces emergency department visits but does not improve patient outcomes', Evidence-Based Medicine, 3 121 (1998)
Co-authors Amanda Wilson
1998 Gibson PG, 'Loss-of-life cost for paediatric illness associated with parental smoking was estimated at U.S. $8.2 billion per year', Evidence-Based Medicine, 3 64 (1998)

Objective Tb calculate the costs of tobacco-related paediatric illness attributable to parental smoking in the United States. Design Cost-estimate study using techniques of litera... [more]

Objective Tb calculate the costs of tobacco-related paediatric illness attributable to parental smoking in the United States. Design Cost-estimate study using techniques of literature synthesis to generate the incidence and costs of tobacco-related paediatric illness. Data sources and selection English-language articles were identified by searching MEDLINE, HEALTH, BIOETHICSLINE, ECONLIT, and Social Sciences Citation Index from January 1980 to May 1996. Articles that included children in the age range of neonate to 18 years were used. For cost data, only articles referring to the United States were included. National databases and textbooks were used to obtain estimates of the prevalence of parental smoking and the incidence of the diseases in question. Main outcome and cost measures Best estimates of the relative risk for smoking-related diseases in children exposed to parental smoking were obtained, and the attributable risk fraction (the fraction of cases of disease that would not have occurred if no one in the population had been exposed) and direct medical expenditures were calculated. The cost of illness (based on costs for loss of life) was also calculated. Costs were adjusted to 1993 U.S. dollars. Main results Estimated annual excess cases of childhood illness and death caused by parental smoking in the United States were 5 400 000 and 6200, respectively, leading to direct medical costs of $4.6 billion and loss-of-life costs of $8.2 billion (Table). Conclusion Loss-of-life cost for paediatric illness associated with parental smoking was estimated at U.S. $8.2 billion per year.

1998 Henry RL, Gibson PG, Carty K, Cai Y, Francis JL, 'Airway inflammation after treatment with aerosolized deoxyribonuclease in cystic fibrosis', PEDIATRIC PULMONOLOGY, 26 97-100 (1998)
DOI 10.1002/(SICI)1099-0496(199808)26:2&lt;97::AID-PPUL4&gt;3.0.CO;2-E
Citations Scopus - 21Web of Science - 14
1998 Gibson PG, Wlodarczyk J, Hensley MJ, Henry RL, Cripps AW, Clancy RL, Gleeson M, 'Epidemiological association of airway inflammation with asthma symptoms and airway hyperresponsiveness in childhood', American Journal of Respiratory and Critical Care Medicine., 158 36-41 (1998) [C1]
Citations Scopus - 168Web of Science - 161
Co-authors Michael Hensley, Maree Gleeson
1998 Gibson PG, Zlatic K, Scott JL, Sewell W, Woolley K, Saltos N, 'Chronic cough resembles asthma with IL-5 and granulocyte-macrophage colony-stimulating factor gene expression in bronchoalveolar cells', Journal of Allergy and Clinical Immunology, 101 320-326 (1998) [C1]
Citations Scopus - 88Web of Science - 75
1998 Hensley MJ, Gibson PG, 'Promoting evidence-based alternative medicine', Medical Journal of Australia, 169 573-574 (1998) [C1]
Citations Scopus - 16Web of Science - 14
Co-authors Michael Hensley
1998 Jones PD, Henry R, Gibson PG, Hankin RG, Carty K, 'Chemotherapy for malignancy induces a remission in asthma symptoms and airway inflammation but not airway hyperreponsivesness', Pediatric Pulmonology, 26 74-77 (1998) [C1]
Citations Scopus - 5Web of Science - 4
1998 Davies HRHR, Olson LLG, Gibson PG, 'Methotrexate as a steroid sparing agent for asthma in adults', Cochrane Database of Systematic Reviews, 2017 (1998)

© 2017 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd. Background: Sustained oral corticosteroid use can lead to complications, so there is interest in iden... [more]

© 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background: Sustained oral corticosteroid use can lead to complications, so there is interest in identifying agents that can reduce oral steroid use in people with asthma. Methotrexate has attracted attention as a possible steroid sparing agent in patients with chronic oral steroid dependent asthma. Objectives: The objective of this review was to assess the effects of adding methotrexate to oral corticosteroids in adults with stable asthma who are dependent on oral corticosteroids. Search methods: The Cochrane Airways Group Specialised Register and reference lists of identified articles were searched. Searches are current as of February 2006. Selection criteria: Randomised trials of the addition of methotrexate compared with placebo in adult steroid dependent asthmatics. Duration of therapy needed to be at least 12 weeks. Data collection and analysis: Trial quality was assessed and data extraction was carried out by two reviewers independently. Study authors were contacted for missing information. Main results: Ten trials involving a total of 185 people were included. Study design and quality, corticosteroid dosages and outcomes varied widely. There was a reduction in oral corticosteroid dose favouring methotrexate in parallel trials (weighted mean difference -4.1 mg per day, 95% confidence interval -6.8 to -1.3) and also in cross-over trials (weighted mean difference -2.9 mg per day, 95% confidence interval -5.9 to -0.2). There was no difference between methotrexate and placebo for forced expiratory volume in one minute (weighted mean difference 0.12 litre, 95% confidence interval -0.21 to 0.45). Hepatotoxicity was a common adverse effect with methotrexate compared to placebo (odds ratio 6.9, 95% confidence interval 3.1 to 15.5). Authors' conclusions: Methotrexate may have a small steroid sparing effect in adults with asthma who are dependent on oral corticosteroids. However, the overall reduction in daily steroid use is probably not large enough to reduce steroid-induced adverse effects. This small potential to reduce the impact of steroid side-effects is probably insufficient to offset the adverse effects of methotrexate.

DOI 10.1002/14651858.CD000391
Citations Scopus - 89
1998 Pizzichini E, Pizzichini MMM, Gibson P, Parameswaran K, Gleich GJ, Berman L, et al., 'Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis', American Journal of Respiratory and Critical Care Medicine, 158 1511-1517 (1998)

A reliable predictor of benefit from corticosteroid treatment in patients with chronic airflow limitation is needed. In a single-blind, sequential crossover trial of placebo and p... [more]

A reliable predictor of benefit from corticosteroid treatment in patients with chronic airflow limitation is needed. In a single-blind, sequential crossover trial of placebo and prednisone (30 mg/day) treatment, with each given for 2 wk, we investigated whether an increased proportion of sputum eosinophils (= 3%) predicts a beneficial effect of prednisone in smokers with severe obstructive bronchitis. Patients were seen before and after each treatment. Clinical measurements were made blind to the laboratory findings and vice-versa. Eighteen of 20 patients completed the study. Eight had sputum eosinophilia and similar clinical and physiologic characteristics to those of 10 patients without a finding of sputum eosinophilia. Only in patients with sputum eosinophilia did prednisone, as compared with placebo, produce a statistically significant and clinically important mean effect on effort dyspnea of 0.8 (95% confidence interval [CI]: 0.3 to 1.2), p = 0.008, and in quality of life of 1.96 (95% CI: 0.5 to 3.3), p = 0.01, associated with a small improvement in FEV1 of 0.11 L (95% CI:0.04 to 0.23 L), p = 0.05. In these patients, prednisone also produced a significant decline in the median sputum eosinophil percentage, from 9.7% to 0.5% (p = 0.002), eosinophil cationic protein (ECP), from 6,000 µg/L to 1,140 µg/L (p < 0.001), and fibrinogen, from 253 mg/L to 5.4 mg/L (p < 0.001). These findings indicate that in smokers with severe airflow limitation, sputum eosinophilia predicts a beneficial effect of prednisone treatment. Improvement in FEV1, after prednisone treatment in this population, is small, and may not be appreciated in clinical practice.

Citations Scopus - 269
1997 Carney IK, Gibson PG, MurreeAllen K, Saltos N, Olson LG, Hensley MJ, 'A systematic evaluation of mechanisms in chronic cough', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 156 211-216 (1997)
DOI 10.1164/ajrccm.156.1.9605044
Citations Scopus - 116Web of Science - 100
Co-authors Michael Hensley
1997 Thorne RF, Meldrum CJ, Harris SJ, Dorahy DJ, Shafren DR, Berndt MC, et al., 'CD36 forms covalently associated dimers and multimers in platelets and transfected COS-7 cells', BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 240 812-818 (1997)
DOI 10.1006/bbrc.1997.7755
Citations Scopus - 31Web of Science - 30
Co-authors Rick Thorne
1997 Gibson P, 'Chronic Cough in Adults', Current Therapeutics, 38 50-56 (1997)

Although chronic cough usually is not catching, the frustration it causes to patients can be! Despite this, much can be achieved by taking a focused history, performing selective ... [more]

Although chronic cough usually is not catching, the frustration it causes to patients can be! Despite this, much can be achieved by taking a focused history, performing selective investigations and instituting trials of treatment. It should be noted, however, that antibiotics are probably overused in the management of this condition. This article details an approach to chronic cough.

1997 Wolley KL, Gibson PG, Carty K, Wilson AJ, Twaddell SH, Woolley MJ, 'Eosinophil apoptosis and the resolution of airway inflammation in asthma', Pediatric Pulmonology, 23 320 (1997)

Asthma is accompanied by the accumulation of potentially damaging eosinophils within inflamed airways. How eosinophils may be removed from the airways is not clear. The phagocytic... [more]

Asthma is accompanied by the accumulation of potentially damaging eosinophils within inflamed airways. How eosinophils may be removed from the airways is not clear. The phagocytic removal of eosinophils in vitro requires that they undergo apoptosis, a form of cell death. We postulated that eosinophil apoptosis may occur in vivo, promoting the removal of airway eosinophils and the resolution of inflammation in asthma. We examined eosinophil apoptosis in sputum samples obtained from 11 subjects during an asthma exacerbation and 2 wk after corticosteroid treatment of the exacerbation. Airway function improved following corticosteroid treatment, and eosinophilic inflammation subsided, with significant decreases occurring in the number of airway eosinophils and the percentage of activated eosinophils. The proportion of apoptotic airway eosinophils increased significantly following corticosteroid treatment, and eosinophil products were apparent within macrophages. Our findings indicate that eosinophil apoptosis is clinically relevant in asthma. Apoptosis may represent a mechanism that promotes the resolution of eosinophilic inflammation in asthma. Comments. Apoptosis, a programmed form of cell death appears to be an important mechanism responsible for the removal of airway eosinophils in the resolution of acute asthma. This is the first report of apoptosis of airway eosinophils.

Co-authors Amanda Wilson
1996 Gibson PG, 'Corticosteroids - Clinical applications: Exacerbations of asthma in adults', Australian Prescriber, 19 44-47 (1996)

Corticosteroids are essential to reverse the eosinophilic airway inflammation which causes symptomatic exacerbations of asthma. Much of the current variation in clinical practice ... [more]

Corticosteroids are essential to reverse the eosinophilic airway inflammation which causes symptomatic exacerbations of asthma. Much of the current variation in clinical practice is not justified by data from clinical trials. Oral prednisolone is as effective as intravenous therapy and very high doses of corticosteroid are no better than modest doses (30- 50 mg prednisolone). Corticosteroids should be given twice a day for optimum effect. Therapy does not need to be tapered, but can be ceased abruptly after 10 days in most patients who are also taking high-dose inhaled corticosteroids. There is an increasing role for inhaled corticosteroids in the management of mild exacerbations of asthma. The dose, route and duration of therapy need to be defined for each patient and written down as part of an action plan to enable early intervention in future exacerbations.

