Barry Linnane


Barry Linnane

Paediatric Respiratory Consultant

Dr Linnane qualified with an honours degree from University College Dublin in 1998. He completed his core training as a Specialist Registrar in Paediatrics in Ireland, and then spent three years as a Paediatric Respiratory Fellow at the Royal Children’s Hospital, Melbourne. While completing his advanced clinical training in Paediatric Respiratory Medicine, he researched early Cystic Fibrosis (CF) lung disease and was awarded an MD in December 2009 from Melbourne University for his thesis entitled “Early Pathophysiological Changes in the Lungs of Infants with Cystic Fibrosis”. Dr Linnane worked for two years as a Paediatric Respiratory Consultant in Our Lady’s Children’s Hospital, Crumlin. In his current post as Paediatric Respiratory Consultant in Universty Hospital Limerick he takes the clinical lead in the provision of care to children with CF.

Dr Linnane is involved in several national strategies. He was a member of the National Steering Group for the Introduction of CF Newborn Screening in Ireland, and sits on the National Bloodspot Screening Programme Governance Group. He is a member of the Scientific Advisory Committee of the CF Registry of Ireland, and is a member of the Medical and Scientific Council of Cystic Fibrosis Ireland. He currently sits on the National Clinical Programme – CF Working Group chaired by Prof Charlie Gallagher. He was Honorary Assistant Secretary of the Irish Thoracic Society (ITS) National Council from 2010 to 2015, and is a member of the ITS Special Advisory Panels on Asthma, Cystic Fibrosis, and Paediatrics. He is also currently on the Steering Group for the Model of Care for Paediatric Critical Care in Ireland. Dr Linnane is also a member of the European CF Society Screening Working Group, and member of European Respiratory Society Infant and Pre-school Working Group.

Dr Barry Linnane, in partnership with Professor Paul McNally, is a director of the Study of Host Immunity and Early Lung Disease in CF (SHIELD CF) project. The aim of SHIELD CF is to become a national framework for translational research into early CF lung disease.

Dr Linnane’s special interests are:

  • Cystic fibrosis
  • Asthma
  • Chronic cough
  • Pre-school wheeze
  • Paediatric sleep disordered breathing
  • Non-invasive ventilation
Barry Linnane

Paediatric Respiratory Consultant

Ellen Obande
Position: Research co-ordinator, Limerick
Ellen.Obande@ul.ie

Role:
Ellen is co-ordinator for clinical research and clinical trials in University Hospital Limerick. She works within the SHIELD CF and CF:INK networks.

Magda Mulligan
Position: Clinical research assistant
Magdalena.Mulligan@hse.ie

Role:
Magda is a a research assistant in the University Hospital Limerick. She is currently working on a study performing Multiple Breath Washout (MBW) tests in the paediatric cystic fibrosis unit. Magda previously completed a cohort study on a group of CF paediatric patients to see how their Lung Clearance Index (LCI) compares with the control non-CF patients. This study led to successful incorporation of MBW into the outpatients clinic visits and annual assessments visits. Currently Magda is investigating how Orkambi affects the performance of peripheral airways by comparing baseline LCI values with LCI values obtained after commencing the Orkambi treatment, in parallel with the spirometry measurements.

The role of rhinovirus infections in young children with Cystic Fibrosis

Viruses are the major cause of respiratory illnesses in children under the age of five years and yet little is known about the impact of viruses on children with CF. Viruses have been well studied in other chronic lung conditions such as asthma and recent evidence suggests that Human Rhinovirus (HRV) may have a significant impact on the development of asthma and recurrent wheezing in young children. The main aims of the study are to examine the prevalence of different HRV species in young children with CF and to examine the impact of different HRV species on clinical outcomes in young children with CF.

The Study of Host Immunity and Early Lung Disease in CF (SHIELD CF)

Summary: SHIELD CF is an ambitious long term translational research programme based in NCRC and running in the CF centres in OLCHC, Tallaght and Limerick. SHIELD CF is based around our annual assessment service, which includes a range of blood tests, x-rays, lung function tests and a bronchoscopy in children who cannot produce sputum specimens. Children are followed up until adulthood. All samples that are taken are catalogued and stored in a specialised biobank for current and future use. In parallel to our clinical sample collection, we are collecting a wide array of clinical information about our patients including complications of the disease and access to medical care. The design of the program allows for a significant degree of collaboration with national and international colleagues in an effort to gain a greater understanding of lung disease in children with CF.

