ProfessorPaul Robinson

Conventional lung function tests (such as spirometry) are insensitive to changes occurring in the lung periphery. Imaging studies have shown us that by the time these tests become abnormal, lung disease is not only established but may be extensive. Novel lung function tests, targeting the peripheral airways, can assess this important lung region and importantly are also feasible in children of all ages. The long-term objective of A/Prof Paul Robinson’s research program is to translate these promising previously research-based tests into clinical tools, with defined utility, for both children and adults. This accomplishment will facilitate not only better understanding of the evolution of early lung disease but also how best to detect initial impairment so that earlier intervention can lead to better short- and long-term outcomes for patients. He continues to lead international standardisation work for MBW: International consensus and technical standards documents have led to the greater availability of robust validated commercial equipment for both researchers and clinicians as interest in these techniques grows rapidly.

Building on the success of this standardiastion work, his research team now focus on defining clinical utility by using these tools (MBW, Oscillometry) in conjunction with advanced imaging techniques in a range of important disease groups.

• Cystic Fibrosis (CF) - He has shown that over 50% of pre-schoolers with Cystic Fibrosis have abnormalities detectable by MBW, which predict later schol aged outcomes, but routine screening is yet to be adopted internationally.
• Disease processes evolving in the peripheral airways are major causes of morbidity and mortality following both lung and bone marrow transplantation, and are poorly responsive to treatment once detectable using spirometry. Earlier detection offers an exciting opportunity to address that.
• Asthma - affects 10% of children and is an ongoing source of morbidity and mortality, with asthma deaths increasing both nationally and internationally. The current symptom-based approach of asthma monitoring to determine management decisions is failing to acheive adequate asthma control.

Collaborative projects currently focus on (1) defining the optimal approach to early lung disease detection in CF and following bone marrow transplantation (2) better understanding the impact of maternal asthma control during pregnancy on an infants lung and immune system development and later asthma risk, and (3) establishing the utility of a home-based oscillometry monitoring strategy in older children to improve asthma control, prevent asthma exacerbations and improve long term asthma outcomes.