Citations Scopus - 7
1996 Dupen F, Higginbotham N, Francis L, Cruickshank D, Gibson P, 'Validation of a new multidimensional health locus of control scale (form C) in asthma research', PSYCHOLOGY & HEALTH, 11 493-504 (1996)
DOI 10.1080/08870449608401985
Citations Scopus - 7Web of Science - 7
Co-authors Nick Higginbotham
1996 Twaddell SH, Gibson PG, Carty K, Woolley KL, Henry RL, 'Assessment of airway inflammation in children with acute asthma using induced sputum', EUROPEAN RESPIRATORY JOURNAL, 9 2104-2108 (1996)
DOI 10.1183/09031936.96.09102104
Citations Scopus - 86Web of Science - 71
1996 Gibson PG, Stuart JE, Wlodarczyk J, Olson LG, Hensley MJ, 'Nasal inflammation and chronic ear disease in Australian Aboriginal children', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 32 143-147 (1996)
DOI 10.1111/j.1440-1754.1996.tb00911.x
Citations Scopus - 20Web of Science - 20
Co-authors John Stuart, Michael Hensley
1996 Twaddell SH, Henry RL, Francis JL, Gibson PG, 'The prediction of hospital admission in children with acute asthma', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 32 532-535 (1996)
DOI 10.1111/j.1440-1754.1996.tb00968.x
Citations Scopus - 14Web of Science - 12
1996 Gleeson M, Clancy RL, Hensley MJ, Cripps AW, Henry RL, Wlodarczyk JH, Gibson PG, 'Development of bronchial hyperreactivity following transient absence of salivary IgA', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 153 1785-1789 (1996)
DOI 10.1164/ajrccm.153.6.8665035
Citations Scopus - 18Web of Science - 15
Co-authors Maree Gleeson, Michael Hensley
1996 Woolley KL, Gibson PG, Carty K, Wilson AJ, Woolley MJ, 'Eosinophil apoptosis and the resolution of airway inflammation in asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 154 237-243 (1996)
DOI 10.1164/ajrccm.154.1.8680686
Citations Scopus - 228Web of Science - 202
Co-authors Amanda Wilson
1996 Gibson PG, 'The use of continuous quality improvement methods to implement practice guidelines in asthma', Journal of Quality in Clinical Practice, 16 87-102 (1996)

National asthma management guidelines have improved awareness of the rising morbidity and mortality from asthma but have not been widely implemented at a local level. This paper d... [more]

National asthma management guidelines have improved awareness of the rising morbidity and mortality from asthma but have not been widely implemented at a local level. This paper describes the use of continuous quality improvement techniques to facilitate the implementation of asthma management guidelines within a tertiary hospital setting. A baseline audit demonstrated satisfactory emergency assessment and treatment, but identified poor compliance with the patient education aspects of the asthma management plan. An evaluation of the literature demonstrated that programs combining asthma education and management were effective when directed towards adults with a recent severe asthma exacerbation. An asthma education and management service was developed to address these deficits. A repeat audit was conducted which identified improvements in asthma control and management skills for patients attending the education program, together with reductions in asthma re-admission rates for patients referred to the service. Ongoing quality assessments will target nonattenders to the service and the maintenance of asthma skills. An area Asthma Health Outcomes Council was formed to address the issues of asthma management throughout the area health service.

Citations Scopus - 27
Co-authors Amanda Wilson
1996 Cai Y, Carty K, Gibson P, Henry R, 'Comparison of sputum processing techniques in cystic fibrosis', PEDIATRIC PULMONOLOGY, 22 402-407 (1996)
Citations Scopus - 16Web of Science - 17
1995 GIBSON PG, NAIR BR, DAVIES C, SAUNDERS NA, 'DEVELOPMENT AND IMPLEMENTATION OF AN INNOVATIVE INTERN TRAINING-PROGRAM', MEDICAL EDUCATION, 29 220-224 (1995)
DOI 10.1111/j.1365-2923.1995.tb02834.x
Citations Scopus - 4Web of Science - 4
Co-authors Kichu Nair
1995 GIBSON PG, MATTOLI S, SEARS MR, DOLOVICH J, HARGREAVE FE, 'INCREASED PEAK FLOW VARIABILITY IN CHILDREN WITH ASYMPTOMATIC HYPERRESPONSIVENESS', EUROPEAN RESPIRATORY JOURNAL, 8 1731-1735 (1995)
DOI 10.1183/09031936.95.08101731
Citations Scopus - 29Web of Science - 30
1995 GIBSON PG, HARGREAVE FE, GIRGISGABARDO A, MORRIS M, DENBURG JA, DOLOVICH J, 'CHRONIC COUGH WITH EOSINOPHILIC BRONCHITIS - EXAMINATION FOR VARIABLE AIR-FLOW OBSTRUCTION AND RESPONSE TO CORTICOSTEROID', CLINICAL AND EXPERIMENTAL ALLERGY, 25 127-132 (1995)
DOI 10.1111/j.1365-2222.1995.tb01017.x
Citations Scopus - 144Web of Science - 121
1995 GIBSON PG, WLODARCZYK J, HENSLEY MJ, MURREEALLEN K, OLSON LG, SALTOS N, 'USING QUALITY-CONTROL ANALYSIS OF PEAK EXPIRATORY FLOW RECORDINGS TO GUIDE THERAPY FOR ASTHMA', ANNALS OF INTERNAL MEDICINE, 123 488-+ (1995)
DOI 10.7326/0003-4819-123-7-199510010-00002
Citations Scopus - 59Web of Science - 60
Co-authors Michael Hensley
1995 GIBSON PG, HENRY RL, VIMPANI GV, HALLIDAY J, 'ASTHMA KNOWLEDGE, ATTITUDES, AND QUALITY-OF-LIFE IN ADOLESCENTS', ARCHIVES OF DISEASE IN CHILDHOOD, 73 321-326 (1995)
DOI 10.1136/adc.73.4.321
Citations Scopus - 116Web of Science - 95
1995 GIBSON PG, WLODARCZYK JH, BORGAS T, 'DRUG-DELIVERY IN ASTHMA - A COMPARISON OF SPACERS WITH A JET NEBULIZER', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 25 324-329 (1995)
DOI 10.1111/j.1445-5994.1995.tb01897.x
Citations Scopus - 12Web of Science - 11
1995 GIBSON PG, TALBOT PI, TONEGUZZI RC, 'SELF-MANAGEMENT, AUTONOMY, AND QUALITY-OF-LIFE IN ASTHMA', CHEST, 107 1003-1008 (1995)
DOI 10.1378/chest.107.4.1003
Citations Scopus - 99Web of Science - 75
1995 Gibson PG, Talbot PI, Toneguzzi RC, 'Self-management, autonomy, and quality of life in asthma. Population Medicine Group 91C.', Chest, 107 1003-1008 (1995)
DOI 10.1378/chest.107.4.1003
1994 Gibson PG, 'Computer-supported education reduced hospital admissions in asthma', Annals of Internal Medicine, 121 20-21 (1994)
1994 SHAH S, GIBSON PG, WACHINGER S, 'RECOGNITION AND CRISIS MANAGEMENT OF ASTHMA IN SCHOOLS', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 30 312-315 (1994)
DOI 10.1111/j.1440-1754.1994.tb00652.x
Citations Scopus - 16Web of Science - 13
1994 HENRY RL, GIBSON PG, VIMPANI GV, HAZELL J, LEGGATT R, MOWBRAY C, et al., 'INTEGRATED HEALTH AND EDUCATION INPUT IN THE DEVELOPMENT OF EDUCATIONAL RESOURCES ABOUT ASTHMA FOR SCHOOLS', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 30 492-496 (1994)
DOI 10.1111/j.1440-1754.1994.tb00719.x
Citations Scopus - 9Web of Science - 9
1993 GIBSON PG, ALLEN CJ, YANG JP, WONG BJO, DOLOVICH J, DENBURG J, HARGREAVE FE, 'INTRAEPITHELIAL MAST-CELLS IN ALLERGIC AND NONALLERGIC ASTHMA - ASSESSMENT USING BRONCHIAL BRUSHINGS', AMERICAN REVIEW OF RESPIRATORY DISEASE, 148 80-86 (1993)
DOI 10.1164/ajrccm/148.1.80
Citations Scopus - 105Web of Science - 94
1993 GIBSON P, 'ASTHMA GUIDELINES AND EVIDENCE-BASED MEDICINE', LANCET, 342 1305-1305 (1993)
DOI 10.1016/0140-6736(93)92399-E
Citations Scopus - 17Web of Science - 16
1993 GIBSON PG, TALBOT PI, HANCOCK J, HENSLEY MJ, 'A PROSPECTIVE AUDIT OF ASTHMA MANAGEMENT FOLLOWING EMERGENCY ASTHMA-TREATMENT AT A TEACHING HOSPITAL', MEDICAL JOURNAL OF AUSTRALIA, 158 775-778 (1993)
Citations Scopus - 45Web of Science - 45
Co-authors Michael Hensley
1993 Blackie JD, Gibson P, Murree-Allen K, Saul WP, 'Acute myopathy in status asthmaticus.', Clinical and experimental neurology, 30 72-81 (1993)

An acute myopathy complicating life-threatening asthma has been reported with increasing frequency. We present a further 3 patients with this complication. Each patient had nerve ... [more]

An acute myopathy complicating life-threatening asthma has been reported with increasing frequency. We present a further 3 patients with this complication. Each patient had nerve conduction studies, electromyography and muscle biopsy performed. The records of a cohort of 12 patients, ventilated in an intensive care unit over a 16 month period, were reviewed. Eleven out of the 12 patients developed an elevated creatine kinase level (median 1311 U/L, range 185-9973 U/L) and 4 developed symptomatic weakness. The myopathy of status asthmaticus is not a homogeneous clinicopathological entity. Although myopathy is the predominant feature, there is a neuropathic component in some patients. Full recovery is usual. The combination of corticosteroids and neuromuscular blocking agents has been proposed as the possible cause of the complication.

Citations Scopus - 13
1993 GIBSON P, HENRY D, FRANCIS L, CRUICKSHANK D, DUPEN F, HIGGINBOTHAM N, et al., 'ASSOCIATION BETWEEN AVAILABILITY OF NONPRESCRIPTION BETA(2) AGONIST INHALERS AND UNDERTREATMENT OF ASTHMA', BRITISH MEDICAL JOURNAL, 306 1514-1518 (1993)
DOI 10.1136/bmj.306.6891.1514
Citations Scopus - 33Web of Science - 36
Co-authors Nick Higginbotham
1992 PIN I, GIBSON PG, KOLENDOWICZ R, GIRGISGABARDO A, DENBURG JA, HARGREAVE FE, DOLOVICH J, 'USE OF INDUCED SPUTUM CELL COUNTS TO INVESTIGATE AIRWAY INFLAMMATION IN ASTHMA', THORAX, 47 25-29 (1992)
DOI 10.1136/thx.47.1.25
Citations Scopus - 781Web of Science - 741
1992 HENRY DA, GIBSON P, CRUICKSHANK D, FRANCIS L, DUPEN F, HIGGINBOTHAM N, HENRY RL, 'NONPRESCRIPTION USE OF BRONCHODILATOR AEROSOLS', MEDICAL JOURNAL OF AUSTRALIA, 156 68-68 (1992)
Citations Scopus - 4Web of Science - 7
Co-authors Nick Higginbotham
1992 GIBSON PG, WONG BJO, HEPPERLE MJE, KLINE PA, GIRGISGABARDO A, GUYATT G, et al., 'A RESEARCH METHOD TO INDUCE AND EXAMINE A MILD EXACERBATION OF ASTHMA BY WITHDRAWAL OF INHALED CORTICOSTEROID', CLINICAL AND EXPERIMENTAL ALLERGY, 22 525-532 (1992)
DOI 10.1111/j.1365-2222.1992.tb00161.x
Citations Scopus - 138Web of Science - 142
1991 WONG BJO, GIBSON PG, DOLOVICH J, HARGREAVE FE, 'EOSINOPHIL MAST-CELLS IN AIRWAY DISEASE', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 87 891-891 (1991)
DOI 10.1016/0091-6749(91)90140-J
1991 GIBSON PG, MANNING PJ, OBYRNE PM, GIRGISGABARDO A, DOLOVICH J, DENBURG JA, HARGREAVE FE, 'ALLERGEN-INDUCED ASTHMATIC RESPONSES - RELATIONSHIP BETWEEN INCREASES IN AIRWAY RESPONSIVENESS AND INCREASES IN CIRCULATING EOSINOPHILS, BASOPHILS, AND THEIR PROGENITORS', AMERICAN REVIEW OF RESPIRATORY DISEASE, 143 331-335 (1991)
DOI 10.1164/ajrccm/143.2.331
Citations Scopus - 129Web of Science - 151
1990 HARGREAVE FE, GIBSON PG, RAMSDALE EH, 'AIRWAY HYPERRESPONSIVENESS, AIRWAY INFLAMMATION, AND ASTHMA', IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 10 439-448 (1990)
Citations Scopus - 13Web of Science - 7
1990 GIBSON PG, BREIT SN, BRYANT DH, 'HYPOXIA DURING BRONCHOALVEOLAR LAVAGE', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 20 39-43 (1990)
DOI 10.1111/j.1445-5994.1990.tb00368.x
Citations Scopus - 5Web of Science - 6
1990 GIBSON PG, DOLOVICH J, GIRGISGABARDO A, MORRIS MM, ANDERSON M, HARGREAVE FE, DENBURG JA, 'THE INFLAMMATORY RESPONSE IN ASTHMA EXACERBATION - CHANGES IN CIRCULATING EOSINOPHILS, BASOPHILS AND THEIR PROGENITORS', CLINICAL AND EXPERIMENTAL ALLERGY, 20 661-668 (1990)
DOI 10.1111/j.1365-2222.1990.tb02705.x
Citations Scopus - 105Web of Science - 100
1990 Gibson PG, Dolovich J, Denburg JA, Girgis-Gabardo A, Hargreave FE, 'Sputum cell counts in airway disease: a useful sampling technique.', Agents and actions. Supplements, 30 161-172 (1990)

Quantitative sputum cell counts from patients with asthma and chronic bronchitis were performed and found to be reproducible. Sputum from carefully characterized subjects with ast... [more]

Quantitative sputum cell counts from patients with asthma and chronic bronchitis were performed and found to be reproducible. Sputum from carefully characterized subjects with asthma contained large numbers of eosinophils and formalin-sensitive metachromatic (mast) cells. In contrast, the macrophage was the dominant cell type in the sputum from smokers with chronic bronchitis. In a third group of patients with corticosteroid responsive-chronic cough and normal methacholine airway responsiveness the sputum contained eosinophils and metachromatic cells, similar to the asthmatic subjects. Sputum cell counts are a useful, noninvasive method for the identification of this pattern of inflammatory response in patients with airway diseases.

