Imaging of Regional Bronchoconstriction and Bronchodilation In Chronic Obstructive Pulmonary Disease (COPD)
Faculty/Research Groups
Airway Physiology and Imaging Group, The Woolcock Institute of Medical Research, The University of Sydney.
School of Life Sciences, Faculty of Science, UTS.
Department of Respiratory Medicine, Royal North Shore Hospital (RNSH), St Leonards.
Supervisors: David Chapman (UTS and Woolcock) and Gregory King (Woolcock and RNSH), Cindy Thamrin (Woolcock), Catherine Farrow (Woolcock and RNSH).
Synopsis: COPD affects 10% of adults in Australia and in western countries, is due mainly to cigarette smoking. COPD is characterised by breathlessness which is predominantly on exertion, cough and wheeze. In COPD, there may be lung destruction (emphysema) and airway narrowing (small airways disease) which result in impairment to airflow in and out of the lungs, leading to symptoms. Therefore, the characteristic functional abnormalities in the lungs is reduced ventilation. Importantly, this reduced ventilation is patchy and heterogeneous between different parts of the lungs, and is a characteristic abnormality in COPD.
Treatment for COPD is based on exercise therapy and medications to dilate the airways (bronchodilators). Bronchodilator treatment (beta agonists and cholinergic antagonists) dilate airways and reverse the lung over-inflation that typically occurs in COPD, thereby providing symptomatic improvement. Treatment responses are variable however, and there are no known predictors of treatment response to bronchodilators, i.e. the basis of a poor response to treatment are not known. The response to bronchodilator, or lack thereof, is likely dependent upon the degree of patchiness of ventilation, which may represent severity of disease or differences in disease mechanisms, which may in turn influence bronchodilator treatment responsiveness. The patchy ventilation could also affect where the inhaled bronchodilator treatment deposits , thereby affecting response. However, there is little understanding as to how the underlying ventilation distribution contributes to the response to bronchodilators. As a consequence, bronchodilator management is ad hoc.
The aim of this study is to better understand bronchodilator responses in COPD in terms of changes in ventilation distribution and to relate the responses in ventilation to symptoms and other lung function measures.
The outcomes of this study may provide insights into how to better measure treatment responses in COPD and may eventually be used to help develop better treatments beyond bronchodilators, or to aid better targeting of treatment.
Study outline: COPD participants will undergo complex lung function tests and measurements of ventilation distribution using Single Photon Emission Computed Tomography (SPECT). This technique was developed at the Airway Physiology and Imaging research group and used at RNSH for research into airways disease. All complex tests and imaging methodology has been well established within this research group. The imaging and physiologic studies will be conducted at the Department of Respiratory Medicine and Respiratory Medicine, Royal North Shore Hospital.
The Airway Physiology and Imaging Group is led by Professor Gregory King. Dr David Chapman is The Chancellors Postdoctoral Research Fellow at the School of Life Sciences, UTS. Dr Gregory King is Conjoint Professor of Respiratory Medicine, Northern Clinical School, University of Sydney and Staff Specialist of the Department of Respiratory Medicine, Royal North Shore Hospital.
The PhD candidate is required to have a Bachelor’s degree in Science with first degree Honours, in the general area of biomedical or health science.
Enquiries should be directed to Dr David Chapman at: david.chapman@woolcock.org.au or 02 9114 0413.