Biochemistry and Pharmacology - Research Publications

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    Trajectories of childhood immune development and respiratory health relevant to asthma and allergy.
    Tang, HH ; Teo, SM ; Belgrave, DC ; Evans, MD ; Jackson, DJ ; Brozynska, M ; Kusel, MM ; Johnston, SL ; Gern, JE ; Lemanske, RF ; Simpson, A ; Custovic, A ; Sly, PD ; Holt, PG ; Holt, KE ; Inouye, M (eLife Sciences Publications, Ltd, 2018-10-15)
    Events in early life contribute to subsequent risk of asthma; however, the causes and trajectories of childhood wheeze are heterogeneous and do not always result in asthma. Similarly, not all atopic individuals develop wheeze, and vice versa. The reasons for these differences are unclear. Using unsupervised model-based cluster analysis, we identified latent clusters within a prospective birth cohort with deep immunological and respiratory phenotyping. We characterised each cluster in terms of immunological profile and disease risk, and replicated our results in external cohorts from the UK and USA. We discovered three distinct trajectories, one of which is a high-risk 'atopic' cluster with increased propensity for allergic diseases throughout childhood. Atopy contributes varyingly to later wheeze depending on cluster membership. Our findings demonstrate the utility of unsupervised analysis in elucidating heterogeneity in asthma pathogenesis and provide a foundation for improving management and prevention of childhood asthma.
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    Airway Microbiota Dynamics Uncover a Critical Window for Interplay of Pathogenic Bacteria and Allergy in Childhood Respiratory Disease
    Teo, SM ; Tang, HHF ; Mok, D ; Judd, LM ; Watts, SC ; Pham, K ; Holt, BJ ; Kusel, M ; Serralha, M ; Troy, N ; Bochkov, YA ; Grindle, K ; Lemanske, RF ; Johnston, SL ; Gern, JE ; Sly, PD ; Holt, PG ; Holt, KE ; Inouye, M (CELL PRESS, 2018-09-12)
    Repeated cycles of infection-associated lower airway inflammation drive the pathogenesis of persistent wheezing disease in children. In this study, the occurrence of acute respiratory tract illnesses (ARIs) and the nasopharyngeal microbiome (NPM) were characterized in 244 infants through their first five years of life. Through this analysis, we demonstrate that >80% of infectious events involve viral pathogens, but are accompanied by a shift in the NPM toward dominance by a small range of pathogenic bacterial genera. Unexpectedly, this change frequently precedes the detection of viral pathogens and acute symptoms. Colonization of illness-associated bacteria coupled with early allergic sensitization is associated with persistent wheeze in school-aged children, which is the hallmark of the asthma phenotype. In contrast, these bacterial genera are associated with "transient wheeze" that resolves after age 3 years in non-sensitized children. Thus, to complement early allergic sensitization, monitoring NPM composition may enable early detection and intervention in high-risk children.