Child Health Research Unit at Barwon Health (CHeRUB)

• BIS achieved 85% retention to nine years of the 1074 babies in the inception cohort.
• Over 560 children were recruited to ARROW across 43 sites, making it the largest Barwon Health and Deakin University-led clinical trial ever. ARROW is testing the role of an orally administered mixture of bacteria in preventing hospital admissions among preschool-aged children with asthma.
• Fifteen peer-reviewed manuscripts were published, including world-first evidence that plastic pollutants increase the risk of autism by suppressing the production of estrogen in the developing baby’s brain (Nature Comm, 2024); that the gut microbiome mediates the protective effect of siblings on baby’s risk of allergic disease (Gao, JACI, 2023); and that poor quality diet during pregnancy partially mediates the impact of socioeconomic disadvantage of child cognitive (thinking) skills.
• Leveraging findings from BIS, and the establishment of PRT-E and SHeBa, the Medical Research Future Fund funded the Bugs and Bumps trial to test a world-first intervention targeting improved diet during pregnancy to improve baby’s brain development.

The Barwon Infant Study (BIS) is a birth cohort study led by CHeRUB in collaboration with Deakin University and the Murdoch Children’s Research Institute (MCRI).

BIS is the most detailed study of its kind in the world, having collected more than 150,000 variables per mother-infant pair. The BIS team has been awarded 15 separate NHMRC/MRFF grants and published more than 70 original, peer-reviewed BIS papers.

World-first findings from BIS data include:

• Exaggerated innate inflammatory responses at birth drive an allergy-associated immune phenotype and subsequent allergic disease (Zhang, Science TM, 2016)
• Mother-to-infant transmission of the ‘metabolic syndrome’ is detectable at birth (McCloskey, Ped Obesity, 2018
• Perinatal microbial exposure influences the early life origins of atherosclerosis (McCloskey, Int J Epi, 2017)
• The gut microbiome impacts both the mother’s risk of preeclampsia and foetal immune development (Hu, Nature Comms, 2017)
• The maternal gut microbiota impacts the composition of the baby’s immune cells at birth (Gao, Frontiers Immunol, 2023) and the infant’s risk of allergic disease (Vuillermin, Nature Comm 2020)
• The of the maternal (Loughman, EBioMed, 2020) and infant (Dawson, EBioMed, 2021) gut microbiota impact subsequent neuropsychiatric behavioural outcomes
• Accelerated maturation of the gut microbiome mediates the protective effect of having older sibling on an infant’s risk of allergic disease (Gao, JACI, 2023)
• Prenatal systemic inflammation partially mediates the impact of maternal obesity on the risk of perinatal depression (Sominsky, Brain Beh and Imm, 2023)
• Prenatal systemic inflammation partially medicates the impact of low socioeconomic status on child neurocognitive outcomes (Marx, Brain Beh Immun, 2022)
• Plastic pollutant exposure during pregnancy increases the risk of autism by suppressing the production of estrogen in the brain (Symeonides and Vacy, Nature Comms, 2024)

For more information visit www.barwoninfantstudy.org.au

CHeRUB participates in the ENDIA Study, an NHMRC-funded longitudinal observational study of 1500 babies Australia-wide who have a first degree relative with type 1 diabetes. Participants include:

• Pregnant women with type 1 diabetes
• Men with type 1 diabetes whose partner is pregnant
• Children with type 1 diabetes whose mother is pregnant
• Babies under 6 months of age with a first degree relative (mum, dad, brother or sister) who has type 1 diabetes.

ENDIA researchers are investigating factors that may contribute to the development of islet autoimmunity and type 1 diabetes in children, such as:

• The genes of the participating child and their family member with type 1 diabetes
• The method of delivery (natural birth versus caesarean section)
• The mother’s nutrition during pregnancy and breast feeding
• Exposure to viruses during pregnancy and early life

Identifying the factors that initiate islet autoimmunity in early life could lead to a means of preventing type 1 diabetes before it begins.

For more information visit http://www.endia.org.au/

CHeRUB leads a multicentre clinical trial to investigate whether the immune modulator OM85 can prevent hospital admission due to asthma among preschool aged children.

Acute wheezing illnesses present a huge health and economic burden and are the most common reason that preschool aged children are admitted to hospital in Australia. Current strategies to prevent hospital admissions due to preschool wheeze are ineffective, and parents and paediatricians identify developing effective treatments to prevent hospital admission as a research priority.

OM-85 is an orally administered bacterial lysate that stimulates immune responses associated with defence against viral infections and reduces the excessive inflammation of the respiratory mucosa associated with wheezing episodes.

