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The University of Cape Town Lung Institute
Outline of Units and Activities:
2007 and 2008

Overview

The UCTLI is nearing the end of its ninth year of operation, and its growth both in terms of projects and budget (of more than 20% year on year) show no signs of slowing. More clinical research units have been formed in response to the need and opportunities for addressing health issues in Southern Africa. The relevance of the research will be evident from the brief summary provided below. Details of the six Clinical Research Units and their current projects can be viewed on the new Institute website www.lunginstitute@co.za. The Institute was reconstituted and in January 2007 became a wholly owned subsidiary of the University of Cape Town, but retains its separate corporate identity, administration, staffing and finance. It benefits from strong representation from the university on its Board and finance committee, and collaborations in research with many units and departments in the Health Sciences Faculty. These links provide substance to the aim of the Institute to serve as an extended platform for the Faculty for teaching, learning and research. Its distinctive contribution however is that its independence provides flexibility to engage in implementation research and service contracts with parties such as departments of health and other funders since its goals extend beyond the academic, into community-based health interventions, strategic development of new treatments and other innovative approaches to health.

The Institute is served by a Management Committee which oversees the day to day management of the Institute comprising the heads of the Clinical Research Units, the manager and financial advisor, and a Finance Committee both of which report to the Board. As Managing Director I am grateful for the excellent service and commitment of members of these committees which have enabled the Institute to function with a high degree of efficiency and accountability and in conformity with accepted business standards. This in term has created maximum opportunity for researchers, teachers and learners to remain focused and productive, for which the publication record of the various CRUs provided at the end of this report serves an appropriate index. While the number and quality of the publications is pleasing it is their scope and relevance to medical science in South Africa that commends them most. I wish to record my gratitude and thanks to every member of the Lung Institute in whatever capacity they have served for their contribution to the Institute over the last two years. Special thanks is due to the directors who serve in an honorary capacity providing valuable guidance and support.

Report of Research Unit activities

The Lung Clinical Research Unit (LCRU) (Head: Professor Eric Bateman) focuses on treatments and management approaches in asthma and chronic obstructive pulmonary disease (COPD) involving investigation of mechanisms of diseases and prospects for disease modification with an emphasis on risk factors relevant to Africa. Data collected during epidemiologic studies performed between 2002 and 2005 is being analysed and follow-up studies of patients with COPD is providing insights on differences between usual tobacco smoking-related COPD and the highly prevalent and debilitating form of the disease seen in the Western Cape in which previous tuberculosis is an important contributing factor. The Unit continues its active programme of clinical studies (phases 2 to 4) of new treatments for asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, chronic bronchitis, allergic rhinitis and other respiratory conditions, directed by Dr Mary Bateman. Highlights for the review period have included:

More than 25 clinical trials have been conducted including the following:

