Characterisation and Treatment of Innate Immune Dysfunction in Older People with Obstructive Airway Disease

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Airway problems in older people are increasing. The two most common airway problems in people over the age of 60 are asthma and chronic obstructive pulmonary disease or COPD. These diseases have a major impact of the quality of life of older people. Airway inflammation is an important mediator of symptoms and exacerbations in younger people with airway disease, however little is understood about airway inflammation in the elderly. We will study airway inflammation in older people with airway disease and make comparisons with both younger and older healthy controls. While many changes occur in our bodies with age, we do not understand how ageing affects airway disease. Some of the changes which occur with ageing include increased inflammation and an increased susceptibility to infection. We do not understand how these changes affect people with respiratory disease or how they occur. Respiratory infections in older people with airway disease often result in hospitalisation, and some bacterial pathogens can survive in the airways for long periods of time without the typical symptoms of infection. This bacterial persistence can lead to an increased influx of inflammatory cells and chemicals which can cause destruction of the airways and lead to changes in the airway structure that are not reversible. We will investigate bacterial infection in older people with and without airway disease and investigate an important pathway of the immune system called innate immunity. We will assess the influence of ageing itself on these immune responses, and also the impact of associated airway disease. We will also trial an anti-inflammatory therapy in older people with airway disease who have persisting bacteria in their airways to see if this will help reduce inflammation and reduce the bacteria that persist in the airways. These are new and exciting approaches to a common and increasing problem for older Australians.