The Woolcock Institute of Medical Research

At the Woolcock, our mission is to improve breathing and sleep health globally through world-class research, clinical care and education. Behind every effective treatment, every refined clinical approach and every step forward in patient care is a foundation built on research – work conducted in labs, data analysis and clinical trials. Bench to bedside is not just theory; it is practical, powerful, and transformative. When clinicians are also researchers, and when research is guided by real-world clinical challenges, the result is science-informed care and improved patient outcomes.

A case in point is work done by current Executive Director Professor Paul Foster and his team, which led to biologic treatments for Type 2 asthma and a range of other allergic conditions.

Professor Foster’s work began as a fundamental investigation into cellular behaviour in the lungs.

“The major treatments for asthma for a long time have been bronchodilators, steroids and combinations thereof,” he explains. “But they're not always very effective for the treatment of severe asthma or for exacerbations. So, the exacerbation phase of asthma for mild to severe asthmatics is still a problem.”

What researchers discovered in the ’80s was that inflammation potentially played a big part in the induction and progression of asthma. That inflammatory response was labelled Type 2 and was found to be linked to the recruitment of cells called eosinophils in the lung which destroy tissue through the release of toxic factors.”

“What my team, in association with others, set out to try and dissect was ‘what were the critical factors in the Type 2 response that might be driving these asthma-like symptoms?’.”

Their aim was to identify the role of the molecules that regulate eosinophils and regulate the Type 2 response – meaning controlling severe asthma or exacerbations. What they identified in their preclinical work that there were two critical checkpoints and they formulated two biologics to target those checkpoints.

This is where Professor Foster’s eyes light up because as a scientist he’s explaining how his work changes lives.

“When you inhibit them, you get amazing success in the treatment of exacerbations. Not only that, they're also now being shown to be effective for the treatment of COPD, because it has an eosinophilic component, but also in other eosinophilic-associated diseases like dermatitis, allergic diseases of the gut, hypersensitivity to certain foods.”

His team’s work has resulted in approved treatments for Type 2 asthma in patients with high eosinophil levels and for other conditions that have been available for around 10 years.

That’s where education enters the picture. Many people with asthma in Australia still rely on over-the-counter relievers – changing that behaviour to having an asthma management plan worked on with their healthcare provider and using a preventer or combination therapy is something that Woolcock research leader and Global Initiative for Asthma Science Committee chair has been working on for years. Informing those healthcare providers about new treatments options and the pipeline of asthma research, which may provide better options for those with severe or uncontrolled asthma is the next step.

“This research into Type 2 Asthma and eosinophils started with a collaboration between basic researchers and clinician researchers at the Brompton Hospital in London and at sites in the USA. The clinicians provided the lab with the samples that informed their work. And those clinician researchers were informed by that research when treating their patients.”

“There’s no doubt in my mind that biologics have taken asthma management to another level. And there’s now more work that’s been done off the back of ours that’s looked at the role of alarmins (sensors of infection) and in the airway epithelium. There are now biologics targeting them and they may be even better.”

“A specialist, and particularly a clinician-researcher is able to look at all the available options to manage someone’s asthma rather than relying unnecessarily on, say, a steroid.”

It’s not just the case for asthma.

“If you have skin allergies or diseases where eosinophils hang around, biologics are a very effective treatment. I know one woman who had been suffering with skin lesions for years – she covered them up; she was on a range of different drugs (e.g. mast cell stabilisers and steroids). She was told she had autoimmune disease. When she visited an immunologist, had her bloods taken, eosinophil numbers determined and was prescribed a biologic, her life completely changed.”

“That’s research-informed clinical care in action and it’s why I do what I do.”

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