Dr Samantha Irving is a respiratory physiologist at Royal Brompton Hospital. She has recently received Charity funding to continue her research into improving lung health monitoring for children with bronchiectasis.

Sam performs various lung function tests on young patients with a range of respiratory conditions. “My particular interest is in non-invasive measurement of the small airways, tests that we can do practically in the clinic that won't hurt our child at all but will give us information about the small airway function,” Sam explains

The health of the small airways is routinely monitored for patients with cystic fibrosis, however there are no guidelines for similar monitoring for patients with bronchiectasis. Sam said:

What I really want to do is discover whether any small airway monitoring tests will be useful in long-term management for these kids. I want to help keep them as well as we can, for as long as we possibly can, because quite a lot of them will potentially have lifelong lung problems.

What is bronchiectasis?

Bronchiectasis is a condition where the fine, tree like structure of the airways is damaged, often following a serious infection. Damaged airways may be overly large and can't adequately clear bacteria, viruses and pathogens out of the lungs.

Most children with bronchiectasis will have it secondary to a condition like cystic fibrosis or primary ciliary dyskinesia, (PCD) but some children can have bronchiectasis without having other conditions.

They’re a very rare group, even in Royal Brompton cohorts, and I think very underserved. They’re often not included in research proposals. I’m thrilled to get this funding as this research is something I’ve wanted to do for a very long time.

Symptoms for patients with bronchiectasis can vary, but many will need medication and daily physiotherapy to clear the airways and prevent infections. Infections and persistent coughing can also affect the energy levels of young patients with bronchiectasis, or impact them socially as they may be less able to play with their friends and take on out of school hobbies.

About Dr Irving’s study

Currently, there are no guidelines for how young patients with bronchiectasis are looked after in regard to lung function tests.

Sam will work with a group of patients at Royal Brompton to find out whether tests used for cystic fibrosis patients are sensitive to changes in a bronchiectasis patient’s health. “What I really hope is that getting the physiology right for these kids and being able to monitor them correctly means that we can keep an eye on exacerbations. We can detect changes when they're mild and early before they become severe, and we can adjust treatment accordingly to keep them well,” Sam said.

Sam is planning an online event for all the kids taking part. This will provide them with a space to talk about their experience in the study, to ask clinical teams questions and to meet peers. Like cystic fibrosis, bronchiectasis patients should not meet in person to prevent cross-infection. “Bronchiectasis is rarely given this kind of attention. It's just been so brilliant to get this funding to deliver this project as a whole package for them,” Sam said.

The data gathered from this period of research could lead to a multi-centre collaboration across the UK, working with a larger cohort of patients, and could ultimately lead to an improved protocol for the routine monitoring of bronchiectasis patients.

Royal Brompton and Harefield Hospitals Charity are pretty much one of the very few places that would consider funding this research. Sometimes it's difficult to get funders to care about small groups where you have these rare diseases, but who have quite a high burden of care.

They’re an amazing, often forgotten group to work with and I'm really excited to get started with it.”

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