  • An investigator-initiated study of metronome-paced hyperinflation and the effects of bronchodilators in COPD (with Drs Richard Raine and Christopher Cooper).
  • A phase II study of the effects of a new treatment, a phospholipase A inhibitor, on nasal antigen challenge in patients with allergic rhinitis, in collaboration with the Allergy and Diagnostics CRU
  • A phase III study of the role of leucotriene modifier, montelukast in asthmatic patients who smoke.
  • Phase III and IV studies of tiotropium in COPD, including the 4year UPLIFT study.
  • The role of ciclesonide, a new inhaled corticosteroid in asthmatic children.
  • A study exploring the potential role of long-acting anticholinergic, tiotropium, in chronic asthma.
  • Studies of new once-daily beta2-agonists and anti-cholinergic agents alone or in combination, in asthma and COPD compared with current treatments.
  • An investigation of the potential role of MAPKinase inhibitor in COPD.
  • A phase IIA study of a novel dual pharmacophore compared with an anticholinergic in patients with COPD.
  • A study of the antibiotic, feropenem medoxomil in acute exacerbations of chronic bronchitis.
  • An analysis of the achievement of guideline-based asthma endpoints, current clinical control and future risk, in the results of the Symbicort as maintenance and reliever therapy studies.
  • A meta-analysis of the safety of the combined use of salmeterol and inhaled corticosteroids in asthma.
  • New methodologies required for mechanistic studies of lung diseases have been introduced. These include examination of inflammatory cells, mediators and proteomics in induced sputum, impedance oscillometry, quantitative evaluation of low-dose thin section computerized tomography and several other tests.
  • A three-month visit by Professor Christopher Cooper, an expert in pulmonary physiology from the University of California, Los Angeles.
  • The annual Clinical Tuberculosis Course offered in February for visiting more than 20 pulmonologists from the Netherlands.
  • A 3-day course on Clinical Exercise Testing led by Professors Christopher Cooper, Eric Bateman and Richard Raine, attended by more than 50 physicians, clinical technologists and sports scientists and physiologists.
  • Commencement of a single centre clinical safety and immunological study of a candidate vaccine for tuberculosis, the AERAS-402/Crucell Ad35 in persons with recent or current active tuberculosis.
  • Evaluation of the Fenzian device, a novel treatment approach, in patients with asthma.
  • A study of Tuberculosis-Associated Obstructive Pulmonary Disease - A clinical, radiological and pathophysiological study of the contribution of previous pulmonary tuberculosis in a community-based cohort of patients with chronic obstructive pulmonary disease.
  • Two PhD, 4 Masters degree and 2 BTechnology students are being supervised.

 

The Knowledge Translation Unit under the leadership of Dr Lara Fairall seeks to bridge “the gap between what we know and what we do” and has made great strides in implementing evidence-based guidelines with educational support and both qualitative and quantitative evaluation in primary care clinics in South Africa. Highlights of the period under review are the following.

The development and implementation of PALSAPLUS which covers chronic respiratory diseases, TB, HIV and the management of sexually transmitted diseases and its adoption as policy by two provincial and the National Department of health for the training of primary care nurses.

  • Ongoing roll-out of PALSAPLUS in the Free State and Western Cape provinces. More than 200 trainers have been trained who in turn have trained more than five thousand primary care nurses in these provinces.
  • Recognition of the PALSAPLUS programme as a demonstration project of the Global Alliance against Chronic Respiratory Diseases (GARD) a recently formed alliance of the World Health Organisation.
  • The STRETCH project in the Free State province. In response to the critical shortage of doctors in primary care centres where anti-retroviral agents are prescribed, this project involves the development, implementation and evaluation of a programme of nurse-initiated anti-retroviral treatment. A similar study is due to begin in the Western Cape province.
  • Collaboration with Dignitas, a medical humanitarian organization operating in Malawi, to implement a customized version of PALSAPLUS in that country. An initial visit by the KTU researchers and nurse educator has resulted in early versions of a guideline for the region and planning with the National Department of Health of Malawi.
  • Participation in the formation of a Centre of Excellence for Chronic Diseases in Sub-Saharan Africa, a collaboration between the KTU, the Department of Medicine at UCT, Stellenbosch University, the University of the Western Cape, health officials in the Western Cape, and colleagues in Tanzania, funded by the Ovations group. This ambitious project will see the implementation of an expanded version of PALSAPLUS that covers several additional chronic diseases (hypertension, diabetes and others) in an attempt to strengthen primary care health services in under-resourced settings.
  • Dr Lara Fairall has been nominated for membership of the WHO Expert Advisory Panel on Clinical Practice Guidelines and Research Methods and Ethics.
  • Three PhD students and other degrees are being supervised in the unit.

The Allergy and Diagnostic Clinical Research Unit under the leadership of Professor Paul Potter continues to provide a specialized service to many patients and is a national resource in research and highly specialized diagnostics in allergy.