Citations Scopus - 3
1990 Hargreave FE, Ramsdale EH, Gibson PG, Pin I, Denburg JA, Dolovich J, 'The role of measurements of airway responsiveness.', Agents and actions. Supplements, 30 35-40 (1990)

In smokers with chronic airflow limitation (CAL), airway hyperresponsiveness (AHR) to stimuli like methacholine, which act directly on airway smooth muscle, are not specific for t... [more]

In smokers with chronic airflow limitation (CAL), airway hyperresponsiveness (AHR) to stimuli like methacholine, which act directly on airway smooth muscle, are not specific for the pathogenesis which is responsible for AHR to methacholine in subjects with normal spirometry, nor predictive for a beneficial effect of glucocorticosteroid (GCS) treatment. In contrast, AHR to stimuli like hyperventilation, which act indirectly through mediator release, may be specific for the pathogenesis of asthma and predictive for a beneficial effect of GCS. The validation of this possibility requires the demonstration that patients with CAL and AHR to hyper-ventilation demonstrate improvement after treatment with GCS (and have an increase in eosinophils and metachromatic cells in the sputum or bronchoalveolar lavage (BAL), like that seen in asthmatics uncomplicated by CAL).

Citations Scopus - 1
1989 GIBSON PG, BRYANT DH, ROBINSON BWS, BREIT SN, MCLENNAN G, 'THE ROLE OF BRONCHOALVEOLAR LAVAGE IN THE ASSESSMENT OF DIFFUSE LUNG-DISEASES', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 19 281-291 (1989)
DOI 10.1111/j.1445-5994.1989.tb00263.x
Citations Scopus - 11Web of Science - 13
1989 GIBSON PG, GIRGISGABARDO A, MORRIS MM, MATTOLI S, KAY JM, DOLOVICH J, et al., 'CELLULAR CHARACTERISTICS OF SPUTUM FROM PATIENTS WITH ASTHMA AND CHRONIC-BRONCHITIS', THORAX, 44 693-699 (1989)
DOI 10.1136/thx.44.9.693
Citations Scopus - 167Web of Science - 182
1989 GIBSON PG, DENBURG J, DOLOVICH J, RAMSDALE EH, HARGREAVE FE, 'CHRONIC COUGH - EOSINOPHILIC BRONCHITIS WITHOUT ASTHMA', LANCET, 1 1346-1348 (1989)
Citations Web of Science - 322
1989 BREIT SN, CAIRNS D, SZENTIRMAY A, CALLAGHAN T, MURRAY D, WACHER T, et al., 'THE PRESENCE OF SJOGREN SYNDROME IS A MAJOR DETERMINANT OF THE PATTERN OF INTERSTITIAL LUNG-DISEASE IN SCLERODERMA AND OTHER CONNECTIVE-TISSUE DISEASES', JOURNAL OF RHEUMATOLOGY, 16 1043-1049 (1989)
Citations Scopus - 22Web of Science - 24
1989 Gibson PG, Denburg J, Dolovich J, Ramsdale EH, Hargreave FE, 'CHRONIC COUGH: EOSINOPHILIC BRONCHITIS WITHOUT ASTHMA', The Lancet, 333 1346-1348 (1989)

Sputum cell-counts were studied in 7 non-smokers with corticosteroid-responsive chronic cough productive of sputum and 8 smokers with a clinical diagnosis of chronic bronchitis, a... [more]

Sputum cell-counts were studied in 7 non-smokers with corticosteroid-responsive chronic cough productive of sputum and 8 smokers with a clinical diagnosis of chronic bronchitis, all of whom had normal lung function tests and methacholine airway responsiveness, and in 10 non-smokers with asthma, examined during an exacerbation. Sputum from asthmatic patients and subjects with corticosteroid-responsive cough contained eosinophils and metachromatic cells. Macrophages were by far the dominant cell type in sputum from subjects with chronic bronchitis. Airway inflammation with eosinophils and metachromatic cells is not always accompanied by increased airway responsiveness, and current definitions of obstructive airways disease may need to be revised. © 1989.

DOI 10.1016/S0140-6736(89)92801-8
Citations Scopus - 364
1989 Hargreave FE, Gibson PG, Ramsdale EH, Fitzgerald JM, Hepperle MJ, 'Airway hyperresponsiveness and asthma.', Agents and actions. Supplements, 28 205-211 (1989)
1988 RIMMER J, GIBSON P, BRYANT DH, 'EXTENSION OF PULMONARY TUBERCULOSIS AFTER FIBEROPTIC BRONCHOSCOPY', TUBERCLE, 69 57-61 (1988)
DOI 10.1016/0041-3879(88)90041-4
Citations Scopus - 4Web of Science - 8
1988 GIBSON PG, BRYANT DH, MORGAN GW, YEATES M, FERNANDEZ V, PENNY R, BREIT SN, 'RADIATION-INDUCED LUNG INJURY - A HYPERSENSITIVITY PNEUMONITIS', ANNALS OF INTERNAL MEDICINE, 109 288-291 (1988)
DOI 10.7326/0003-4819-109-4-288
Citations Scopus - 76Web of Science - 78
1987 GIBSON PG, BRYANT DH, HARKNESS J, MUNRO VF, PENNY R, COOPER DA, 'PULMONARY MANIFESTATIONS OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 17 551-556 (1987)
DOI 10.1111/j.1445-5994.1987.tb01254.x
Citations Scopus - 2Web of Science - 2
Show 610 more journal articles

Review (12 outputs)

Year Citation Altmetrics Link
2017 McDonald VM, Maltby S, Gibson PG, 'Severe asthma: Can we fix it? Prologue to seeking innovative solutions for severe asthma', RESPIROLOGY (2017)
DOI 10.1111/resp.12956
Citations Scopus - 1Web of Science - 4
Co-authors Steven Maltby, Vanessa Mcdonald
2016 Grainge CL, Maltby S, Gibson PG, Wark PAB, McDonald VM, 'Targeted therapeutics for severe refractory asthma: monoclonal antibodies', EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2016)
DOI 10.1586/17512433.2016.1172208
Citations Scopus - 8Web of Science - 13
Co-authors Christopher Grainge, Steven Maltby, Peter Wark, Vanessa Mcdonald
2013 Gibson PG, 'Asthma and Obesity, the Twin Epidemics (2013) [D2]
2004 Powell HG, Gibson PG, 'High Dose versus low dose inhaled corticosteroid as initial starting dose for asthma in adults and children', ACP Journal Club (2004) [D2]
Citations Scopus - 49Web of Science - 5
2004 Wark PA, Gibson PG, Wilson AJ, 'Azoles for Allergic Bronchopulmonary Aspergillosis Associated With Asthma', Cochrane Database of Systematic Reviews (2004) [D1]
DOI 10.1002/14651858.CD001108
Citations Scopus - 1
Co-authors Amanda Wilson, Peter Wark
2004 Taramarcaz P, Gibson PG, 'Intranasal Corticosteroids for Asthma control in People with Coexisting Asthma and Rhinitis', Cochrane Database of Systematic Reviews (2004) [D1]
Citations Web of Science - 23
2004 Shah S, Wilson AJ, Gibson PG, Coughlan J, 'Long Acting Beta-Agonists Versus Theophylline for Maintenance Treatment of Asthma', Cochrane Database of Systematic Reviews (2004) [D1]
DOI 10.1002/14651858.CD001281
Citations Scopus - 13
Co-authors Amanda Wilson
2004 Gibson PG, Powell HG, Coughlan J, Wilson AJ, Abramson M, Haywood P, et al., 'Self-Management Education and Regular Practitioner Review for Adults With Asthma', Cochrane Database of Systematic Reviews (2004) [D1]
Citations Scopus - 525
Co-authors Amanda Wilson, Michael Hensley
2004 Powell HG, Gibson PG, 'Options for Self-Management Education for Adults with Asthma', Cochrane Database of Systematic Reviews (2004) [D1]
Citations Scopus - 17
2004 Gibson PG, Henry RL, Coughlan J, 'Gastro-Oesophageal Reflux Treatment for Asthma in Adults and Children', Cochrane Database of Systematic Reviews (2004) [D1]
Citations Scopus - 104
2003 Lacasse Y, Brosseau L, Milne S, Gibson PG, 'Respiratory rehabilitation improves health-related quality of life in chronic obstructive pulmonary disease', A C P Journal Club (2003) [D1]
2003 Wood LG, Gibson PG, Garg ML, 'Biomarkers of lipid peroxidation, airway inflammation and asthma', The European Respiratory Journal (2003) [D2]
Citations Scopus - 190Web of Science - 187
Co-authors Manohar Garg, Lisa Wood
Show 9 more reviews

Conference (413 outputs)