Compelling evidence from animal, laboratory and clinical studies supports the hypothesis that OM-85 has the potential to reduce the risk of hospital admission due to preschool wheeze.

Over 40 hospitals in the Children’s Inpatient Research Collaboration of Australia and New Zealand (CIRCAN) participate in this multi-centre, randomised, double-blind, placebo-controlled trial. There are now more than 500 children enrolled.

For more information visit https://circan.org/om-85

The Child Health Research Unit at Barwon Health, in collaboration with Ballarat Health Services, East Grampians Health Service, Colac Area Health, Western District Health Service, Deakin University, Gen V (Murdoch Children’s Research Institute) and Federation University, leads the Pregnancy Research and Translation Ecosystem (PTR-E). PRT-E aims to generate and implement best evidence to improve maternal and infant health.

PRT-E has four priority areas:

• Optimising the rate of birth caesarean section
• Reducing the burden of perinatal depression
• Improving maternal nutrition during pregnancy
• Preventing preterm births

To find out more or get involved, visit the PRT-E website or email prte@deakin.edu.au

Findings from the Barwon Infant Study, published in Brain, Behaviour and Immunity journal, provide evidence that chronic activation of the body’s immune system, also known as inflammation, plays a role in the risk to develop perinatal depression.

The team, led by paediatrician and Barwon Health Director of Research Professor Peter Vuillermin, collected blood samples from nearly 1000 pregnant women and also collected information regarding the women’s mental health.

Barwon Health and Deakin University School of Medicine senior scientist Dr Luba Sominsky (pictured) then led the analysis of inflammatory markers in the blood samples. The team then also analysed if differences in the levels of these inflammatory markers related to perinatal depression risk.

Dr Sominsky said the study showed pregnant women with high concentration of inflammatory markers in their blood were more likely to experience depression and stress symptoms during pregnancy.

Read more here.

Findings from the Barwon Infant Study, published in the Journal of Allergy and Clinical Immunology, provide strong evidence that older siblings speed up the rate at which babies develop their gut microbiome and that this protects them from allergic disease.

The team, led by Professor Peter Vuillermin, a paediatrician and Director of Research at Barwon Health collected poo samples over the course of infancy among over 1000 infants and then tested whether the children were allergic to five different foods at one year of age. The babies had a skin prick allergy test, and if this was positive, a food challenge at the University Hospital Geelong. The most common forms of food allergy were egg and peanut. The team examined DNA from the poo samples to measure the baby’s gut bacteria. They analysed whether having siblings and owning dogs impacted how fast the baby’s gut microbiome matured; and then whether a more mature microbiome impacted the risk of developing food allergy.

Read more here.

The Barwon Infant Study (BIS) – a collaboration between the Barwon Health Child Health Research Unit, Deakin University and the Murdoch Children’s Research Institute – is the first to show that children with a lower amount of Prevotella at age one are more likely to have anxiety-like behaviours at two.

The research team examined data from 201 children, analysing faecal samples at one, six and 12 months of age, then measuring behavioural outcomes at two years.

They found children with a lower abundance of the bacteria Prevotella in their poo at 12 months of age had a higher prevalence of anxiety-like behaviours, including shyness, sadness and an internal focus, an indicator they may be at higher risk of going on to develop childhood anxiety.

Dr Amy Loughman said the study also added to the growing evidence supporting the role of the infant gut microbiota for neurodevelopment and mental health in later life. In previous cross-sectional studies Prevotella abundance has been associated with both autism and Parkinson’s disease.

The research team now hope to build further evidence to consider Prevotella as a gut bacteria key to both identifying health risk, and potentially, as an intervention to improve health outcomes.

The full publication can be read here.

The Barwon Health and Deakin Partnership has won a $1.6 million NHMRC grant to lead a new multicentre trial of a bacterial lysate (OM-85) for prevention of hospital admissions.

Acute wheezing illnesses pose a large health and economic burden and are the most common reason that pre-school aged children are admitted to hospital in Australia. There is a recognised need for novel approaches. Emerging evidence suggests OM-85 may also be effective in preventing wheeze episodes in young children, but larger studies are urgently required to replicate this important finding and evaluate whether OM-85 reduces wheeze-related hospital admissions.

To undertake this study, a highly experienced transdisciplinary research team has been assembled that leverages the newly established Children’s Inpatient Research Collaborative of Australia and New Zealand (CIRCAN). This novel and feasible strategy aims to address a gap in current knowledge of critical significance and generate health and economic findings that are clearly implementable.

A welcome new addition to the Barwon Infant Study (BIS) is the “BIS Bus”, a mobile laboratory funded by the Gandel Foundation and supported by Jayco, which enables BIS Researchers to visit participants at school, which is much more convenient for the participants and their families.