  • A clinical trial section research unit focuses on studies of paediatric and adult asthma, rhinitis, urticaria, eczema, allergen immunotherapy and allergy diagnosis. Current studies include eczema studies (Novartis), chronic urticaria (MSD Pharma), paediatric asthma (MSD, Nycomed and Triclinium), and sublingual immunotherapy studies (a three-year study for Stallergenes, and a 2-year study of seasonal rhinitis for Leti (Spain).
  • Specialist allergy clinics for investigation and treatment of children and adults with allergic diseases, with a special focus on sublingual and subcutaneous allergen immunotherapy, food allergy, chronic urticaria and drug allergy.
  • The ADCRU laboratory service run by Mrs B Fenemore offers a range of specialised allergy tests for the Western Cape Teaching Hospitals through the NHLS, the Private sector and for clinical and basic science trials in allergy and asthma at the Institute. In addition Specific IgE testing for indigenous allergens is available using Western Blot Techniques. Nasal smear cytology, serum tryptase determinations and samples are processed for autoantibody determinations to the fc Epsilon receptor on basophils.
  • Training of undergraduates and postgraduates students in clinical and laboratory aspects of Allergology.
  • Professor Potter has recently received ad hominem promotion to the rank of Professor.

The Centre for Tuberculosis Research Innovation comprises a section devoted to novel treatments and trials of new candidate drugs for tuberculosis (headed by Dr Rodney Dawson) based in the Institute and the Lung Infection and Immunity Unit under the direction Associate Professor Keertan Dheda which forms part of the same Unit based in the Department of Medicine, in the Faculty of Health Sciences. The CTBRI was formed in 2007 and has over a short period developed a reputation for trials with both high quality and recruitment. Highlights have been:

  • Phase 2 and 3 studies of the novel drug SQ109.
  • Host response to TB and AIDS. A NIH-funded collaboration with Professor W Rom (New York University). The goals of this project are to evaluate the utility and molecular effects of recombinant IFN-gamma in patients with active tuberculosis. The outcome of a renewal application for this grant is awaited.
  • Longitudinal studies of HIV-associated bacterial pneumonia to understand the epidemiology, longitudinal evolution, and molecular pathogenesis of HIV-associated bacterial pneumonia. A NIH-funded collaboration with Professor W Rom (New York University).
  • The ReMOX trial. A phase III randomized, double-blind, placebo controlled study to assess the utility of two moxifloxacin treatment shortening regimens in pulmonary tuberculosis. Funded by EDCTP, British MRC, Global Alliance for TB Drug Development and Roche Pharmaceuticals Ltd. Principal investigator, Dr Stephen Gillespie.
  • The Chest Radiography Recording and Recording System (CRRS) developed in the Institute in collaboration with Stellenbosch University and the International Union against Tuberculosis and Lung Diseases for community-based study of lung disease is gaining popularity. Courses attended by more than 30 readers were held in 2007 and 2008 and another is planned for 2009. Dr Dawson presented a workshop and the Union Conference in Paris in October 2008.
  • Computer-aided diagnosis of tuberculosis. In collaboration with Rogan-Delft, the Computer-Aided Diagnosis section of the Image Sciences Institute, University Medical Center Utrecht (ISI) and the Desmond Tutu TB Centre of Stellenbosch University, the Centre is exploring computer-aided reporting and diagnosis of chest radiographs using the CRRS system. Utilizing pattern recognition technology the projects aims to develop a system that will enable health personnel other than physicians to undertake screening for tuberculosis and community-based surveys of lung disease.
  • A digital radiology unit has been acquired from Delft Imaging Systems to undertake the CRRS projects. It will also provide the opportunity for other chest imaging initiatives and projects.
  • Satellite clinics have been set up at the Langa and Chapel Street Tuberculosis Clinics with the support of the City of Cape Town Health Department. At the former site a new building was constructed together with a novel booth for collection of induced sputum for diagnostic and research purposes. These clinics enable Institute staff to recruit patients for studies, while providing assistance to clinic staff with their service commitments.