Year Citation Altmetrics Link
2019 Price DB, Wang E, Busby J, Heaney LG, Pfeffer P, Jackson DJ, et al., 'Cross-Country Comparison of Demographic and Clinical Characteristics of Patients Managed in Severe Asthma Services Across UK, USA, Australia, South Korea, and Italy', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Dallas, TX (2019)
2019 Harvey E, Langton D, Powell H, Gibson P, 'CLINICAL RESPONSE TO MEPOLIZUMAB IN PATIENTS WITH SEVERE EOSINOPHILIC ASTHMA', RESPIROLOGY (2019)
Co-authors Erin Harvey
2019 Niessen NM, Simpson JL, Baines KJ, Gibson PG, Fricker M, 'Differential Tumor Necrosis Factor Ligand and Receptor Expression on Monocyte Subsets in Blood and Sputum', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Dallas, TX (2019)
Co-authors Michael Fricker, Jodie Simpson, Katherine Baines
2019 Robijn A, Jensen M, McLaughlin K, Gibson P, Murphy V, 'EVALUATING INHALED CORTICOSTEROID USE AMONG PREGNANT WOMEN WITH ASTHMA', RESPIROLOGY (2019)
Co-authors Vanessa Murphy, Megan Jensen
2019 Mclaughlin K, Jensen M, Foureur M, Gibson P, Murphy V, 'KNOWLEDGE AND CONFIDENCE OF HEALTH PROFESSIONALS IN PROVIDING ASTHMA MANAGEMENT IN PREGNANCY: RESULTS OF AN AUSTRALIAN NATIONWIDE SURVEY', RESPIROLOGY (2019)
Co-authors Vanessa Murphy
2019 Gibson P, Yang I, Upham J, Reynolds P, Hodge S, James A, et al., 'EFFICACY OF AZITHROMYCIN IN SEVERE ASTHMA', RESPIROLOGY (2019)
Co-authors Jodie Simpson
2019 Niessen N, Simpson J, Baines K, Gibson P, Fricker M, 'DIFFERENTIAL TNF alpha, TNFR1 AND TNFR2 EXPRESSION ON BLOOD- AND SPUTUM-DERIVED IMMUNE CELLS IN ASTHMA', RESPIROLOGY (2019)
Co-authors Michael Fricker, Jodie Simpson, Katherine Baines
2019 Thompson C, Berthon B, Scott H, Gibson P, Young P, Oliver B, Wood L, 'MACRONUTRIENT EFFECTS ON BRONCHODILATOR RESPONSIVENESS IN OBESE ASTHMA', RESPIROLOGY (2019)
2019 Clark V, Gibson P, McDonald V, 'WHAT SEVERE ASTHMA TREATMENT OUTCOMES MATTER TO PATIENTS?', RESPIROLOGY (2019)
Co-authors Vanessa Mcdonald
2019 McDonald V, Cordova-Rivera L, Gibson P, Gardiner P, Hiles S, 'EXTRAPULMONARY DISEASE CHARACTERISTICS AND HEALTH-STATUS IN SEVERE ASTHMA AND BRONCHIECTASIS', RESPIROLOGY (2019)
Co-authors Sarah Hiles, Vanessa Mcdonald
2019 Hiles S, Gibson P, McDonald V, 'TREATABLE TRAITS PREDICT HEALTH STATUS AND TREATMENT RESPONSE IN AIRWAYS DISEASE', RESPIROLOGY (2019)
Co-authors Vanessa Mcdonald, Sarah Hiles
2019 Twaddell S, Baines K, Grainge C, Gibson P, 'MARKERS OF NEUTROPHIL EXTRACELLULAR TRAPS (NETS) ARE HIGHER IN EMPYEMA THAN IN MALIGNANT AND TRANSUDATIVE EFFUSIONS', RESPIROLOGY (2019)
Co-authors Christopher Grainge
2018 Vertigan AE, Kapela SM, Franke I, Gibson PG, 'The Effect of a Vocal Loading Test on Cough and Phonation in Patients with Chronic Cough', LUNG (2018)
2018 McLoughlin R, Berthon BS, Baines KJ, Gibson PG, Rogers GB, Arnold D, Wood LG, 'Soluble Fibre Downregulates Airway Histone Deacetylase 9 Expression Which Is Associated with Eosinophilic Inflammation in Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Diego, CA (2018)
Co-authors Katherine Baines, Lisa Wood
2018 Williams EJ, Guilleminault L, Berthon BS, Baines KJ, Gibson PG, Wright T, et al., 'Anti-Inflammatory Effects of Sulforaphane on Adipose Tissue Macrophages Isolated from Obese Subjects with and Without Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Diego, CA (2018)
Co-authors Katherine Baines, Lisa Wood
2018 Christensen M, Baines KJ, Gibson PG, Backer V, Sverrild A, Bulow AV, Porsbjerg C, 'Validation of the Six-Gene Sputum Signature for Inflammatory Phenotyping Severe Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Diego, CA (2018)
Co-authors Katherine Baines
2018 Periyalil HA, Wood LG, Wright TA, Karihaloo C, Starkey MR, Miu AS, Baines KJ, 'Obese asthmatics are characterized by altered adipose tissue macrophage activation', CLINICAL AND EXPERIMENTAL ALLERGY (2018)
DOI 10.1111/cea.13109
Citations Scopus - 1Web of Science - 1
Co-authors Philip Hansbro, Malcolm Starkey, Lisa Wood, Katherine Baines
2018 Harvey E, Langton D, Upham J, Hew M, Rimmer J, Chung L, et al., 'SEVERE EOSINOPHILIC AASTHMA IN AUSTRALIA: THE AUSTRALIAN MEPOLIZUMAB REGISTRY', RESPIROLOGY (2018)
2018 Gomes GMC, Belinelo PDG, Malcolm RS, Jesson K, Phil MH, Vanessa EM, et al., 'Cord blood eosinophils and Type 2 Innate lymphoid cells are correlated in infants born to mothers with asthma during pregnancy', EUROPEAN RESPIRATORY JOURNAL, Paris, FRANCE (2018)
DOI 10.1183/13993003.congress-2018.PA5433
Co-authors Adam Collison, Malcolm Starkey, Philip Hansbro, Joerg Mattes, Vanessa Murphy
2018 Mcdonald VM, Maltby S, Clark VL, Hew M, King GG, Oo S, et al., 'DEVELOPMENT OF THE SEVERE ASTHMA TOOLKIT: A CLINICAL WEBSITE RESOURCE FOR THE MANAGEMENT OF SEVERE TREATMENT-REFRACTORY ASTHMA', RESPIROLOGY (2018)
Citations Web of Science - 1
Co-authors Steven Maltby, Vanessa Clark, Vanessa Mcdonald
2018 Lane A, Campbell L, Gibson P, Woolard A, Barker D, Tait J, et al., 'Early signs of autism in 12 month infants born to mothers with asthma', Griffith University, Gold Coast (2018)
Co-authors Frini Karayanidis, Alix Woolard Uon, Alison Lane, Vanessa Murphy, Linda E Campbell, Adam Collison, Joerg Mattes
2018 Frossing L, Von Bulow A, Christensen MR, Backer V, Gibson P, Baines K, Porsbjerg C, 'Discriminating phenotypes of severe eosinophilic asthma using gene profiling in sputum', EUROPEAN RESPIRATORY JOURNAL, Paris, FRANCE (2018)
DOI 10.1183/13993003.congress-2018.OA5153
Co-authors Katherine Baines
2018 Murphy VE, Powell H, Porsbjerg C, Gibson P, 'Treatment decisions with an exhaled nitric oxide (eNO)-based algorithm vs a symptoms-based algorithm for asthma in pregnancy', EUROPEAN RESPIRATORY JOURNAL, Paris, FRANCE (2018)
DOI 10.1183/13993003.congress-2018.PA5042
Co-authors Vanessa Murphy
2018 McDonald VM, Hiles SA, Godbout K, Harvey ES, Marks GB, Hew M, et al., 'Identification of treatable traits in a severe asthma registry: prevalence and exacerbation predictors', EUROPEAN RESPIRATORY JOURNAL, Paris, FRANCE (2018)
DOI 10.1183/13993003.congress-2018.PA5043
Co-authors Vanessa Mcdonald, Sarah Hiles, Erin Harvey, Peter Wark
2018 Beinelo DGP, Jesson K, Sena SC, Collison A, Murphy V, Robinson P D, et al., 'LUNG FUNCTION AT 6 WEEKS OF AGE IS ASSOCIATED WITH THE RISK OF DEVELOPING BRONCHIOLITIS IN INFANTS BORN TO MOTHERS WITH ASTHMA DURING PREGNANCY', RESPIROLOGY (2018)
Co-authors Vanessa Murphy, Adam Collison, Joerg Mattes
2018 Ruffles T, Marchant J, Buntain H, Mastera I, Upham J, Yerkovich S, et al., 'PROTRACTED BACTERIAL BRONCHITIS (PBB)-LONG-TERM OUTCOMES AT FIVE YEARS: A COHORT STUDY', RESPIROLOGY (2018)
Co-authors Jodie Simpson
2018 Cordova-Rivera L, Gibson P, Gardiner P, Mcdonald V, 'DETERMINANTS OF PHYSICAL ACTIVITY IN OBSTRUCTIVE AIRWAY DISEASES', RESPIROLOGY (2018)
Citations Web of Science - 1
Co-authors Vanessa Mcdonald
2018 Fricker M, Powell H, Gibson P, Baines K, 'A SPUTUM SIX GENE SIGNATURE PREDICTS INFLAMMATORY AND EXACERBATION PHENOTYPES IN UNCONTROLLED MODERATE-TO-SEVERE ASTHMA: AN AMAZES SUB-ANALYSIS', RESPIROLOGY (2018)
Co-authors Michael Fricker
2018 Mcdonald V, Godbout K, Hiles S, Harvey E, Gibson P, 'SEVERE ASTHMA TREATABLE TRAITS: PREVALENCE AND EXACERBATION PREDICTION', RESPIROLOGY (2018)
Co-authors Sarah Hiles, Vanessa Mcdonald
2018 Cousins J, Wood-Baker R, Wark P, Yang I, Hutchinson A, Sajkov D, et al., 'MANAGEMENT OF ACUTE COPD EXACERBATIONS: DO WE FOLLOW THE GUIDELINES?', RESPIROLOGY (2018)
Co-authors Vanessa Mcdonald, Peter Wark
2018 Clark V, Gibson P, Cordova-Rivera L, Wark P, Mcdonald V, 'MULTIDIMENSIONAL ASSESSMENT OF TREATABLE TRAITS IN SEVERE ASTHMA AND COPD', RESPIROLOGY (2018)
Co-authors Vanessa Mcdonald, Peter Wark
2018 Mcdonald V, Yorke J, Niven R, Smith A, Gibson P, 'PATIENT PERSPECTIVES ON SEVERE ASTHMA EPISODES: ATTACKS, FLARE-UPS OR EXACERBATIONS?', RESPIROLOGY (2018)
Co-authors Vanessa Mcdonald
2018 Jesson K, Belinelo DGP, Sena C RS, Collison A, Murphy V, Robinson P, et al., 'PREMATURITY, LUNG FUNCTION AT 6 WEEKS OF AGE AND BRONCHIOLITIS IN BABIES BORN TO MOTHERS WITH ASTHMA DURING PREGNANCY', RESPIROLOGY (2018)
Co-authors Adam Collison, Joerg Mattes, Vanessa Murphy
2018 Fricker M, Qin L, Erriah M, Brooks C, Simpson J, Baines K, Gibson P, 'COMBINED FLOW CYTOMETRY AND GENE EXPRESSION PROFILING OF MAST CELLS AND BASOPHILS IN ASTHMATIC SPUTUM', RESPIROLOGY (2018)
Co-authors Jodie Simpson, Michael Fricker
2018 Murphy VE, Metcalfe TB, Robijn A, Gibson PG, McCaffery K, Jensen ME, 'BELIEFS ABOUT MEDICINES AND ADHERENCE TO ASTHMA MEDICATION IN PREGNANCY', RESPIROLOGY (2018)
Co-authors Megan Jensen, Vanessa Murphy
2018 Robijn A, Jensen M, Gibson P, Murphy V, 'ASTHMA SELF-MANAGEMENT EDUCATION AND PERCEIVED ASTHMA MEDICATION RISK DURING PREGNANCY', RESPIROLOGY (2018)
Co-authors Vanessa Murphy
2018 Gomes G, Starkey M, Belinelo DGP, Jesson K, Hansbro P, Murphy V, et al., 'PROFILING INNATE LYMPHOID CELLS IN THE CORD BLOOD OF INFANTS BORN TO MOTHERS WITH ASTHMA IN PREGNANCY', RESPIROLOGY (2018)
Co-authors Philip Hansbro, Joerg Mattes, Adam Collison, Vanessa Murphy
2017 Wood LG, Berthon BS, Zapirain R, Leong LEX, Baines KA, Gibson PG, et al., 'Airway Inflammation, Asthma Control And Gut Microbiome Are Improved By Soluble Fibre Supplementation', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Washington, DC (2017)
Co-authors Lisa Wood
2017 Simpson JL, Pabreja K, Baines KJ, Eyres F, Yang M, Nair P, et al., 'Sputum Il-27 Gene Expression In Asthma Endotypes', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Washington, DC (2017)
Co-authors Kavita Pabreja, Jodie Simpson, Ming Yang, Katherine Baines
2017 Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'Azithromycin Reduces Exacerbations In Adults With Persistent Symptomatic Eosinophilic Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Washington, DC (2017)
Co-authors Jodie Simpson
2017 Wood LG, Li Q, Scott HA, Berthon BS, Gibson PG, Baines KA, 'Saturated Fatty Acids, But Not N-6 Polyunsaturated Fatty Acids Or Carbohydrates, Increase Airway Inflammation In Non-Obese Asthmatics', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Washington, DC (2017)
Co-authors Lisa Wood, Hayley Scott
2017 Wood LG, Berthon BS, Zapirain R, Leong LEX, Baines KJ, Gibson PG, et al., 'ASTHMA CONTROL, AIRWAY INFLAMMATION AND GUT MICROBIOME ARE IMPROVED BY SOLUBLE FIBRE SUPPLEMENTATION', RESPIROLOGY (2017)
Co-authors Katherine Baines, Lisa Wood
