Thunderstorm asthma season is rolling in

Monash clinical immunologists at Eastern Health and Alfred Health
warn of potential thunderstorm asthma risks. Image: Shutterstock

 

 

It's thunderstorm asthma season again, and  Monash researchers have just published a review on epidemic thunderstorm asthma (ETSA). 

Professor Frank Thien is first author and Professor Robyn O'Hehir is the senior author on the review. They write, "Epidemic thunderstorm asthma (ETSA) is due to a complex interaction of environmental and individual susceptibility factors, with outbreaks reported globally over the last four decades. Australia has been particularly susceptible with nearly half of episodes reported internationally, culminating in the catastrophic Melbourne 2016 event."

The 'bible' of allergy updated

Middleton’s Allergy Principles and 

Practice 9th Edition

Since 1978, when the late Elliott Middleton, Jr., together with the founding editors Elliot Ellis and Charles Reed, published the comprehensive book Allergy: Principles and Practice, these two volumes have been the definitive text on allergy practice and disease mechanisms worldwide.

A number of Monash University researchers have contributed to the new 9th edition and Monash's Head of Central Clinical School’s Department of Allergy, Immunology and Respiratory Medicine, Professor Robyn E O’Hehir AO FAHMS, is one of the editors.

Congratulations to our inaugural Robyn O'Hehir Honours dux prize winners!

Matthew Drill

Elan L'Estrange-Stranieri

The Robyn O'Hehir medal is awarded for the top-ranked Honours student in CCS. The medal is named for Professor Robyn O'Hehir AO, Professor-Director of Allergy, Immunology and Respiratory Medicine in Central Clinical School and the Alfred Hospital. It was instituted in 2019 by our outgoing Head of School, Professor Stephen Jane.

Congratulations to our 2019 inaugural awardees!

• Matthew Drill (Department of Neuroscience)
  Honours thesis: The link between Purinergic P2X receptor 7 (P2X7R) and Granulocytic-Macrophage Colony-Stimulating Factor (GM-CSF) in  Glioblastoma.
  Matthew was supervised by Dr Mastura Monif. 
• Elan L'Estrange-Stranieri (Department of Immunology and Pathology)
  Honours thesis: Assessing the kinase independent role of Lyn in preventing lupus.
  Elan was supervised by Associate Professor Margaret Hibbs.

Congratulations to AIRmed research team for international recognition!

The AIRmed team's paper was nominated as one of the top 6 papers

Accolades for the RES4 Allergy and Asthma Team at the recent European Respiratory Symposium highlighting the best of the European Respiratory Journal in 2018.

Public health lessons from the 2016 thunderstorm asthma epidemic

Figure 1 from the article, showing
the meteorological conditions

A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies. 11 of the coauthors are affiliated with Monash University including several from the Department of Allergy, Immunology and Respiratory Medicine,  Central Clinical School.

They write, "Convergent environmental factors triggered a thunderstorm asthma epidemic of unprecedented magnitude, tempo, and geographical range and severity on Nov 21, 2016, creating a new benchmark for emergency and health service escalation. Asian or Indian ethnicity and current doctor-diagnosed asthma portended life-threatening exacerbations such as those requiring admission to an ICU. Overall, the findings provide important public health lessons applicable to future event forecasting, health care response coordination, protection of at-risk populations, and medical management of epidemic thunderstorm asthma."

Donald Cockroft writes in a published comment in the same issue, "An unusual observation was the high prevalence of Asian or Indian ethnicity among the patients, including six of the ten deaths." Melbourne's population is one quarter Asian and Indian ethnicity, yet they were almost two fifths (39%) of those presenting to emergency.

Sashimi or kebab? The effect of cooking on crustacean allergy

Allergy to crustaceans is complicated, and
can differ depending whether the food is
cooked or raw.

 by Dr Jodie Abramovitch (one of the authors on the study)

Allergy to crustaceans, such as crab and prawns, is a major cause of food induced anaphylaxis. To more accurately diagnose and treat crustacean allergies, investigation into the underlying immunological mechanisms that cause the allergy is necessary.