The Lung Infection and Immunity Unit in the Lung Institute has as its main research interests the study of pulmonary regulatory immunological pathways in relation to infection, development and validation of rapid and field-friendly diagnostics for tuberculosis, and outcome and intervention studies of drug-resistant tuberculosis. This work has received funding from the SA MRC, SA NRF, EU FP7, EDCTP, NIH and several other agencies. Projects include:

  • LIN-TB (Lung Innate Immunity in TB infection): This study investigates the immunopathogenesis underlying the failure of substantial numbers of close contacts failing to develop presumed LTBI.
  • TB-NEAT Study (Tuberculosis- novel and emerging technologies for diagnosis): The performance outcomes and feasibility of several new TB diagnostics (T cell assays, antigen detection assays, NAAT, breath analysis and LED microscopy etc) are being evaluated in pulmonary and extra-pulmonary TB, and in cohorts with a high sero-prevalence of HIV. Longitudinal studies are also being conducted.
  • Drug-resistant TB: Comparative prospective outcome, PK and cost analysis studies of drug-sensitive and resistant tuberculosis as part of the Western Cape Drug-resistant TB Research Group.
  • Health care workers: Evaluation of newer screening tools for LTBI and their predictive value for the development of active TB.
  • Smoking and tuberculosis: Immunological study evaluating the role of cigarette smoke on pulmonary mycobactericidal host immune responses.
  • SAIGRA study (SA IFN-gamma release assay study) examines TST-mediated boosting and the utility of T cell immune assays in the diagnosis of pulmonary and extra-pulmonary TB using cells from peripheral blood, the lung, the pleural space and cerebrospinal fluid.
  • Diagnostic Biomarkers in Pleural Effusion: examines the utility of several novel biomarkers, including proteomics, for the diagnosis of malignant and TB-related pleural effusions.
  • Performance outcomes of sputum induction and rapid immunodiagnosis: a randomised controlled trial evaluating the outcomes of sputum induction in HIV + and HIV negative suspects in primary care.
  • Novel technologies for the diagnosis of tuberculous meningitis: evaluates the utility and performance outcomes of newer technologies for the diagnosis of TBM.
  • Outcome studies of infectious and non-infectious pneumonitis in HIV + subjects: evaluation of the immmonological profile and treatment-related outcomes of community acquired pneumonia and lymphocytic interstitial pneumonitis.
  • Collaborative projects with Dr J Huggett at UCL on urine PCR and PCP: these studies, led by Dr Jim Huggett, as part of the UCL-UCT collaboration, are evaluating the utility of trans-renal and peripheral blood DNA amplification for the diagnosis of TB and PCP.
  • Cutaneous adverse drug reaction to anti-tuberculous drugs: RCT evaluating step-wise versus simultaneous rechallenge of anti-TB drugs and predictive variables for the development of drug reactions (in collaboration with Prof Gail Todd).
  • Active collaborations have been established with the following centres: McGill University, Canada (M Pai); UCL, London (CIDIH- A Zumla, G Rook and J Huggett); NYU; USA (Bill Rom and Doris Tse); University of Sassari, Italy (Leonardo Sechi); Lusaka, Zambia (Peter Mwaba); UKZN, Durban, South Africa (Richard Naidoo); UNJMD, New Jersey, USA (Stephan Schwander); University of Stellenbosch, SA (Gerhardt Walzl); AIIMS, India (Suren Sharma); SVIMS, India (Mohan Alladi); Centre for Proteomics, UCT (Jonathan Blackburn).
  • Keertan Dheda took up a NRF-funded SA Research Chair (SARChI) in October 2007.
  • Six PhD candidates are being supervised.
  • Capacity development: Keertan Dheda attended as faculty the PATS MECOR course in Malawi to train African doctors in Research Methods.
The Occupational Health Unit directed by Dr Greg Kew moved to more spacious premises in early 2008 to accommodate it expanded activities. A follow-up clinic for City of Cape Town power station workers continues at the Institute.
The Asbestos Trust, directed by Dr Jim ter water Naude has made steady progress in processing and awarding claims for persons affected by asbestos mining in South Africa and in outreach activities to improve the quality of surveillance for asbestos-related disease in several areas of the country.
The Conference Facility remains an asset and although frequently hired for medical and educational meetings, its greatest value is for institute-related courses and research meetings of all descriptions.
The Institute building which is now 8 years old has undergone repainting and minor structural repairs. In addition, over the last 2 years, extra offices have been built for its growing staff, storage and archiving rooms have been upgraded, a research pharmacy served by a part-time pharmacist, and a store for refrigerators has been built.

