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The Royal Children’s Hospital and The Murdoch Children’s Research Institute (Melbourne, Australia)

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The Murdoch Children’s Research Institute (MCRI) is Australia’s largest child health research organisation. It includes Victorian Clinical Genetics Services (VCGS), a wholly owned subsidiary of the Institute. Our strength lies in our partnership and co-location with The Royal Children’s Hospital and University of Melbourne - the Melbourne Children’s Campus. This rare model amplifies opportunities to quickly translate research into clinical care. Our Vision and Mission is to be a major global contributor to the creation of knowledge and to obtain knowledge to improve the health of children.

Work at the MCRI covers a number of research themes, representing broad areas of research focus. Within the Infection & Immunity and Population Allergy themes sit the Allergy Immunology Research group, led by Professor Mimi Tang, and the Population Allergy Research group, led by Associate Professor Kirsten Perrett and Dr Jennifer Koplin.

Professor Tang’s Allergy Immunology Research group aims to bring together public health, clinical and laboratory research expertise to identify novel strategies for the prevention or treatment of allergic disease and investigate immune mechanisms leading to allergic disease. The group is involved with a range of investigator led and industry sponsored randomized controlled trials, as well as large community based cohort studies which provide access to valuable biological samples for immunological and microbiological investigations. In a world first randomized controlled trial of a combination therapy comprising probiotic together with peanut oral immunotherapy (PPOIT) for the treatment of peanut allergy, PPOIT was found to be highly effective with just over 74% of children who received PPOIT achieving remission of their peanut allergy after 18 months of treatment (compared with 3.6% in placebo group). Eighty percent of PPOIT treatment responders were still eating peanut 4 years later, and 70% had challenge-confirmed long-term remission of their peanut allergy. These findings provide proof-of-concept for the effectiveness of a combined probiotic and oral immunotherapy approach to treat peanut allergy, with lasting benefit. Additional clinical trials are underway to determine whether addition of the probiotic improves either efficacy and/or safety of peanut oral immunotherapy on its own. It is anticipated that additional trials will be initiated over the next 5-10 years to develop the novel technology. Studies of the underlying immune mechanisms of peanut allergy and remission of allergy are underway. Additional trials evaluating whether the combination probiotic food oral immunotherapy approach will be effective for treatment of other food allergies, such as egg allergy, are also ongoing.

Associate Professor Perrett’s and Dr Koplin’s Population Allergy Research group aims to find ways to prevent allergy, reduce adverse events in food allergic children, and improve food allergy treatment through early intervention. The group leads a series of cohort studies which are internationally unique due to the precision of their food allergy measures (oral food challenge), large sample size and population-representative sampling frame. These cohorts provided the first information on the burden of food allergy in Australia and its environmental and genetic risk factors. The HealthNuts study, the largest single-centre food allergy cohort study in the world, demonstrated the extraordinarily high prevalence of food allergy in Australia, finding that food allergy affects up to one in ten Australian infants. Potential prevention strategies for food allergy identified in the HealthNuts study are now being tested in large-scale prevention trials. Ongoing research within the Population Allergy group is also studying the relationship between food allergy, vitamin D and immune function in infants in our Vitality study and studying new models of care for early intervention in young children with food allergies.

     
Professor Mimi Tang            Associate Professor Kirsten Perret               Dr Jennifer Koplin

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