Researchers within the Monash University Departments of Allergy, Immunology and Respiratory Medicine (AIRMed) and of Immunology and Pathology have published a paper investigating the effect of cooking of crab and prawn species on immune cells involved in the allergic response.

For the first time, this study looked at the response of four different immune cell subsets – CD4+, CD8+,  and CD56+ lymphocytes, and Foxp3+ regulatory T cells -  to raw and cooked crustaceans in crustacean-allergic individuals.

‘Retraining’ the immune system of patients with allergies

L-R: Allergy lab colleagures Dr Sara Prickett, Prof Robyn O'Hehir
and Emeritus Prof Jenny Rolland

Professor Robyn O'Hehir gives an overview of her research into immune system components involved in reducing allergic response.

Turning off the T cells in allergy

An aberrant allergic (IgE) response to a usually harmless stimulus (allergen) is orchestrated by a population of white blood cells known as helper T cells.  By reining in the activities of these T cells, it is possible to reduce the severity of the allergy.

Congratulations to Dr Astrid Voskamp on the completion of her PhD!

L to R: Promoter: Professor Maria Yazdanbakhsh, Leiden University

Co-promoter: Dr Sara Prickett, Monash University
Candidate: Dr Astrid Voskamp
Promoter: Professor Robyn O'Hehir, Alfred Health/Monash University
Examiner: Professor Christian Taube, Leiden University

Congratulations to Dr Astrid Voskamp, past member of Prof Robyn O'Hehir's & Prof Jenny Rolland's Allergy lab, who has recently successfully completed her PhD in the Netherlands. She did all of her lab work in the Allergy lab. Astrid achieved 12 publications in her seven years with the Allergy group.

Astrid was awarded her PhD through Leiden University, The Netherlands, June 2016 (Defense date: 16th June), for her thesis, titled "Clinical Allergy: Basophils, T cells and Therapeutic Design". The research was conducted at Monash University (Department of Immunology & Pathology; Allergy lab) and Alfred Health (Department of AIRMed).

New book published: Middleton's Allergy Essentials

Professor Robyn O'Hehir (Director, Department of Allergy, Immunology and Respiratory Medicine, Alfred & Monash) and her international co-authors have published a book of comprehensive information on allergic disorders for medical practitioners. Middleton’s Allergy Essentials, by Professors Robyn E. O'Hehir, Stephen T. Holgate, and Aziz Sheikh, offers a concise resource that is both easily accessible and highly authoritative. Perfect for clinicians in primary and secondary care settings, this practical volume covers what is most useful in your daily practice, with a strong emphasis on disease diagnosis and management.

See more or order at:
https://elsevier.ca/product.jsp?isbn=9780323375795

Anaphylaxis to oats – link between food-based moisturisers and food allergy

By Dr Jodie Abramovitch

Food allergy is a growing health issue and, for those affected, can be associated with serious medical outcomes. Allergic reactions to food can range from relatively mild (swelling, rashes) to potentially life threatening (anaphylaxis). 

Allergy Research Group:
(back) L-R Jade Jaffar, Nirupama Varese
Jennifer Rolland (Head), Robyn O'Hehir (Head), Jodie Abramovitch
(front) L-R Sara Prickett, Tracy Phan

Researchers within the Department of Allergy, Immunology and Respiratory Medicine (AIRMed) and the Department of Immunology and Pathology have recently published an interesting case study on oat allergy. A female patient presented with anaphylaxis following consumption of oats in an apple crumble crust. Analysis of the patient’s clinical history noted that, whilst previously able to eat oats without incident, she had been using an oat-based moisturiser to soothe her eczema (broken skin). The patient had also experienced some allergic symptoms (difficulty in breathing) in response to the moisturiser as well as an oat-based bath product.