Publications in 2007 and 2008

2007

  1. Bateman ED, Jithoo A. Asthma and Allergy - A Global Perspective. Allergy 2007; 62:213-215.
  2. Bateman ED, Bousquet J, Busse WW, Clark TJH, Pedersen SE on behalf of the GOAL Investigators Group. The correlation between asthma control and health status: the GOAL study. European Respiratory Journal, 2007;29:56-62.
  3. English RG, Fairall L, Bateman ED. Keeping Allergy on the Agenda: Integrated guidelines for respiratory disease in developing countries. Allergy 2007;62:224-229.
  4. Spencer S, Mayer B, Bendall KL, Bateman ED. Validation of a guideline-based composite outcome assessment tool for asthma control. Respiratory Research 2007;8:26 doi:10.1186/1465-9921-8-26.
  5. Den Boon S, Verver S, Marais BJ, Enarson DA, Lombard CJ, Bateman ED, Irusen E, Jithoo A, Gie RP, Borgdorff MW, Beyers N. Association between passive smoking and infection with Mycobacterium tuberculosis in children. Pediatrics 2007; 119:734-739.
  6. Boulet L-P, Bateman ED, Voves R, Müller T, Wolf S, Engelstätter R. A randomised study comparing ciclesonide and fluticasone propionate in patients with moderate persistent asthma. Respiratory Medicine 2007; 101: 1677-86.
  7. Woodcock AA, Bagdonas A, Boonsawat W, Gibbs MR, Bousquet J, Bateman ED on behalf of the GOAL Steering Committee & Investigators. Improvement in asthma endpoints when aiming for total control: salmeterol/fluticasone propionate and fluticasone propionate alone. Primary Care Respiratory Journal 2007;16:155-61.
  8. Bateman ED, Clark TJH, Frith L, Bousquet J, Busse WW, Pedersen SE for the GOAL Investigators Group. Rate of response of individual asthma control measures varies and may overestimate asthma control. J Asthma 2007, 44:667-73.
  9. den Boon S, van Lill SW, Borgdorff MW, Enarson DA, Verwer S, Bateman ED, Irusen E, Lombard CJ, White NW, de Villiers C, Beyers N. High prevalence of previously treated tuberculosis among undetected cases of tuberculosis, Cape Town, South Africa. Emerg Infect Dis 2007; 13: 1189-94.
  10. Pedersen SE, Bateman ED, Bousquet J, Busse WW, Yoxall S, Clark TJ, Gaining Optimal Asthma controL Steering Committee and Investigators. Determinants of response to fluticasone propionate and salmeterol/fluticasone propionate combination in the Gaining Optimal Asthma ControL study. J Allergy Clin Immunol 2007; 120: 1036-42.
  11. Barnes NC, Jacques L, Goldfrad C, Bateman ED. Initiation of maintenance treatment with salmeterol/ fluticasone propionate 50/100µg bd versus fluticasone propionate 100µg bd alone in patients with persistent asthma: Integrated analysis of four randomized trials. Respir Med 2007; 101: 2358-65.
  12. Bateman ED, Cheung D, Lapa e Silva J, Guhring UMG, Schaefer M, Engelstatter R. Randomized comparison of ciclesonide 160μg/day and 640μg/day in severe asthma. Pulm Pharmacol Ther 2007, Epub ahead of print: http://dx.doi.org/10.1016/j.pupt.2007.11.002
  13. Feldman C, Brink AJ, Richards GA, Maartens G, Bateman ED, for working group of the South African Thoracic Society. Management of community-acquired pneumonia in adults. S Afr Med J, 2007; 97: 1295-1306.
  14. Lalloo U, Ainslie G, Wong M, Abdool-Gaffar S, Irusen E et al. Guidelines for the management of chronic asthma in adolescents and adults. SA Fam Pract 2007; 49: 19-31.
  15. Mash R, Ainslie G, Irusen E, Mayers P & Bheekie A. The dissemination and implementation of national asthma guidelines in South Africa: the use of outcome mapping. SA Fam Pract 2007; 49: 5-8.