2017 Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'AZITHROMYCIN REDUCES EXACERBATIONS IN ADULTS WITH PERSISTENT SYMPTOMATIC EOSINOPHILIC ASTHMA', RESPIROLOGY (2017)
Citations Web of Science - 1
Co-authors Jodie Simpson
2017 Pabreja K, Gibson PG, Baines KJ, Eyers F, Yang M, Nair P, et al., 'INCREASED EXPRESSION OF IL-27 IN NEUTROPHILIC ASTHMA', RESPIROLOGY (2017)
Co-authors Kavita Pabreja, Paul Foster, Jodie Simpson, Ming Yang, Katherine Baines
2017 Nguyen TH, Maltby S, Simpson JL, Eyers F, Baines KJ, Gibson PG, et al., 'MACROPHAGES REGULATE THE DEVELOPMENT OF RSV INDUCED ASTHMA EXACERBATIONS', RESPIROLOGY (2017)
Co-authors Paul Foster, Jodie Simpson, Steven Maltby, Ming Yang, Katherine Baines
2017 Wood LG, Li Q, Berthon BS, Gibson PG, Baines KJ, 'SATURATED FATTY ACIDS, BUT NOT N-6 POLYUNSATURATED FATTY ACIDS OR CARBOHYDRATES, INCREASE AIRWAY INFLAMMATION IN NON-OBESE ASTHMATICS', RESPIROLOGY (2017)
Co-authors Lisa Wood, Katherine Baines
2017 McDonald VM, Clark VL, Wark PAB, Baines KJ, Gibson PG, 'MULTIDIMENSIONAL ASSESSMENT AND TARGETED THERAPY OF SEVERE PERSISTENT ASTHMA: A RANDOMISED CONTROLLED TRIAL', RESPIROLOGY (2017)
Citations Web of Science - 1
Co-authors Peter Wark, Vanessa Mcdonald, Katherine Baines
2017 Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM, 'PHYSICAL INACTIVITY AND SEDENTARY TIME IN SEVERE ASTHMA', RESPIROLOGY (2017)
Co-authors Vanessa Mcdonald
2017 Negewo NA, Gibson PG, Wark PAB, Simpson JL, Mcdonald VM, 'COMPLEX MEDICATION REGIMENS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE ASSOCIATED WITH DISEASE SEVERITY AND COMORBIDITIES', RESPIROLOGY (2017)
Co-authors Vanessa Mcdonald, Peter Wark, Jodie Simpson
2017 Maltby S, Gibson PG, Powell H, Mcdonald VM, 'OMALIZUMAB TREATMENT RESPONSE IN A SEVERE ALLERGIC ASTHMA POPULATION WITH OVERLAPPING COPD', RESPIROLOGY (2017)
Co-authors Vanessa Mcdonald, Steven Maltby
2017 Morten M, Collison A, Murphy V, Barker D, Meredith J, Powell H, et al., 'ASTHMA CONTROL DURING PREGNANCY, 17Q21 VARIANTS AND CHILDHOOD-ONSET ASTHMA', RESPIROLOGY (2017)
Co-authors Daniel Barker, Joerg Mattes, Vanessa Murphy, Adam Collison
2017 Fricker M, Erriah M, Brooks C, Simpson J, Gibson PG, 'FLOW CYTOMETRY-BASED PROFILING OF IMMUNE CELLS IN ASTHMATIC SPUTUM', RESPIROLOGY (2017)
Co-authors Jodie Simpson, Michael Fricker
2017 Powell H, Simpson JL, Yang IA, Upham JW, Reynolds PN, Hodge S, et al., 'AN ANALYSIS OF THE EFFECT OF AZITHROMYCIN IN PERSISTENT ASTHMA, BASED ON PRE-SPECIFIED ASTHMA PHENOTYPES', RESPIROLOGY (2017)
Co-authors Jodie Simpson
2017 Baines K, Negewo N, Gibson P, Fu J-J, Simpson J, Wark P, Mcdonald V, 'SPUTUM 6 GENE EXPRESSION SIGNATURE PREDICTS INFLAMMATORY PHENOTYPE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE', RESPIROLOGY (2017)
Co-authors Peter Wark, Jodie Simpson, Vanessa Mcdonald
2017 Wang G, Gibson PG, Wang F, Guo M, Zhang W, Gao P, et al., 'Severe Asthma, Uncontrolled Asthma, And The Use Of Triple Controller Therapy For Asthma In China', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Washington, DC (2017)
Co-authors Erin Harvey
2016 Jensen ME, Camargo CA, Gibson PG, Mattes J, Murphy VE, 'Maternal Serum Ditamin D Levels \= 75nmol/l During Pregnancy Are Associated With Fewer Adverse Respiratory Outcomes In Infants At 12 Months Of Age', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Megan Jensen, Joerg Mattes, Vanessa Murphy
2016 Steel K, Gibson P, Murphy V, 'ASTHMA SELF-MANAGEMENT EDUCATION AND INHALED CORTICOSTEROID USE DURING PREGNANCY AND POSTPARTUM FROM 2004 TO 2014', RESPIROLOGY (2016)
Co-authors Vanessa Murphy
2016 Negewo N, Mcdonald V, Baines K, Wark P, Simpson J, Jones P, Gibson P, 'BLOOD EOSINOPHILS AS A SURROGATE MARKER FOR SPUTUM EOSINOPHILIA IN STABLE COPD', RESPIROLOGY (2016)
Co-authors Netsanet Negewo, Jodie Simpson, Vanessa Mcdonald, Peter Wark
2016 Jensen M, Murphy V, Mattes J, Gibson P, Carmargo JC, 'MATERNAL SERUM VITAMIN D LEVELS \= 75 NMOL/L DURING PREGNANCY ARE ASSOCIATED WITH FEWER ADVERSE RESPIRATORY OUTCOMES IN INFANTS AT 12 MONTHS OF AGE', RESPIROLOGY (2016)
Co-authors Vanessa Murphy, Joerg Mattes
2016 Leong L, Rogers G, Gibson P, Yang I, Reynolds P, Hodge S, et al., 'THE LUNG MICROBIOTA IN STABLE ADULT ASTHMA DIFFERS ACCORDING TO INFLAMMATORY PHENOTYPE', RESPIROLOGY (2016)
Co-authors Jodie Simpson
2016 Murphy V, Gibson P, 'THE USE OF FRACTIONAL EXHALED NITRIC OXIDE-BASED MANAGEMENT FOR NON-EOSINOPHILIC ASTHMA DURING PREGNANCY', RESPIROLOGY (2016)
Co-authors Vanessa Murphy
2016 Simpson J, Lochrin A, Wood L, Gibson P, 'SPUTUM COLOUR AS A MARKER OF NEUTROPHILIC BRONCHITIS IN ADULTS WITH ASTHMA', RESPIROLOGY (2016)
Co-authors Jodie Simpson
2016 Simpson J, Powell H, Yang I, Upham J, Reynolds P, Hodge S, et al., 'SPUTUM INFLAMMATORY PHENOTYPES IN SYMPTOMATIC ASTHMA AROUND AUSTRALIA', RESPIROLOGY (2016)
Co-authors Jodie Simpson
2016 Harvey E, Gibson P, Bardin P, Peters M, Reynolds P, Upham J, et al., 'CHARACTERISATION OF SEVERE ASTHMA PHENOTYPES VIA A SEVERE ASTHMA REGISTRY: THE SEVERE ASTHMA WEB-BASED DATABASE', RESPIROLOGY (2016)
Citations Web of Science - 1
Co-authors Vanessa Mcdonald, Peter Wark
2016 Harvey E, Gibson P, Bardin P, Peters M, Reynolds P, Upham J, et al., 'SEVERE ASTHMA IS ASSOCIATED WITH WORK PRODUCTIVITY LOSS, ACTIVITY IMPAIRMENT AND REDUCED QUALITY OF LIFE', RESPIROLOGY (2016)
Co-authors Vanessa Mcdonald, Peter Wark
2016 Rogers GB, Leong LE, Gibson PG, Yang IA, Hodge SJ, Reynolds PN, et al., 'The Lung Microbiota In Stable Adult Asthma Differs According To Inflammatory Phenotype, Sex, And Atopy', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
2016 Negewo N, Gibson, Wood, Baines, McDonald, 'Effect of weight loss on COPD-associated comorbidities in obese COPD', London (UK) (2016)
DOI 10.1183/13993003.congress-2016.PA643
Co-authors Katherine Baines, Lisa Wood, Vanessa Mcdonald
2016 Jensen M, Wood L, Gibson P, Garg M, 'NEUTROPHIL ACTIVITY IS HIGHER IN OVERWEIGHT, VERSUS HEALTHY-WEIGHT, ADULTS WITH ASTHMA, BUT DECREASES FOLLOWING A 14-WEEK DIETARY INTERVENTION', RESPIROLOGY (2016)
Co-authors Manohar Garg
2016 Wood L, Ballantyne D, Scott H, Mcdonald-Wicks L, Gibson P, 'RESISTIN AND RESISTIN : ADIPONECTIN RATIO AS PREDICTORS OF LUNG FUNCTION IN ASTHMA', RESPIROLOGY (2016)
2016 Wood L, Halnes I, Baines K, Mcdonald-Wicks L, Gibson P, 'A SOLUBLE FIBRE SUPPLEMENT REDUCES AIRWAY INFLAMMATION IN ASTHMA', RESPIROLOGY (2016)
2016 Scott H, Gibson P, Grag M, Upham J, Wood L, 'SEX HORMONES AND SYSTEMIC CYTOKINES ARE INDEPENDENT MODULATORS OF THE OBESE-ASTHMA PHENOTYPE', RESPIROLOGY (2016)
2016 Hew M, Gillman A, Sutherland M, Wark P, Bowden J, Macdonald V, et al., 'CLINICAL EFFECTIVENESS OF OMALIZUMAB IN SEVERE ALLERGIC ASTHMA ABOVE THE STANDARD DOSING RANGE: THE AUSTRALIAN XOLAIR REGISTRY', RESPIROLOGY (2016)
2016 Hu X, Gibson P, Wark P, 'IMPACT OF A STORM RELATED POWER OUTAGE ON PATIENTS REQUIRING LONG TERM DOMICILIARY RESPIRATORY SUPPORT IN THE HUNTER REGION', RESPIROLOGY (2016)
2016 Negewo N, Gibson P, Wood L, Baines K, McDonald V, 'DOES WEIGHT LOSS COUPLED WITH RESISTANCE TRAINING IN OBESE COPD PATIENTS IMPROVE OTHER INTERRELATED COMORBIDITIES?', RESPIROLOGY (2016)
Co-authors Netsanet Negewo, Vanessa Mcdonald
2016 Kim RY, Pinkerton JW, Essilfie A-T, Robertson AA, Baines KJ, Mayall JR, et al., 'Nlrp3 Inflammasome-Mediated, Il-1 beta-Dependent Inflammatory Responses Drive Severe, Steroid-Insensitive Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Philip Hansbro, Malcolm Starkey, Jay Horvat, Peter Wark, Katherine Baines
2016 Wood LG, Halnes I, Baines K, McDonald-Wicks L, Gibson PG, 'A Soluble Fibre Challenge Reduces Airway Inflammation In Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Lisa Wood
2016 Wood LG, Ballantyne D, Scott H, McDonald-Wicks L, Gibson PG, 'Lung Function Is Predicted By Resistin And Resistin: Adiponectin Ratio In Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Lisa Wood
2016 Simpson JL, Lochrin A, Wood LG, Gibson PG, 'Bronko Test (R) Sputum Colour As A Marker Of Neutrophilic Bronchitis In Adults With Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Jodie Simpson, Lisa Wood
2016 Jensen ME, Gibson PG, Garg M, Wood LG, 'Neutrophil Activity Markers Are Reduced Following A High, Versus A Low, Fruit And Vegetable Diet, In Overweight And Obese Adults With Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Megan Jensen, Lisa Wood
2016 Samuel S, Wood-Baker R, Gibson P, Yang I, Hutchinson A, Sajkov D, Mcdonald V, 'COPD ASSESSMENT TEST (CAT) AS A PREDICTOR FOR MORTALITY AND READMISSION FOLLOWING HOSPITALISATION FOR ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)', RESPIROLOGY (2016)
Co-authors Vanessa Mcdonald
2016 Kim R, Pinkerton J, Essilfie A, Robertson A, Baines K, Mayall J, et al., 'NLRP3 INFLAMMASOME- MEDIATED, IL-1 beta-DEPENDENT INFLAMMATORY RESPONSES DRIVE SEVERE, STEROID-INSENSITIVE ASTHMA', RESPIROLOGY (2016)
Co-authors Philip Hansbro, Jay Horvat, Peter Wark
2016 Berthon B, Gibson P, Wood L, Macdonald-Wicks L, Baines K, 'A NOVEL GENE EXPRESSION SIGNATURE IN SPUTUM PREDICTS ORAL CORTICOSTEROID RESPONSE IN ASTHMA', RESPIROLOGY (2016)
Co-authors Lesley Wicks
2016 Nguyen TH, Maltby S, Simpson JL, Eyers F, Gibson PG, Foster PS, Yang M, 'Macrophages regulate steroid resistant airway inflammation in a mouse model of respiratory syncytial virus-induced asthma exacerbation', EUROPEAN JOURNAL OF IMMUNOLOGY, Melbourne, AUSTRALIA (2016)
Co-authors Ming Yang, Steven Maltby, Paul Foster, Jodie Simpson
2016 Kim R, Pinkerton J, Essilfie A-T, Robertson A, Baines K, Mayall J, et al., 'NLRP3 inflammasome-mediated, IL-1 beta-dependent inflammatory responses drive severe, steroid-resistant asthma', EUROPEAN JOURNAL OF IMMUNOLOGY, Melbourne, AUSTRALIA (2016)
Co-authors Jay Horvat, Peter Wark, Philip Hansbro
2016 Hew M, Gillman A, Sutherland M, Wark P, Bowden J, McDonald V, et al., 'Clinical Effectiveness Of Omalizumab In Severe Allergic Asthma Above The Recommended Dosing Range: The Australian Xolair Registry', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Peter Wark, Vanessa Mcdonald
2016 Murphy VE, Gibson PG, 'The Use Of Fractional Exhaled Nitric Oxide-Based Management For Non-Eosinophilic Asthma During Pregnancy', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, San Francisco, CA (2016)
Co-authors Vanessa Murphy