Experiments were able to show that the patient had oat-specific IgE antibodies (a diagnostic marker of allergy) within her blood. In the presence of oat extract or the oat-containing products, these antibodies were able to activate the patient's basophils, an important cell type activated during an allergic reaction, indicating that they were indeed leading to clinical symptoms when the patient was exposed to oat.

Combined with the clinical history, these data suggest that the patient was sensitised to oat via the application of oat-based products to broken skin. As quoted in a previous article published within this blog, the head of AIRMed and senior author of this case study Professor O’Hehir states that: “This new study adds extra evidence to the argument for skin care preparations to be bland and to avoid agents capable of sensitisation, especially foods.”

Reference: Radhakrishna N, Prickett S, Phan T, Rolland JM, Puy R, O'Hehir RE. Anaphylaxis to oats after cutaneous sensitization by oatmeal in skin products used for the treatment of atopic dermatitis. J Allergy Clin Immunol Pract. 2016 Jan-Feb: 4;152-3

doi: 10.1016/j.jaip.2015.07.005

Peanut allergy vaccine receives commercial funding boost

The AIRMed Allergy research group.
L-R Back row: Dr Jade Jaffar, Ms Jodie Abramovitch,
Dr Sara Prickett, Professor Robyn O'Hehir

L-R Front row: Ms Neeru Varese, Ms Kirsten Deckert,
E/Professor Jennifer Rolland, Ms Anita Hazard, Ms Tracy Phan

The effort to develop a vaccine that could change the lives of sufferers of peanut allergy has taken another step forward with the announcement of $4.85 million of further funding to support the Melbourne-based research.

The Director and Head of the Allergy, Immunology and Respiratory Medicine department in The Alfred and Monash University, Prof Robyn O'Hehir said peanut allergy is a rapidly growing problem in Australia and around the world.

This new investment from the Brandon Capital managed Medical Research Commercialisation Fund, together with the support of an additional $1.44M National Health and Medical Research Council grant (announced in November), will ensure Prof O'Hehir and her team at The Alfred and Monash University can continue the research effort that she began close to 15 years ago.

CCS successes in 2015 NHMRC funding

Publication: Oats and goat's milk - Case studies on becoming allergic to food via skin products

L-R: Dr Sara Prickett, Prof Robyn O'Hehir and Prof Jenny
Rolland.

Goat milk first, now oats are revealed by Monash allergy researchers to be allergenic ingredients in skin care products.

"Food is meant to be eaten, not rubbed into inflamed skin," said Professor Robyn O'Hehir, Director of Allergy, Immunology and Respiratory Medicine at The Alfred and Monash University, on publication of her article in 2014 which demonstrated both clinical and laboratory evidence of a link between topical application of cosmetics and the development of food allergy to goat's milk.

Central Clinical School Gender Equity Committee

At the most recent Central Clinical School Executive meeting it was decided to form a Gender Equity Committee composed of senior academics to oversee this critical issue. 

The Committee consists of Professors Robyn O'Hehir, Harshal Nandurkar, Jayashri Kulkarni and Anton Peleg,

The Committee will meet two times a year and report back to the Executive, providing ideas and direction for Gender Equity at all levels of the School. 

Congratulations to Prof Robyn O'Hehir FThorSoc, new Fellow of the Thoracic Society of Australia and New Zealand

Congratulations to Professor Robyn O'Hehir FThorSoc, who has been awarded the Fellow status of the Thoracic Society of Australia and New Zealand on 28 March 2015 . The status is awarded to Thoracic Society members who demonstrate exceptional contributions to the field of respiratory health in Australia or New Zealand. Professor O'Hehir's outstanding clinical and research achievements in the field has earned her the Fellow status.