  16. Dheda K, Chang JS, Huggett JF, Kim LU, Johnson MA, Zumla A and Rook GAW. The stability of mRNA encoding IL-4 is increased in pulmonary tuberculosis, while stability of mRNA encoding the antagonistic splice variant, IL-4δ2, is not. Tuberculosis (Edinb) 2007; 87: 237-41.
  17. Dheda K, Pooran A, Pai M, Miller RF, Lesley K, Booth HL, Scott GM, Akbar AN, Zumla A, Rook GA. Interpretation of Mycobacterium tuberculosis antigen-specific IFN-gamma release assays (T-SPOT.TB) and factors that may modulate test results. J Infect 2007; 55: 169-73.
  18. Pai M, Mohan A, Dheda K, Leung CC, Yew WW, Christopher, DJ, Sharma, SK. Lethal interaction: the colliding epidemics of tobacco and tuberculosis. Expert Rev Anti Inf Ther 2007; 5: 385-91.
  19. Pai M, Dheda K, Cunningham J, Scano F, O'Brien R. T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward. Lancet Infect Dis 2007; 7: 428-38.
  20. Lala S, Dheda K , Chang J-S, Huggett JF, Kim LU, Johnson MA, Rook GAW, Keshav SA, Zumla A. The pathogen recognition sensor, NOD2, is variably expressed in patients with pulmonary tuberculosis. BMC Infectious Diseases 2007; 7: 96.
  21. Parham KL, Roberts A, Thomas A, Wűrzner R, Henderson HE, Potter PC, Morgan BP, Orren A. Prevalence of mutations leading to complete C6 deficiency (C6Q0) in the Western Cape, South Africa and detection of novel mutations leading to C6Q0 in an Irish family. Molecular Immunol 2007; 44: 2756-2760.
  22. Potter PC. Investigating adverse reactions to sulphites and benzoates in patients with chronic urticaria and angioedema. Int J Immunorehab 2007; 9: 31-32.
  23. Potter PC. Allergies and asthma in Southern Africa: an update. Int J Immunorehab 2007; 9(1): 37-38.
  24. Canonica GW, Baena-Cagnani CE, Bousquet J, Bousquet PJ, Lockey RF, Malling H, Passalacqua G, Potter PC, Valovirta E. Recommendations for standardization of clinical trials with Allergen Specific Immunotherapy for respiratory allergy – A statement of a World Allergy Organization (WAO) taskforce. Allergy 2007; 62: 317-324.
  25. Potter PC. Allergies and asthma in Southern Africa: an update. Int J Immunorehab 2007; 9: 37-38.
  26. Potter PC. Investigating adverse reactions to sulphites and benzoates in patients with chronic urticaria and angioedema. Int J Immunorehab, 2007; 9: 31-32.
  27. Potter PC. Trends in Beta-2-Agonist Therapy. Allergy Clin Immunol Int – J World Allergy Org 2007; 19: 155-158.
  28. Canonica GW, Passalacqua G, Lockey RF, Pawankar R, Potter PC. Current status of allergen immunotherapy around the globe: Four commentaries. Allergy Clin Immunol Int – J World Allergy Org, 2007; 19: 117-120.
  29. Del Giacco S, Rosenwasser LJ, Crisci CD, Frew AJ, Kaliner MA, Wah Lee B, Guanghui L, Maspero J, Moon HB, Takemasa N, Potter PC, Singh AB, Valovirta E, Vervliet D, Warner JO. WAO Position Paper: What is an Allergist? WAO Journal 2008; 19-20.
  30. Bousquet J, Baena-Cagnani C, Canonica G, Custovic A, Kaliner M, Bateman ED, Potter PC et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the WHO). Allergy 2008; 63 (Suppl 86): 8-160.
  31. PC Potter. Overview of the indigenous allergies of Southern Africa. Current Allergy & Clin Immunol 2007; 4: 174-178.
  32. PC Potter. The future direction of Allergology in South Africa. Current Allergy & Clin Immunol 2007; 4: 170-173.
  33. Green R, Potter PC. Antibiotic allergy in the intensive care unit. Current Allergy & Clin Immunol 2007; 3: 130-134.
  34. Prescott RA, Potter PC. Immunochemical characterization of grass pollen allergens in South Africa. Current Allergy & Clin Immunol 2007; 4: 189-193.

