Advanced pulmonary diagnostics in paediatric respiratory medicine: From technical development to clinical implementation

Chronic lung diseases present a serious health challenge for Canadian children and youth. For example, cystic fibrosis (CF) shortens life expectancy and carries an enormous treatment cost (>$250,000 per person per year). Another example is asthma, which affects nearly 1 in 7 Canadians under age 20. Improving the lives of people with these conditions is possible but requires accurate detection and close monitoring of their lung disease.

Unfortunately, the tests available to paediatric respiratory physicians are often difficult for children to perform and not sensitive enough to detect or subtle disease. This significantly limits physicians’ ability to detect, treat and monitor lung disease in children and must change.

My research program focuses on the development of easy-to-perform and sensitive tools to help physicians diagnose and monitor lung disease in children. Specifically, I am an expert in techniques known as hyperpolarised xenon lung MRI (XeMRI) and multiple breath washout testing (MBW).

During tenure of this Health Professional-Investigator award, I will lead research focused on improving the XeMRI and MBW techniques and using these new tools clinically to improve the health of children with lung diseases.

Development of a non-invasive diagnostic to detect bacterial pulmonary infections in patients with cystic fibrosis

Cystic fibrosis (CF), once known as an untreatable fatal disease in early childhood, is now recognized as a fairly manageable disease but with a primary morbidity dominated by persistent lung infections. Our team and others have shown that bacterial volatile molecules in human breath represent a substantive diagnostic potential for lung infections. The focus of almost all breath research in CF, including ours, has been on two bacterial pathogens (Pseudomonas aeruginosa and Staphylococcus aureus). Here, we propose to target three additional pathogens (Haemophilus influenza, Stenotrophomonas maltophilia, and Burkholderia cepacia complex) that are common for patients with CF and are also broadly relevant to pneumonia in children. My scientific approach spans the careful testing of the molecules produced by bacterial cultures as well as breath of patients with CF. The expected outcomes (biomarker signatures) will provide clinical utility in the diagnosis of these pathogens as well as monitoring antimicrobial therapy efficacy. In addition, the signatures will likely provide a greater understanding of pathogen metabolism.