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Full NameProfessor Jonathan O'Brien Hourihane
Department:Paediatrics and Child Health
Organisation:University College Cork
- genetics, genomics and molecular biology
- infectious disease and the immune system
- epidemiology/population health research
- Adolescent medicine
- Clinical Trials
Paediatric allergy is a dynamic field of translational medicine and our department and the INFANT Research centre are internationally recognised for the original research done here and for our international collaborations including clinical trials.
UCC is the biggest European recruiting site in ongoing trials of oral and epicutaneous immunotherapy for peanut allergy (with other food allergies and conditions being worked up now), and is leading the field internationally in the implementation of single dose food challenge studies. Ongoing studies of neonatal digestion and quality of life in food allergy bring interactions with other leading groups in INFANT, UCC and the wider academic community in Ireland and further afield.
Our work is mainly based on clinical activity involving infants and children so wide clinical experience in paediatric allergy is available during PhD related studies here, with excellent links to basic science groups in INFANT and elsewhere.
Atopic dermatitis (AD, also known as eczema) is the most common inflammatory skin disease of childhood, affecting 20% of the Irish population. AD is often the first manifestation of atopic comorbidities including food allergy, asthma and allergic rhinitis. Cumulatively, these atopic conditions account for a very significant burden of disease in the Irish population; simple prevention strategies for AD and/or the associated comorbidities would be a major advance in public health.
Skin barrier disruption significantly increases transepidermal passage of topically applied drugs and allergens, including aeroallergens and food allergens such as peanut. Our recent work confirms the link of eczema with food allergy at 2 years. There is great interest and ongoing multicentre trials examining skin barrier preservation from the first 3 weeks of life until 8 months, to reduce the incidence of eczema. Our own BASELINE data show a plateau of TEWL from 2-6 months, suggesting an earlier window for this skin barrier protection may exist - from 0-2 months. A shorter, early treatment period would improve acceptability to families, adherence to the suggested prevention regimen and would demonstrate cost effectiveness for health care providers. If our hypothesis is correct, then parents of children with a low calculated risk could be reassured, whereas those at high risk could be targeted for intensive intervention.
We are about to start a funded randomized trial of short term skin barrier protection and aim to prospectively determine known genotypes, examine skin architecture, and skin microbiome in these children, measuring the impact of this intervention on eczema and food allergy at 6m, 12m and 2 years. The impact of eczema on sleep is an emerging aspect of this work which would also fit the interests of students of neonatal neurology, These projects would all be suitable for dermatology or paediatric trainees interested in a career in a rapidly evolving discipline where the impact of these studies could change the natural history of not just one common disease but 3 or 4.