2008

  1. Voshaar T, Lapidus R, Maleki-Yazdi R, Timmer W, Rubin E, Lowe L, Bateman E. A randomised study of tiotropium Respimat® Soft Mist™ Inhaler versus ipratropium pMDI in COPD. Respir Med 2008; 102: 32-41.
  2. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, Gibson P, Ohta K, O’Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ. Global Strategy for Asthma Management and Prevention: GINA Executive Summary. Eur Respir J, 2008; 31: 1-36.
  3. Bateman ED, Linnhof AE, Homik L, Freudensprung U, Smau L, Engelstatter R. Comparison of twice-daily inhaled ciclesonide and fluticasone propionate in patients with moderate-to-severe persistent asthma. Pulm Pharmacol Ther 2008; 21:264-75. doi:10.1016/j.pupt.2007.05.002
  4. Fairall LR, Bachmann MO, Louwagie GM, van Vuuren C, Chikobvu P, Steyn D, Staniland GH, Timmerman V, Msimanga M, Seebregts CJ, Boulle A, Nhiwatiwa R, Bateman ED, Zwarenstein MF. Effectiveness of antiretroviral treatment in a South African program: cohort study. Archives Internal Medicine 2008; 168:86-93.
  5. Den Boon S, Verver S, Lombard CJ, Bateman ED, Irusen EM, Enarson DA, Borgdorff MW, Beyers N. Comparison of symptoms and treatment outcomes between actively and passively detected tuberculosis cases: the additional value of active case finding. Epidemiol Infect 2008;136:1342-9. Epub 2008 Jan 4. PMID: 18177518
  6. Fairall LR, Bachmann MO, Zwarenstein MF, Lombard CJ, Uebel K, van Vuuren C, Steyn D, Boulle A, Bateman ED. Streamlining tasks and roles to expand treatment and care for HIV: randomised controlled trial protocol. Trials 2008; 9:21
  7. Bateman ED, Nelson H, Bousquet J, Kral K, Sutton L, Ortega H, Yancey S. Meta-analysis: Effects of adding salmeterol to inhaled corticosteroids on serious asthma-related events. Ann Intern Med 2008;148 [Epub ahead of print]
  8. Bateman ED, Bousquet J, Busse WW, Clark TJH, Gul N, Gibbs M, Pedersen S on behalf of the GOAL Steering Committee and Investigators. Stability of asthma control with regular treatment: an analysis of the Gaining Optimal Asthma controL (GOAL) study. Allergy 2008; 63: 932-8.
  9. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FE, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D; World Health Organization; GA(2)LEN; AllerGen. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update. Allergy 2008; 63 Suppl 86:8-160.
  10. Green RJ, Feldman C, Schoub B, Richards GA, Madhi SA, Zar HJ, Lalloo U; Guideline Committee of 1999, Klugman K, Phillips D, Cameron NA, Eggers RR. Influenza guideline for South Africa – update 2008. S Afr Med J 2008; 98: 224-30.
  11. English RG, Bateman ED, Zwarenstein MF, Fairall LR, Bheekie A, Bachmann MO, Majara B, Ottmani S-E, Scherpbier RW. Development of a South African integrated syndromic respiratory disease guideline for primary care. Primary Care Respiratory Journal 2008;17;156-63.
  12. van Weel C, Bateman ED, Bousquet J, Reid J, Grouse L, Schermer T, Valovirta E, Zhong N. Asthma management pocket reference 2008. Allergy 2008;63:997-1—4.