Photo of the Week: Allergy Laboratory

Professors Robyn O'Hehir (Head, Department of Allergy, Immunology and Respiratory medicine) and Jennifer Rolland are co-supervisors of PhD student Jodie Abramovitch. Jodie's project is clinical, looking at the effect that food processing, particularly cooking, has on shellfish allergy. She is investigating whether cooking shellfish makes a difference to the allergic reaction when compared to eating them raw.
See more:

• Allergy laboratory research
• Allergy lab photo gallery
• CCSMonash Google+ photo galleries

Australian Academy of Health and Medical Sciences Fellowships for AMREP researchers

Recently elected AAHMS Fellows at the ceremony in Canberra 25 March 2015

The Australian Academy of Health and Medical Sciences (AAHMS) was established in 2014 with the aim of influencing the health and medical scientific and policy landscape of Australia. Its three broad aims are:

• Mentoring the next generation of clinician researchers.
• Providing independent advice to government and others on issues relating to evidence based medical practice and medical research.
• Providing a forum for discussion on progress on medical research with an emphasis on translation of research into practice.

Congratulations to all the Alfred Medical Research and Education Precinct (AMREP) based researchers recently elected as Fellows.

• Prof Jamie Cooper (Monash/Alfred)
• Prof Mark Cooper (Baker IDI/Alfred)
• Prof Brendan Crabb (Burnet)
• Professor Suzanne Crowe (Burnet/Alfred)
• Prof Stephen Jane (Monash/Alfred)
• Prof Garry Jennings (Baker IDI/Alfred)
• Prof David Kaye (Baker IDI/Alfred)
• Prof Bronwyn Kingwell (Baker IDI)
• Prof Paul Myles (Monash/Alfred)
• Prof Robyn O’Hehir (Monash/Alfred)
• Prof Jeffrey Rosenfeld (Monash/Alfred)
• Prof Jonathan Shaw (Baker IDI) 
• Prof John Zalcberg (Monash)

See more about AAHMS: www.aahms.org/

Follistatin promising for cystic fibrosis treatment

Lung scan showing airways obstructed with mucus
Image: Guy Viner

Cystic fibrosis (CF) is the most common life-limiting genetically acquired respiratory disorder. Patients with CF have thick mucus obstructing the airways leading to recurrent infections, bronchiectasis and neutrophilic airway inflammation culminating in deteriorating lung function. Current management targets airway infection and mucus clearance, but despite recent advances in care, life expectancy is still only 40 years.

Researchers from the Monash Department of Allergy, Immunology and Respiratory medicine investigated whether activin A (a proinflammatory protein associated with excessive mucus secretion) is elevated in CF lung disease and whether inhibiting activin A with its natural antagonist follistatin retards lung disease progression. They found that activin A levels are elevated in CF and provide proof-of-concept from an experimental model for the use of the activin A antagonist, follistatin, as a therapeutic in the long-term management of lung disease in CF patients.

Reference: http://www.nature.com/icb/journal/vaop/ncurrent/full/icb20157a.html

Interpreting Lung Function Tests: A Step-by-Step Guide

L-R: The authors with their book - Ms Brigitte Borg,
Professor Bruce Thompson and Professor Robyn O'Hehir

Lung function assessment is the central pillar of modern respiratory diagnosis, providing invaluable information to assist in clinical decision making and management strategies.
Interpreting Lung Function Tests: A Step-by Step Guide is a recently published practical “how-to” training manual, which provides the reader with the necessary skills to interpret lung function test results, and to write a concise and informative report on the outcome.
Reference: au.wiley.com/WileyCDA/WileyTitle/productCd-111840551X.html

Goat’s milk moisturizer induces goat’s cheese allergic reaction

Image: Jinx!

"Food is meant to be eaten, not rubbed into inflamed skin," says Professor Robyn O'Hehir. A woman has experienced a life-threatening allergic reaction after eating goat’s cheese, which Alfred-based researchers say was triggered through repeated use of a moisturiser containing goat's milk. The case study, published this week in The Journal of Allergy and Clinical Immunology: In Practice, pinpoints goat’s milk as the offending ingredient, and highlights the argument for skin care preparations to be bland and to avoid "agents capable of sensitisation, especially foods."