2015 Murphy VE, Powell H, Gibson P, 'Exacerbations Following Step Down And Step Up Inhaled Corticosteroid Therapy In The Managing Asthma In Pregnancy (map) Study', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Denver, CO (2015)
Co-authors Vanessa Murphy
2015 Backer V, Baines K, Powell H, Porsbjerg C, Gibson P, 'LATE-BREAKING ABSTRACT: Mast cell markers in adipose tissue, systemic inflammation and asthma', EUROPEAN RESPIRATORY JOURNAL (2015)
DOI 10.1183/13993003.congress-2015.PA1084
2015 Periyalil H, Wood L, Wright T, Karihaloo C, Gibson P, 'Characterisation of adipose tissue macrophage phenotypes in obese asthma', EUROPEAN RESPIRATORY JOURNAL (2015)
DOI 10.1183/13993003.congress-2015.PA2556
Co-authors Lisa Wood
2015 Tang F, Foxley G, Gibson P, Burgess J, Baines K, Oliver B, 'Different innate neutrophil responses in controlled and uncontrolled asthma', EUROPEAN RESPIRATORY JOURNAL (2015)
DOI 10.1183/13993003.congress-2015.PA5037
Co-authors Katherine Baines
2015 Upham J, Chen A, Carroll M, Petsky H, Pizzutto S, Yerkovich S, et al., 'IMMUNE RESPONSES TO NONTYPEABLE HAEMOPHILUS INFLUENZAE IN PROTRACTED BACTERIAL BRONCHITIS', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Citations Web of Science - 1
Co-authors Katherine Baines, Jodie Simpson
2015 Baines K, Wright T, Simpson J, Mcdonald V, Wood L, Gibson P, 'EXCESSIVE NEUTROPHIL EXTRACELLULAR TRAPS ARE ASSOCIATED WITH INFLAMMATION IN CHRONIC AIRWAY DISEASE', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Co-authors Katherine Baines, Jodie Simpson, Vanessa Mcdonald, Lisa Wood
2015 Simpson J, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'SPUTUM AND SERUM PERIOSTIN LEVELS ARE ASSOCIATED WITH, BUT DO NOT PREDICT SPUTUM EOSINOPHIL PROPORTION IN SEVERE ASTHMA', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Citations Web of Science - 1
Co-authors Jodie Simpson
2015 Erriah M, Gao P, Baines K, Gibson P, Simpson J, 'SPUTUM GALECTIN-3 EXPRESSION IS ASSOCIATED WITH EOSINOPHILS IN COPD', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Co-authors Jodie Simpson, Katherine Baines
2015 Murphy V, Powell H, Gibson P, 'EXACERBATIONS FOLLOWING STEP DOWN AND STEP UP INHALED CORTICOSTEROID THERAPY IN THE MANAGING ASTHMA IN PREGNANCY (MAP) STUDY', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Citations Web of Science - 1
Co-authors Vanessa Murphy
2015 Wark P, Mcdonald V, Gibson P, 'A TREATMENT ALGORITHM ADJUSTING ORAL CORTICOSTEROID USING BLOOD EOSINOPHILS REDUCES EXACERBATIONS AND IMPROVES ASTHMA CONTROL, IN DIFFICULT ASTHMATICS', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Co-authors Vanessa Mcdonald, Peter Wark
2015 Steven A, Gibson P, Wark P, Mcdonald V, 'THE USE OF AZOLES IN AIRWAYS DISEASE: A RETROSPECTIVE AUDIT', RESPIROLOGY, Queensland, AUSTRALIA (2015) [E3]
Co-authors Peter Wark, Vanessa Mcdonald
2015 Negewo N, McDonald V, Baines K, Wark P, Simpson J, Jones P, Gibson P, 'Can blood eosinophils predict sputum eosinophils in stable COPD?', EUROPEAN RESPIRATORY JOURNAL (2015)
DOI 10.1183/13993003.congress-2015.PA3967
Citations Web of Science - 1
Co-authors Katherine Baines, Netsanet Negewo, Peter Wark, Vanessa Mcdonald, Jodie Simpson
2015 Essilfie A-T, Horvat J, Kim R, Mayall J, Pinkerton J, Beckett E, et al., 'Macrolide therapy suppresses key features of experimental steroid-sensitive and steroid insensitive asthma', JOURNAL OF IMMUNOLOGY, New Orleans, LA (2015)
Co-authors Philip Hansbro, Paul Foster, Jodie Simpson, Jay Horvat
2015 Upham JW, Chang A, Pizzutto S, Carroll M, Gibson P, Simpson J, et al., 'Immune Responses To Non-Typeable Haemophilus Influenzae In Protracted Bacterial Bronchitis', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Denver, CO (2015)
Co-authors Jodie Simpson, Katherine Baines
2015 Simpson J, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al., 'Sputum And Serum Periostin Levels Are Associated With, But Do Not Predict Sputum Eosinophil Proportion In Severe Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Denver, CO (2015)
Citations Web of Science - 1
Co-authors Jodie Simpson
2015 McDonald V, Wark P, Baines K, Gibson P, 'A multidimensional assessment of severe asthma', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2015) [E3]
Co-authors Katherine Baines, Peter Wark, Vanessa Mcdonald
2015 Tang F, Gibson P, Foxley G, Burgess J, Baines K, Oliver B, 'Neutrophils from people with uncontrolled asthma have a deficient CXCL8 response to bacteria but not to viruses', Am J Resp Crit Care Med (2015) [E3]
Co-authors Katherine Baines
2015 Baines K, Wright T, Simpson J, McDonald V, Wood L, Gibson P, 'Accumulation of neutrophil extracellular traps is associated with inflammation in neutrophilic asthma and COPD', Am J Resp Crit Care Med (2015) [E3]
Co-authors Katherine Baines, Jodie Simpson, Vanessa Mcdonald, Lisa Wood
2015 McDonald V, Wark P, Baines K, Gibson P, 'The multidimensional components of severe asthma', Respirology, Gold Coast, Qld (2015) [E3]
Co-authors Vanessa Mcdonald, Katherine Baines, Peter Wark
2015 Tang F, Gibson P, Foxley G, Burgess J, Baines K, Oliver B, 'Deficient CXCL8 response to bacteria but not to viruses in neutrophils from people with uncontrolled asthma', Respirology, Gold Coast, QLD (2015) [E3]
Co-authors Katherine Baines
2015 Hew M, Gillman A, Wark P, Bowden J, Sutherland M, Gibson P, 'OMALIZUMAB TREATMENT IMPROVES CLINICAL OUTCOME IN SEVERE ALLERGIC ASTHMA PATIENTS ABOVE THE DOSING RANGE', INTERNAL MEDICINE JOURNAL (2015) [E3]
Co-authors Peter Wark
2014 Wang G, Li H, Liang B, Zhang H, Wang Y, Gibson P, 'Anxiety Rather Than Depression Symptoms Deteriorate Perceptual Responses Of Dyspnea To Bronchoconstriction In Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
2014 Jensen ME, Gibson PG, Collins CE, Hilton JM, Wood LG, 'Sleep, Diet, Activity, And Metabolic Outcomes In Children With And Without Asthma: A Cross-Sectional Study', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2014 Fu J-J, McDonald VM, Baines KJ, Mao B, Gibson PG, 'Airway Il-1 Pathway Activation And Systemic Inflammation Predict Future Exacerbation Risk In Asthma And COPD', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
Co-authors Vanessa Mcdonald, Katherine Baines
2014 Upham JW, Carroll M, Gibson P, Yang IA, Simpson J, 'Anti-Viral Innate Immunity Varies Across Different Asthma Inflammatory Phenotypes', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, San Diego, CA (2014) [E3]
DOI 10.1016/j.jaci.2013.12.515
Co-authors Jodie Simpson
2014 Wood LG, Shivappa N, Berthon BS, Gibson P, Hebert JR, 'Asthma Risk, Lung Function And Systemic Inflammation Are Associated With Dietary Inflammatory Index In Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
Co-authors Lisa Wood
2014 Baines KJ, Simpson JL, Wood LG, Scott RJ, Fibbens NL, Powell H, et al., 'An Expression Signature Of 6 Genes Can Reliably Distinguish Eosinophilic And Neutrophilic Inflammation And Corticosteroid Response In Asthma', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
Co-authors Rodney Scott, Lisa Wood, Jodie Simpson, Katherine Baines
2014 Vertigan AE, Gibson PG, Bone SL, 'Laryngeal Hypersensitivity in Chronic Refractory Cough and Paradoxical Vocal Fold Movement', LUNG (2014) [E3]
2014 Lewis A, Pretto J, Gibson P, 'UTILITY OF IMPULSE OSCILLOMETRY IN DETECTING UPPER AIRWAY DYSFUNCTION DURING HYPERTONIC SALINE CHALLENGE', RESPIROLOGY (2014) [E3]
DOI 10.1111/resp.12261
2014 Eckert B, Simpson J, Powell H, Pretto J, Upham J, Gibson P, 'EXHALED NITRIC OXIDE MEASUREMENT: INTER-INSTRUMENT VARIABILITY AND IMPLICATIONS ON TEST INTERPRETATION', RESPIROLOGY (2014) [E3]
DOI 10.1111/resp.12262_16
Co-authors Jodie Simpson
2014 Periyalil H, Scott H, Jensen M, Wood L, Gibson P, 'MACROPHAGE ACTIVATION IS A DETERMINANT OF DEVELOPMENTAL EFFECTS OF IMMUNOMETABOLISM IN OBESE ASTHMA', RESPIROLOGY (2014) [E3]
DOI 10.1111/resp.12263_7
Co-authors Lisa Wood, Hayley Scott, Megan Jensen
2014 Berthon B, Macdonald-Wicks L, Gibson P, Wood L, 'SHORT TERM ORAL CORTICOSTEROID THERAPY DOES NOT INCREASE APPETITE, DIETARY INTAKE, BODY WEIGHT AND BODY COMPOSITION IN ADULTS WITH ASTHMA - A RANDOMIZED-CONTROLLED TRIAL', RESPIROLOGY (2014) [E3]
Co-authors Lesley Wicks, Lisa Wood
2014 Wright T, Gibson P, Simpson J, Mcdonald V, Wood L, Baines K, 'ALARMINS IN ASTHMA AND COPD: RELATIONSHIPS TO INFLAMMATORY PHENOTYPES AND DISEASE SEVERITY', RESPIROLOGY (2014) [E3]
Co-authors Jodie Simpson, Vanessa Mcdonald, Lisa Wood, Katherine Baines
2014 Baines K, Simpson J, Wood L, Scott R, Fibbens N, Powell H, et al., 'SPUTUM GENE EXPRESSION OF SIX MARKERS IDENTIFIES ASTHMA INFLAMMATORY PHENOTYPE AND CORTICOSTEROID RESPONSE', RESPIROLOGY (2014) [E3]
Co-authors Jodie Simpson, Katherine Baines, Lisa Wood, Rodney Scott
2014 Wood L, Shivappa N, Berthon B, Gibson P, Hebert J, 'DIETARY INFLAMMATORY INDEX IS RELATED TO ASTHMA RISK, LUNG FUNCTION AND SYSTEMIC INFLAMMATION IN ASTHMA', RESPIROLOGY (2014) [E3]
Citations Web of Science - 2
Co-authors Lisa Wood
2014 Mcdonald V, Gibson P, Scott H, Baines P, Hensley M, Pretto J, Wood L, 'SHOULD WE TREAT OBESITY IN COPD? THE EFFECTS OF WEIGHT LOSS AND RESISTANCE TRAINING IN OBESE COPD', RESPIROLOGY (2014) [E3]
Co-authors Vanessa Mcdonald, Lisa Wood, Michael Hensley, Hayley Scott
2014 Baines K, Upham J, Yerkovich S, Chang A, Marchant J, Carroll M, et al., 'INTERLEUKIN-1B IS RELATED TO CLINICAL OUTCOMES IN PROTRACTED BACTERIAL BRONCHITIS', RESPIROLOGY (2014) [E3]
Co-authors Katherine Baines, Jodie Simpson
2014 Eckert B, Simpson J, Powell H, Pretto J, Upham J, Gibson P, 'EXHALED NITRIC OXIDE MEASUREMENT: INTER-INSTRUMENT VARIABILITY AND IMPLICATIONS ON TESTS INTERPRETATION', RESPIROLOGY (2014) [E3]
Co-authors Jodie Simpson
2014 Simpson J, Gao P, Baines K, Yang I, Reynolds P, Hodge S, et al., 'GALECTIN 3 AND GALECTIN 3 BINDING PROTEIN IN ASTHMA INFLAMMATORY SUBTYPES', RESPIROLOGY (2014) [E3]
Co-authors Katherine Baines, Jodie Simpson
2014 Simpson J, Carroll M, Gibson P, Yang I, Reynolds P, Hodge S, et al., 'REDUCED ANTI-VIRAL INNATE IMMUNITY IN PATIENTS WITH SEVERE ASTHMA IS ASSOCIATED WITH NEUTROPHILIC INFLAMMATION AND HIGH DOSE INHALED STEROIDS', RESPIROLOGY (2014) [E3]
Co-authors Jodie Simpson
2014 Murphy V, Powell H, Gibson P, 'THE ROLE OF MATERNAL OBESITY IN SUSCEPTIBILITY TO RESPIRATORY VIRAL INFECTION AND EXACERBATION RATE IN PREGNANT WOMEN WITH ASTHMA', RESPIROLOGY (2014)
Co-authors Vanessa Murphy
