Our hospital is a setting for groundbreaking asthma research. One of our most exciting new discoveries is that very early in life children with asthma have striking changes in lung function called filling defects. Filling defects are regions of the lung that do not fill with air. This discovery was possible through research done in partnership with a pediatric radiologist in the Children’s Hospital, Dr. Tally Altes. Dr. Altes and her team have pioneered the use of inhaled helium gas as a means to safely image the lungs of small children without exposure to the radiation that accompanies standard imaging methods. We are now working with colleagues in Pediatric Allergy and Immunology to study whether the immune cells found in regions of the lungs with filling defects are different and account for the structural changes observed by MRI.
The University of Virginia Children’s Hospital also offers a wide variety of clinical trials to develop and test new asthma therapies. One of our current studies, funded by the National Institutes of Health, targets children with severe asthma and offers supervised care and detailed diagnostic tests. Through participation in a clinical trial we have shown that even children who get the placebo or inactive treatment often experience an improvement in their.
asthma symptoms through the relationship and coaching available from frequent interactions with a study coordinator. The asthma clinical trials program at UVa Children’s Hospital is novel in that children interact with an experienced coordinator staff that includes experts in respiratory care, exercise physiology, and nutrition.
I’m also excited about my work on a landmark review, completed after a five years of discussions with representatives of the American Respiratory Society and the European Respiratory Society. The purpose of our effort was to synthesize all available knowledge about severe asthma and how to treat it. One of the positions taken by our group should change how primary care physicians approach adults and children with poorly controlled asthma. We conclude that only a few patients who present with poorly controlled asthma have a severe form of the disease that requires special treatment, but others have variations that require simple solutions, such as taking medication or changing their environment. We’ve learned that physicians and providers need to go through a very detailed process before concluding that a patient has severe asthma. That process should include close observation of asthma symptoms for at least three months of supervised care with high doses of inflammatory medications.
My work is important to me because the knowledge that stems from the clinical trials can be directly applied to improve outcomes in children with asthma. The work is primarily based on having close relationships with study subjects and patients, which to me is a defining feature of a Children’s Hospital environment. Each day feels more like an exciting mission than work. The children and families that I have the privilege to serve are a constant source of inspiration.
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