Complex Airways-disease Translational Team

Etiology of inflammation towards precision medicine approaches in asthma

The Complex Airways-Disease Translational Team (CATT) is a new research team that includes three principal investigators with very different expertise and training. Based on the local expertise in basic research on inflammatory phenotypes (Dr. Lisa Cameron), novel pulmonary functional imaging to establish imaging phenotypes (Dr. Grace Parraga) and high volume of clinically phenotyped asthma patients in the Asthma Centre (Dr. Cory Yamashita), the newly established CATT Research team aims to develop a unique research collaboration to improve our understanding of how inflammatory phenotypes in blood and sputum relate to asthma severity, local airway dysfunction and drug response.

Asthma is a chronic inflammatory airway disease that 1/3 Canadians will develop in their lifetime, costing over $50 billion/year. Many asthmatics experience persistent and debilitating symptoms that require multiple medications, ER visits and the use of systemic steroids. Though clinical symptoms are similar, a major advance was the discovery that severe asthma may be driven by one or more inflammatory phenotypes. For instance, the recently developed approach of treating asthma mediated by type 2 cytokines, typically identified as eosinophilic asthma (EA), with novel anti-type 2 agents has been very successful. However, a major problem is identifying these patients. Some show eosinophilic inflammation in the blood, others only in the sputum, while others in both blood and sputum. From a clinical perspective, it remains unknown which of these compartments is the best predictor of asthma severity and/or responses to novel anti-type 2 medications. Further, the anti-type 2 approach is appropriate for only ~ 50% of severe asthmatics and not those with non-eosinophilic asthma (NEA).

Goals

• To develop local capacity for inflammation phenotyping by sputum cellular analysis

• To determine functional imaging characteristics of patients with EA versus NEA

• To monitor efficacy of therapeutic interventions using MRI in patients with NEA

Overarching Hypothesis

We believe that molecular immunological analysis of inflammatory profiles with functional lung imaging will advance our understanding of asthma inflammatory phenotypes and therapeutic approaches for severe asthma.

The Team

	Dr. Cory Yamashita is the Medical Director of the St Joseph Health Centre Asthma Centre (SJHCAC). His responsibilities include oversight of patient care and research-focused activities. He will be responsible for patient enrollment and implementing specified treatment protocols.
	Dr. Lisa Cameron is a basic and translational research scientist with expertise in cellular profiling of asthma phenotypes. Her research program has been consistently funded through CIHR and other mechanisms and has resulted in publications identifying peripheral immune cell profiles associated with asthma severity.
	Dr. Grace Parraga is an Imaging Scientist at Robarts and her lab has pioneered functional imaging biomarkers that are ?intermediate endpoints? of asthma and COPD. Her ongoing work has resulted in landmark findings that showed MRI uniquely predicts longitudinal outcomes in patients. Her research team will be responsible for scientific input, application of functional MRI and interpretation of results.