2014 Guo M, Gibson P, Thien F, Peters M, Sutherland M, Upham J, et al., 'SEVERE REFRACTORY ALLERGIC ASTHMA IN AUSTRALIA: THE AUSTRALIAN XOLAIR REGISTRY (AXR)', RESPIROLOGY (2014)
2014 Hodge G, Upham J, Chang A, Gibson P, Pizzutto S, Petsky H, Hodge S, 'INCREASED PERIPHERAL BLOOD PRO-INFLAMMATORY/CYTOTOXIC T AND NKT-LIKE CELLS IN INDIGENOUS CHILDREN WITH BRONCHIECTASIS', RESPIROLOGY (2014)
2014 Sutherland M, Gibson P, Thien F, Peters M, Upham J, Reddel H, et al., 'SEVERE REFRACTORY ALLERGIC ASTHMA IN AUSTRALIA: THE AUSTRALIAN XOLAIR REGISTRY (AXR)', INTERNAL MEDICINE JOURNAL (2014) [E3]
2013 Scott HA, Gibson PG, Garg ML, Smart J, Wood LG, 'Female Reproductive Stage Drives The Association Between Obesity And Neutrophilic Airway Inflammation In Adults With Asthma', American Journal of Respiratory and Critical Care Medicine, Philadelphia, PA (2013) [E3]
Co-authors Lisa Wood, Manohar Garg, Hayley Scott
2013 Scott HA, Gibson PG, Garg ML, Smart JM, Wood LG, 'The Association Between Obesity and Asthma is Driven By Female Reproductive Stage', Australasian Medical Journal, Brisbane (2013) [E3]
Co-authors Hayley Scott, Manohar Garg, Lisa Wood
2013 Jayasinha R, Brown N, Towns SM, Gibson PG, Jaffe A, Chang AB, 'Preventing tobacco smoking in disadvantaged and indigenous young people', Respirology, Darwin, NT (2013) [E3]
2013 Berthon B, MacDonald-Wicks L, Gibson P, Wood L, 'Changes in body composition are associated with corticosteroid use in adult asthma', EUROPEAN RESPIRATORY JOURNAL (2013)
Co-authors Lesley Wicks, Lisa Wood
2013 Scott HA, Gibson PG, Garg ML, Smart J, Wood LG, 'REPRODUCTIVE STAGE DRIVES LINK BETWEEN OBESITY AND NEUTROPHILIC AIRWAY INFLAMMATION IN FEMALES WITH ASTHMA', RESPIROLOGY (2013) [E3]
Co-authors Hayley Scott, Lisa Wood, Manohar Garg
2013 Fu JJ, Mcdonald VM, Simpson JL, Higgins I, Mao B, Gibson PG, 'VALIDATION OF THE NEW GOLD COMBINED ASSESSMENT IN AN AUSTRALIAN COPD COHORT', RESPIROLOGY (2013) [E3]
Co-authors Vanessa Mcdonald, Jodie Simpson, Isabel Higgins
2013 Mattes J, Murphy V, Powell H, Gibson P, 'THE EFFECT OF BETTER ASTHMA CONTROL IN PREGNANCY ON WHEEZY ILLNESSES IN INFANCY', RESPIROLOGY (2013) [E3]
Citations Web of Science - 2
Co-authors Vanessa Murphy, Joerg Mattes
2013 Forbes RL, Gibson PG, Murphy VE, Wark PA, 'H1N1PDM09 ALTERS MATERNAL IMMUNITY DURING PREGNANCY', RESPIROLOGY (2013) [E3]
Co-authors Vanessa Murphy, Peter Wark
2013 Gunawardhana LP, Baines KJ, Mattes J, Murphy VE, Simpson JL, Gibson PG, 'EPIGENETIC ALTERATIONS IN INFANTS ASSOCIATED WITH MATERNAL ASTHMA DURING PREGNANCY', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson, Katherine Baines, Joerg Mattes, Vanessa Murphy
2013 Powell H, Garside CG, Simpson JL, Yang IA, Reynolds PN, Hodge SJ, et al., 'CHARACTERISTICS OF UNCONTROLLED ASTHMA IN AUSTRALIA', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson
2013 Simpson JL, Yang IA, Reynolds PN, Hodge SJ, James AL, Upham J, et al., 'ALTERNATIVES TO INDUCED SPUTUM FOR IDENTIFYING PATIENTS WITH EOSINOPHILIC ASTHMA', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson
2013 Simpson JL, Baines KJ, Ryan NM, Gibson PG, 'NEUTROPHILIC ASTHMA IS CHARACTERIZED BY INCREASED GERD AND RHINOSINUSITIS WITH SLEEP DISTURBANCE', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson, Katherine Baines, Nicole Ryan
2013 Berthon BS, Macdonald-Wicks LK, Gibson PG, Wood LG, 'PARTIAL OR POOR ASTHMA CONTROL IS RELATED TO ANXIETY AND DEPRESSION SCORES', RESPIROLOGY (2013) [E3]
Co-authors Lesley Wicks, Lisa Wood
2013 Baines KJ, Simpson JL, Mcdonald VM, Hsu AC, Gibson PG, 'DIFFERENTIAL AIRWAY GENE EXPRESSION IN COPD', RESPIROLOGY (2013) [E3]
Co-authors Alan Hsu, Jodie Simpson, Vanessa Mcdonald, Katherine Baines
2013 Mcdonald VM, Wood LG, Baines P, Higgins I, Gibson PG, 'OBESITY IN COPD PROTECTIVE FOR OSTEOPOROSIS?', RESPIROLOGY (2013) [E3]
Co-authors Lisa Wood, Vanessa Mcdonald, Isabel Higgins
2013 Wang G, Baines KJ, Fu JJ, Gibson PG, 'MAST CELL-BASED PHENOTYPES OF ASTHMA IN INDUCED SPUTUM SAMPLES', RESPIROLOGY (2013) [E3]
Citations Web of Science - 1
Co-authors Katherine Baines
2013 Horvat JC, Essilfie A-T, Kim RY, Mayall JR, Starkey MR, Beckett EL, et al., 'MACROLIDES SUPPRESS KEY FEATURES OF EXPERIMENTAL STEROID-SENSITIVE AND STEROID-RESISTANT ASTHMA', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson, Paul Foster, Philip Hansbro, Jay Horvat, Malcolm Starkey, Emma Beckett
2012 Scott HA, Gibson PG, Garg ML, Smart JM, Wood LG, 'Female reproductive stage drives the association between obesity and neutrophilic airway inflammation in adults with asthma', Abstracts. American Thoracic Society 2012 International Conference, San Francisco, CA (2012) [E3]
Co-authors Hayley Scott, Manohar Garg, Lisa Wood
2012 Jensen ME, Gibson PG, Collins CE, Wood LG, 'Distribution of lean and fat mass differentially affect lung function in children', Abstracts. American Thoracic Society 2012 International Conference, San Francisco, CA (2012) [E3]
Co-authors Lisa Wood, Megan Jensen, Clare Collins
2012 Jensen ME, Gibson PG, Collins CE, Wood LG, 'Systemic inflammation and clinical asthma outcomes in obese and non-obese children: A cross-sectional study', Abstracts. American Thoracic Society 2012 International Conference, San Francisco, CA (2012) [E3]
Co-authors Lisa Wood, Megan Jensen, Clare Collins
2012 Fu J, McDonald VM, Gibson PG, Simpson JL, 'Systemic inflammation in older adults with asthma-COPD overlap syndrome', Abstracts. European Respiratory Society Annual Congress 2012, Vienna (2012) [E3]
Co-authors Vanessa Mcdonald, Jodie Simpson
2012 Scott HA, Gibson PG, Garg ML, Smart JM, Wood LG, 'Reproductive stage drives link between obesity and neutrophilic airway inflammation in females with asthma', Abstracts. TSANZ Annual Scientific Meeting 2012, Canberra, ACT (2012) [E3]
Co-authors Hayley Scott, Manohar Garg, Lisa Wood
2012 Jia C-E, Zhang H-P, Yan LV, Liang R, Jiang Y-Q, Powell H, et al., 'Asthma control test/Questionnaire for assessing asthma control: Systematic review and meta-analysis', EUROPEAN RESPIRATORY JOURNAL (2012)
2012 McDonald V, Fu J, Simpson J, Gibson P, 'The longitudinal determinants of decline in COPD and asthma-COPD overlap in an Australian population', EUROPEAN RESPIRATORY JOURNAL (2012)
Co-authors Jodie Simpson, Vanessa Mcdonald
2012 Ryan NM, Gibson PG, 'Gabapentin for idiopathic chronic cough: A randomised controlled trial', Lung, New York, NY (2012) [E3]
Co-authors Nicole Ryan
2012 Simpson JL, Phipps S, Baines KJ, Oreo KM, Gibson PG, 'NALP3 INFLAMMASOME ACTIVATION IN NEUTROPHILIC ASTHMA', RESPIROLOGY (2012) [E3]
Co-authors Jodie Simpson, Katherine Baines
2012 Garside CG, Simpson JL, Yang IA, Reynolds PN, Hodge SJ, James AL, et al., 'Inflammatory subtypes of uncontrolled asthma in Australia', Respirology, Canberra, ACT (2012) [E3]
Co-authors Jodie Simpson
2012 McDonald VM, Fu J, Simpson JL, Gibson PG, 'The longitudinal determinants of decline in obstructive airway diseases', Respirology, Canberra, ACT (2012) [E3]
Co-authors Vanessa Mcdonald, Jodie Simpson
2012 McDonald VM, Wark PA, Roberts M, Spencer LM, Alison JA, Wood LG, Gibson PG, 'Development and audience testing of a COPD education DVD', Respirology, Canberra, ACT (2012) [E3]
Co-authors Vanessa Mcdonald, Peter Wark, Lisa Wood
2012 Parsons KS, Tooze MK, Grissell TV, Bell N, Chapman JN, Ryan J, et al., 'Patterns (2007-2009) of respiratory viruses isolated from acute exacerbations of airways disease', Respirology, Canberra, ACT (2012) [E3]
Co-authors Peter Wark
2012 Powell HG, McCaffery K, Murphy VE, Giles W, Clifton VL, Hensley MJ, Gibson PG, 'Psychosocial outcomes are related to future exacerbation risk and perinatal outcomes in pregnant women with asthma', Respirology, Canberra, ACT (2012) [E3]
Citations Web of Science - 1
Co-authors Michael Hensley, Vanessa Murphy
2012 Simpson JL, Phipps S, Baines KJ, Oreo K, Gibson PG, 'NALP3 inflammasome activation in neutrophilic asthma', Respirology, Canberra, ACT (2012) [E3]
Co-authors Jodie Simpson, Katherine Baines
2012 Suthers BG, McDonald VM, Gibson PG, 'Leptin is associated with breathlessness in obstructive airways disease (OAD)', Respirology, Canberra, ACT (2012) [E3]
Co-authors Vanessa Mcdonald
2012 Wark PA, Tooze MK, Cheese L, Whitehead BF, Gibson PG, McDonald VM, 'Viral infections trigger CF exacerbations and worsen infection with P Aeruginosa in adults and children', Respirology, Canberra, ACT (2012) [E3]
Co-authors Vanessa Mcdonald, Peter Wark
2012 Wood LG, Garg ML, Smart JM, Scott HA, Barker D, Gibson PG, 'Manipulating antioxidant intake in asthma: A randomized clinical trial', Respirology, Canberra, ACT (2012) [E3]
Citations Web of Science - 2
Co-authors Hayley Scott, Manohar Garg, Lisa Wood
2012 Gao P, Wang L, Zhang J, Wang F, Gibson PG, 'Inflammatory cellular phenotypes in adults with acute exacerbations of chronic obstructive pulmonary disease', Respirology, Hong Kong (2012) [E3]
2012 Brooks CR, Gibson PG, Douwes J, Van Dalen CJ, Simpson JL, 'Assessment of the relationship between airway neutrophilia and aging in asthmatics and non-asthmatics', Respirology, Hong Kong (2012) [E3]
Co-authors Jodie Simpson
2012 Baines KJ, Simpson JL, Wood LG, Scott RJ, Gibson PG, 'Sputum gene expression of mast cell specific proteases are increased in eosinophilic asthma', Respirology, Canberra, ACT (2012) [E3]
Co-authors Rodney Scott, Jodie Simpson, Katherine Baines, Lisa Wood
2012 Baines KJ, Simpson JL, Wood LG, Scott RJ, Gibson PG, 'Induced sputum differential gene expression implicates increased p38 signalling activity in severe asthma', Respirology, Canberra, ACT (2012) [E3]
Co-authors Rodney Scott, Jodie Simpson, Lisa Wood, Katherine Baines
2012 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Weight loss improves clinical asthma outcomes and airway inflammation in overweight and obese asthmatics', Obesity Research & Clinical Practice, Auckland, New Zealand (2012) [E3]
Co-authors Hayley Scott, Manohar Garg, Philip Morgan, Robin Callister, Lisa Wood
2011 Berthon B, MacDonald-Wicks LK, Gibson PG, Wood LG, 'Asthmatics have an altered eating pattern with increased fat and decreased fibre intake associated with airway inflammation and poorer lung function', Australasian Medical Journal, Queenstown, NZ (2011) [E3]
Co-authors Lisa Wood, Lesley Wicks
2011 Berthon B, MacDonald-Wicks LK, Gibson PG, Wood LG, 'Plasma leptin levels are elevated in stable asthma', Australasian Medical Journal, Queenstown, NZ (2011) [E3]