  13. Taylor DR, Bateman ED, Boulet L-P, Boushey HA, Busse WW, Casale TB, Chanez P, Enright PL, Gibson PG, de Jongste JC, Kerstjens HAM, Lazarus SC, Levy ML, O’Byrne PM, Partridge MR, Pavord ID, Sears MR, Sterk PJ, Stoloff SW, Szefler SJ, Sullivan SD, Thomas MD, Wenzel SE, Reddel HK. A new perspective on concepts of asthma severity and control. Eur Respir J 2008; 32:545-54.
  14. Busse WW, Pedersen S, Pauwels RA, Tan WC, Chen YZ, Lamm CJ, O’Byrne PM; START Investigators Group. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma. J Allergy Clin Immunol 2008;121:167-74.
  15. Jeebhay MF, Robins TG, Miller ME, Bateman ED, Smuts M, Baatjies R, Lopata AL. Occupational allergy and asthma among salt water fish processing workers. Amer J Indust Med 2008;51:899-910.
  16. Stein J, Lewin S, Fairall L, Mayers P, English R, Bheekie A, Bateman E, Zwarenstein M. Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme. BMC Health Serv Res 2008, 8:240. [Epub ahead of print] PMID:19017394.
  17. Tashkin DP, Celli B, Senn S, Burkhart D, Kesten S, Menjobe S, Decramer M UPLIFT Study Investigators. N Engl J Med 2008; 359:1543-54.
  18. Greening AP, Stempel D, Bateman ED, Virchow JC. Managing asthma patients: which outcomes matter? Eur Respir Rev 2008;17:53-61.
  19. Middelkoop K, Bekker L-G, Myer L, Dawson R, Wood R. Rates of tuberculosis transmission to children in a community with a high prevalence of HIV infection among adults. CID 2008.
  20. Raju B, Hoshino Y, Belitskaya-Levy I, Dawson R, Ress S, Gold JA, Condos R, Pine R, Brown S, Nolan A, Rom WN, Weiden MD. Gene expression profiles of bronchoalveolar cells in pulmonary TB. Tuberculosis. 2008. 88:39-51.
  21. Dheda K, Chang JS, Lala S, Huggett JF, Zumla A, Rook GA. Gene expression of IL17 and IL23 in the lungs of patients with active tuberculosis. Thorax 2008; 63:566-8.
  22. Trajman A , Pai M, Dheda K, van Zyl Smit R, Zwerling AA, Joshi R, Kalantri S, Daley P, Menzies D. Novel tests for diagnosing tuberculous pleural effusion: what works and what does not? Eur Respir J 2008;31:1098-106.
  23. Dhasmana DJ, Dheda K, Ravn P, Wilkinson RJ, Meintjes G. Immune reconstitution inflammatory syndrome in HIV-infected patients receiving antiretroviral therapy: pathogenesis, clinical manifestations and management. Drugs 2008;68:191-208.
  24. Gruber C, Warner J, Hill D, Bauchau V: EPAAC Study Group. Early atopic disease and early childhood immunization – is there a link? Allergy 2008;63:1464-72.

Non-Peer reviewed journals:

  1. Potter PC. Allergic evaluation of the atopic patient. SA Family Practice 2008; 50(5): 10-15.
  2. Potter PC. Drug allergy: recent developments. The Specialist Forum, April 2008: 4-8.
  3. Potter PC. New developments in allergy: Update. CME, September 2008; 26(9): 454-458.
  4. Potter PC. Update on Allergies 2008. PedMed, September 2008 (Issue 5).
  5. Potter PC. Challenges facing guidelines for asthma in children. International Journal on Immunorehabilitation 2008, 10(1): 24-25.
  6. Potter PC. Heterogeneity of response in patients on sublingual immunotherapy. International Journal on Immunorehabilitation 2008, 10(1): 26-27.

Eric D Bateman
15th December 2008