Major Research Programs
Asthma, Allergy and other Respiratory DiseaseFamily Studies of Cancer
The Melbourne Collaborative Cohort Study
Hereditary Haemochromatosis
Statistical Methods
Community-Onset Staphylococcus aureus Household Cohort study
Asthma, Alergy and other Respiratory Disease
The research program on allergy, asthma and other respiratory disease at the Centre is headed by Dr Shyamali Dharmage. The aim of this program is to understand the complex interplay between environmental and genetic risk factors for these diseases both in children and adults, and thereby to contribute to the development of interventions that could be directed at the population level, at high-risk groups, or at individuals.Over the past seven years, this program has provided training opportunities for a number of honours and doctoral students, and post doctoral researchers to undertake ground-breaking research at the forefront of airway disease research. As of April 2008, four PhD students and two postdoctoral research fellows are conducting their research within this research program. Over 2007, the research conducted within this program has been published in high impact journals including the world’s top allergy journal and the researchers have frequently been interviewed by the media.
This program mainly encompasses two world-class longitudinal studies and is funded by a number of external funding bodies including NHMRC.
The Centre, in collaboration with Monash University and the University of Tasmania, is investigating the natural history, environmental and genetic risk factors for adult asthma and chronic obstructive pulmonary disease using a large population-based prospective study of the 1961 birth cohort enrolled in the 1968 Tasmanian Asthma, their parents and siblings. This is currently funded by the NHMRC project grants scheme, Tasmanian Asthma Foundation, Victorian Asthma Foundation, GSK and Sypkes Trust. The 40-year follow-up of the siblings commenced with a postal survey on 21,000 siblings. The Centre, in collaboration with Murdoch Childrens Research Institute and Royal Children’s Hospital, is investigating the natural history, environmental and genetic risk factors for childhood asthma and allergies using a population-based prospective study of a high risk cohort of children born from 1991-94 (the Melbourne Atopic Cohort Study). Fifteen-year follow-up of the MACS cohort including their parents and siblings is now funded by a Healthy Start to Life for All Australians NHMRC strategic award and commenced at the beginning of 2008.
In addition, the researchers of this program are collaborating with other local and international research groups working in this research area. The Centre is part of an international working group investigating early-life risk factors for asthma in collaboration with Haraldsplass Hospital, Bergen, Norway and Department of Public Health Sciences, King's College London. This is a working group within the European Community Respiratory Health Survey that has been conducted in 56 centres in 28 countries including Australia. A separate collaboration with the Royal Children’s Hospital is investigating the prevalence of food allergy and its risk factors among infants, which is a population based cross sectional study funded by NHMRC. The Centre is part of a study investigating the impact of air pollutants and pollen on asthma hospital admissions conducted by the Latrobe University in collaboration with the Department of Human Services and Monash University. The Centre also has a collaborative study of occupational allergy underway. This is a study of prognostic indicators for occupational contact dermatitis in collaboration with the Occupational Dermatology Research & Education Centre i.e. Skin Watch Study and currently following up a cohort of 600 workers who have been diagnosed as having occupational contact dermatitis.
Family Studies of Cancer
This program of research is headed by Professor John Hopper. The Centre has pioneered population based family studies of cancer that are emerging as a standard for genetic epidemiological research. The Australian Breast Cancer Family Registry, the Australasian Colorectal Cancer Family Registry, the Australian Melanoma Family Study, the Victorian Paediatric Cancer Family Study, Australian Prostate Cancer Family Study (in conjunction with The Cancer Council Victoria), and The Twins and Sisters Study of Mammographic Breast Density (in conjunction with the University of Toronto and the Queensland Institute of Medical Research) are large population-based and clinic-based case-control family studies funded by the National Health and Medical Research Council (NHMRC), VicHealth, NSW Cancer Council and the National Institutes of Health (USA). The analysis of genetic mutations and variants is a common thread to all studies and much of this work is being conducted in the Genetic Epidemiology Laboratory in the Department of Pathology at The University of Melbourne.The Australasian Colorectal Cancer Family Study is Australia’s foremost resource for research into the genetic and environmental causes of bowel cancer. The Principal Investigator, Prof. John Hopper in collaboration with Prof Jeremy Jass and colleagues throughout Australia and New Zealand, has been awarded $16.7m over 10 years to recruit colorectal cancer families, and collect blood samples, epidemiological questionnaires, tumour samples, medical records, dietary questionnaires and family cancer histories from over 28,000 individuals from over 7,400 families. This study is funded by the National Institutes of Health (USA) as part of an international consortium, the Colon Cancer Family Registry. Other collaborating institutions include the Mayo Clinic, the Fred Hutchinson Cancer Research Center, the University of Hawaii, Cancer Care Ontario, and the University of Southern California. More than 13,000 families have been recruited. Major funded projects stemming from the Colon CFR include: studies to identify new genes for bowel cancer; studies on bowel cancer aetiology including molecular pathways; studies on the risk of cancer in carriers of mutations in known high risk genes; and studies on cancer prevention including screening – as well as over 100 other studies related to bowel cancer. The Australasian Colorectal Cancer Family Study is expected to continue recruitment and follow-up of all participants under new funding in 2008 for a further 4 years.