Co-authors Lesley Wicks, Lisa Wood
2011 Jensen ME, Collins CE, Gibson PG, Hilton JM, Wood LG, 'Dietary induced weight loss improves asthma control and lung function after 10 weeks in obese children and adolescents with asthma', Australasian Medical Journal, Queenstown, NZ (2011) [E3]
Co-authors Clare Collins, Megan Jensen, Lisa Wood
2011 Jensen ME, Gibson PG, Collins CE, Wood LG, 'Lean mass is positively associated with respiratory function in male asthmatic children', Australasian Medical Journal, Queenstown, NZ (2011) [E3]
Co-authors Clare Collins, Megan Jensen, Lisa Wood
2011 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'The influence of body composition and inflammation on lung function in asthma', Australasian Medical Journal, Queenstown, NZ (2011) [E3]
Co-authors Philip Morgan, Robin Callister, Lisa Wood, Manohar Garg, Hayley Scott
2011 Baines KJ, Simpson JL, Scott R, Wood LG, Gibson PG, 'Systemic upregulation of neutrophil a-defensins and serine proteases in neutrophilic asthma', European Respiratory Society Annual Congress 2011 Abstracts, Amsterdam (2011) [E3]
Co-authors Lisa Wood, Katherine Baines, Rodney Scott, Jodie Simpson
2011 Baines KJ, Simpson JL, Scott R, Wood LG, Gibson PG, 'Sputum gene expression of mast cell tryptase and carboxypeptidase A3 are increased in eosinophilic asthma', European Respiratory Society Annual Congress 2011 Abstracts, Amsterdam (2011) [E3]
Co-authors Jodie Simpson, Lisa Wood, Katherine Baines, Rodney Scott
2011 Baines KJ, Simpson JL, Scott R, Wood LG, Gibson PG, 'Induced sputum differential gene expression implicates increased p38 signalling activity in severe asthma', European Respiratory Society Annual Congress 2011 Abstracts, Amsterdam (2011) [E3]
Co-authors Lisa Wood, Rodney Scott, Katherine Baines, Jodie Simpson
2011 Porsbjerg C, Gibson PG, Pretto JJ, Salome C, Brown N, King G, 'Airway inflammation and airway pathophysiology in older asthmatics', European Respiratory Society Annual Congress 2011 Abstracts, Amsterdam (2011) [E3]
2011 Namazy JA, Murphy VE, Powell H, Gibson PG, Chambers C, Schatz M, 'Effects of asthma severity and medication use on prematurity and intrauterine growth: A meta analysis from published data', Journal of Allergy and Clinical Immunology, San Francisco, CA (2011) [E3]
Co-authors Vanessa Murphy
2011 Foster P, Li J, Wang W, Baines K, Bowden N, Hansbro P, et al., 'IL-27 underpins steroid resistant airway hyperresponsiveness via MyD88 dependent pathways', ALLERGY, Istanbul, TURKEY (2011) [E3]
Co-authors Philip Hansbro, Nikola Bowden, Ming Yang
2011 Gibson PG, Powell H, Giles W, Clifton V, Hensley MJ, Taylor DR, et al., 'Asthma exacerbations during pregnancy are reduced by inflammometry (FENO) guided asthma management: A randomised controlled trial', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Michael Hensley, Vanessa Murphy
2011 Hansbro PM, Horvat JC, Essilfie A-T, Kim RY, Simpson JL, Dunkley ML, et al., 'Infection-induced neutrophilic allergic airways disease is resistant to steroid treatment', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Jodie Simpson, Philip Hansbro, Jay Horvat, Margaret Dunkley, Paul Foster
2011 Jensen ME, Collins CE, Gibson PG, Hilton JM, Wood LG, 'Characterising the obese phenotype in asthmatic children and adolescents', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2011 Jensen ME, Gibson PG, Collins CE, Hilton JM, Latham-Smith F, Wood LG, 'Gender differences in sleep duration & sleep quality in children with & without asthma using polysomnography', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2011 Jensen ME, Gibson PG, Collins CE, Hilton JM, Wood LG, 'Results from a ten week pilot weight loss intervention in obese asthmatic children and adolescents', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Megan Jensen, Lisa Wood, Clare Collins
2011 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Clinical asthma outcomes are improved after body fat reduction in overweight and obese asthmatics', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Philip Morgan, Hayley Scott, Manohar Garg, Robin Callister, Lisa Wood
2011 Sukkar MB, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Deficiency of srage in asthma and COPD is selectively associated with neutrophilic airway inflammation', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Peter Wark, Vanessa Mcdonald, Jodie Simpson, Lisa Wood
2011 Wood LG, Scott HA, Gibson PG, 'Systemic inflammation is increased in neutrophilic asthma', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Lisa Wood, Hayley Scott
2011 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Success in a weight loss trial is greatest in subjects with more severe asthma', American Journal of Respiratory and Critical Care Medicine, Denver, CO (2011) [E3]
Co-authors Lisa Wood, Robin Callister, Manohar Garg, Hayley Scott, Philip Morgan
2011 Vertigan AE, Gibson PG, 'Development of a brief speech pathology intervention for chronic refractory cough', Pulmonary Pharmacology & Therapeutics, London (2011) [E3]
2011 McLaughlin KM, Mattes J, Murphy VE, Steel KR, Powell H, Gibson PG, 'The Growing Into Asthma (GIA) Study: Need for improved management of respiratory illnesses in early life', PSANZ 2011 15th Annual Congress: Poster Abstracts, Hobart, TAS (2011) [E3]
Co-authors Joerg Mattes, Vanessa Murphy
2011 McDonald VM, Higgins IJ, Wood LG, Gibson PG, 'Multidimensional assessment and individualized management (MDAIM) of obstructive airway diseases (OAD) in older adults - A pilot clinical trial', Respirology, Perth, WA (2011) [E3]
Co-authors Isabel Higgins, Lisa Wood, Vanessa Mcdonald
2011 Sukkar M, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Soluble RAGE is deficient in neutrophilic asthma and COPD', Respirology, Perth, WA (2011) [E3]
DOI 10.1183/09031936.00022011
Citations Scopus - 76Web of Science - 65
Co-authors Jodie Simpson, Vanessa Mcdonald, Peter Wark, Lisa Wood
2011 Baines KJ, Simpson JL, Scott R, Wood LG, Gibson PG, 'Analysis of systemic gene expression according to inflammatory phenotype of asthma', Respirology, Perth, WA (2011) [E3]
Co-authors Jodie Simpson, Katherine Baines, Lisa Wood, Rodney Scott
2011 Berthon B, MacDonald-Wicks LK, Gibson PG, Wood LG, 'Diet quality is poor in severe asthmatics compared to healthy controls', Respirology, Perth, WA (2011) [E3]
Co-authors Lisa Wood, Lesley Wicks
2011 Vanders RL, Gibson PG, Murphy VE, Wark PA, 'Reduced antiviral interferons during pregnancy explains susceptibility to influenza virus infection', Respirology, Perth, WA (2011) [E3]
Co-authors Vanessa Murphy, Rebecca Vanders, Peter Wark
2011 Garside CG, Simpson JL, Yang IA, James AL, Upham JW, Reynolds PN, et al., 'Characterizing the severe asthma phenotype in an Australian setting: The Amazes Study', Respirology, Perth, WA (2011) [E3]
Co-authors Jodie Simpson
2011 Gunawardhana LP, Baines KJ, Simpson JL, Mattes J, Murphy VE, Gibson PG, 'Maternal asthma is associated with alterations in DNA methylation profile of peripheral blood of infants', Respirology, Perth, WA (2011) [E3]
Co-authors Katherine Baines, Joerg Mattes, Vanessa Murphy, Jodie Simpson
2011 Hodge S, Richard S, Simpson JL, Garside CG, Herewane K, Yang I, et al., 'Granzyme B is increased in induced sputum both from patients with COPD and non-eosinophilic asthma', Respirology, Perth, WA (2011) [E3]
Co-authors Jodie Simpson
2011 Hodge S, Simpson JL, Richard S, Garside CG, Yang I, Upham J, et al., 'Non-eosinophilic asthma resembles COPD with suppressed apoptotic cell clearance and macrophage recognition molecules', Respirology, Perth, WA (2011) [E3]
Co-authors Jodie Simpson
2011 Horvat JC, Essilfie A-T, Kim RY, Simpson JL, Dunkley ML, Beagley KW, et al., 'Investigation of infection-induced steroid resistant asthma', Respirology, Perth, WA (2011) [E3]
Co-authors Jay Horvat, Margaret Dunkley, Jodie Simpson, Paul Foster, Philip Hansbro
2011 Mattes J, Murphy VE, McLaughlin KM, Steel KR, Powell H, Gibson PG, 'Are maternal asthma exacerbations during pregnancy related to impaired infant growth in the first six months of life?', Respirology, Perth, WA (2011) [E3]
Co-authors Joerg Mattes, Vanessa Murphy
2011 Oreo K, Baines KJ, Gibson PG, Hansbro PM, 'Pro-inflammatory cytokine production is impaired in response to TLR2 activation in healthy ageing and COPD', Respirology, Perth, WA (2011) [E3]
Co-authors Philip Hansbro, Katherine Baines
2011 Ryan NM, Vertigan AE, Ferguson JK, Wark PA, Gibson PG, 'Investigation and characterization of persistent cough associated with H1N1 2009 influenza', Respirology, Perth, WA (2011) [E3]
Co-authors Nicole Ryan, Peter Wark, John Ferguson
2011 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Success in a weight loss trial is related to asthma severity', Respirology, Perth, WA (2011) [E3]
Co-authors Philip Morgan, Hayley Scott, Manohar Garg, Robin Callister, Lisa Wood
2011 Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG, 'Body fat reduction improves clinical asthma outcomes in overweight and obese asthma', Respirology, Perth, WA (2011) [E3]
Co-authors Hayley Scott, Philip Morgan, Manohar Garg, Lisa Wood, Robin Callister
2011 Wood LG, Scott HA, Gibson PG, 'The neutrophilic inflammatory phenotype is associated increased systemic inflammation in asthma', Respirology, Perth, WA (2011) [E3]
Co-authors Hayley Scott, Lisa Wood
2011 Wang F, Xy HA, Baines KJ, Gunawardhana LP, Simpson JL, Ki F, Gibson PG, 'Is chalamydophyla a pneumoniae infection related to non-eosinophilic asthma?', Respirology, Perth, WA (2011) [E3]
Co-authors Jodie Simpson, Katherine Baines
2011 Fu J, Baines KJ, Wood LG, Scott HA, Gibson PG, 'Low-grade systemic inflammation is associated with airway neutrophilia in asthma', Respirology, Shanghai (2011) [E3]
Co-authors Katherine Baines, Lisa Wood, Hayley Scott
2011 Fu J, Baines KJ, Gibson PG, Scott HA, Wood LG, 'Systemic inflammation mediates airway neutrophilia via the regulation of IL-8 receptor mRNA expression', Respirology, Shanghai (2011) [E3]
Co-authors Katherine Baines, Lisa Wood, Hayley Scott
2011 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'Mucus hypersecretion and chronic bronchitis in older adults with chronic obstructive airway diseases', Respirology, Shanghai (2011) [E3]
Citations Web of Scienc