The Melbourne Collaborative Cohort Study
The Melbourne Collaborative Cohort Study (MCCS) is conducted by The Cancer Council Victoria and is headed by Professor Graham Giles (honorary professorial fellow). Professor Dallas English and Professor John Hopper are chief investigators on the study and it represents Professor English’s main research interest. It is a prospective cohort study of 41,528 people (17,049 men, 24,479 women) aged between 40 and 69 years at recruitment, which occurred between 1990 and 1994. An unusual feature of the study is that 25 percent of participants are migrants to Australia from Italy and Greece. These migrants were included to increase the variability in lifestyle and genetic factors. The main focus of the study to date has been on identifying risk factors for cancer, type 2 diabetes, cardiovascular disease, eye disease and arthritis. During 2007, new grants were awarded to study the role of infection and inflammation in causing prostate cancer, risk factors for gastro-oesophageal reflux disease and Barrett’s oesophagus (a precursor to oesophageal cancer), risk factors for molecular subtypes of colorectal cancer and risk factors for breast cancer.Hereditary Haemochromatosis
This program of research is headed by Dr Lyle Gurrin and Associate Professor Katie Allen from the Murdoch Childrens Research Institute. Between 2003 and 2006, more than 1,000 participants in the Melbourne Collaborative Cohort Study (which started in the early 1990s) were recruited by the HealthIron study, an investigation into the genetic and environmental modifiers of inherited disease of iron overload known as hereditary haemochromatosis. These participants visited a study centre in Carlton, provided blood samples, completed questionnaires and underwent a clinical examination. Analysis of data during 2007 revealed that those experiencing iron overload are much more likely to have symptoms of serious disease than previous thought. Almost 30% of men who are genetically predisposed to accumulate too much iron in their body (due to having two faulty copies of the HFE (haemochromatosis) gene) had signs of iron overload related disease such as fatigue, arthritis, abnormal liver function tests or signs of liver damage. Women with the same genetic predisposition to iron overload had only a 1% chance of developing signs and symptoms of disease. Reasons for the difference in disease risk between men and women, and the identification of other genetic and environmental modifiers (using genotyping of iron-related genes from collected blood samples and the extensive databases of questionnaire responses) will be the focus of research on the HealthIron project over the next year.Investigators from the HealthIron study at the Centre for MEGA Epidemiology, The Cancer Council Victoria and the Murdoch Childrens Research Institute have been awarded a project grant from the National Health and Medical Research Council to link records from the HealthIron database to the Australian Red Cross Blood Service to obtain details of the blood donation history of HealthIron participants. Although hereditary haemochromatosis can be both treated and prevented by regular blood donation it is not known how frequently those at genetic risk of iron overload need to donate blood for them to benefit from it, and whether the age at which people start donating blood is important. The aim of this study will determine whether earlier treatment by blood removal is more effective at preventing disease than treatment after diagnosis when symptoms are already present. Results from this new work will have important implications for the cost-effectiveness of population genetic screening for hereditary haemochromatosis. We hope that this collaborative project will demonstrate that the resources of a large, population-based cohort study can be combined effectively with health services databases to answers questions about chronic conditions of adult life and promote healthy ageing.