The airway microbiome in children with CF (AIM CF)

In recent years we have come to understand that a vast array of bacteria lives in our airways – even in healthy people. It has become clear that the interaction between the healthy and harmful bacteria in the lungs is complex. We are conducting a long term and very wide-ranging study in children with CF looking at how these bacteria vary over time and whether they are related to lung inflammation, changes in antibiotic use and lung function at school age.

Inflammatory and Microbiological Implications of Pooling of Bronchoalveolar Lavage samples in Preschool Children with Cystic Fibrosis (the POOL study)

Bronchoalveolar lavage fluid is collected when salt water is instilled temporarily in the lungs during a bronchoscopy procedure. It collects the proteins and bacteria from the lower airways that otherwise could not be collected. This is potentially a very useful test for clinical trials of new medications in children with CF, but there are several different approaches internationally to the way the test is performed. This multicentre study seeks to determine if different ways of handling and processing the fluid impact on its utility as a marker of lung pathology.

CF Urinary biomarker study (CUBS)

Lots of substances that are produced in the body are excreted in the urine. This has been shown to be true of markers of lung damage in people with lung diseases. This is of significant interest to doctors looking after children with CF as the collection of urine is a painless and harmless procedure, urine is always accessible, and it is an easy fluid to work with. This study is looking to collect information about what substances are in the urine, how they naturally vary over time and whether we can see any patterns in these substances relating to lung infection and inflammation in children with CF. We are working with a company called Mologic in the UK who have experience in this area and are currently working on a similar study to this in adults with CF.

Protease activity: Lung Measurement in Children with Cystic Fibrosis (PALM)

This is a longitudinal study looking at a type of enzyme called a protease. Different types of proteases such as neutrophil elastase, are risk factors for lung damage in children with CF. Presently not a lot is known about the role of other proteases in the preschool CF lung. The study is designed to establish the degree and pattern of protease and anti-protease activity (PAPA) in the lungs of preschool children with CF, and to determine if specific proteases or anti-proteases are associated with either pulmonary infection or clinical disease parameters. The study also proposes to determine whether markers of PAPA can be detected in urine.

Children's Follow up Orkambi Real Word MBW Study (C-FORMS)

Cystic fibrosis is a common inherited life threatening disease which is particularly common in Ireland. People with CF have a mutation in a gene that produces a protein called cystic fibrosis transmembrane conductance protein or CFTR. CFTR regulates the movement of salt in and out of cells. When CFTR doesn’t work well the result is thick, sticky mucus in the respiratory, digestive and reproductive systems, and inability to fight lung infections. Medications have now been designed to specifically target the CFTR protein. These are called CTR modulators. One such modulator is Orkambi, which has recently been approved to treat children over 6 years in Ireland. In this study we are using a new type of specialised lung function technique called ‘multiple breath washout’ (MBW) to look at the lung function of children aged 6-11 years with CF. Children will undergo MBW and a new form of low dose CT scanning called ‘spirometrically controlled CT’ before they commence on Orkmabi. In the first study of its kind in the world, we will be working with colleagues in Rotterdam, London and Cincinnati to assess the effects of Orkambi on the lung structure and lung function of these Irish children for two years following commencement of Orkambi in a real world setting.

Predicting REsponses in Disease outcomes in CF using iPSCs for new CFTR Therapies (PREDiCT)

The introduction of promising new medications to treat the basic defect in people with CF holds great promise to improve the survival and health of our patients with CF. New CF treatment such as Orkambi are currently only available for CF patients with the most common mutations. Furthermore only individuals with common or well-recognised mutations are being recruited to clinical trials of these new investigational medications. There are likely to be a significant group of children and adults with rarer mutations who may be left behind, with no prospect of having new drugs licensed for use in these people. What is required here is a patient specific ‘test’ to determine whether an individual may benefit from treatment with a given drug. The purpose of this research is to create a repository or “bank” of a type of stem cell called “induced pluripotent stem cells” or iPSCs. Stem cells are special kinds of cells that can renew themselves. Under certain experimental conditions, iPSCs can be directed to grow into any type of tissue or organ. In the case of this study, we are working with colleagues in RCSI and Boston University to develop a special type of lung cell which can readily be used to determine whether the child’s own lung cells may respond to new CF drugs. Ultimately, we would like to develop a test that can be offered to all patients with cystic fibrosis, particularly those with rare mutations not currently able to avail of approved drugs, to determine whether or not they will respond to a given drug.

Role of Exosomes in CF Airway Pathogenesis (RECAP)

RECAP is a new joint project between our CF clinical team and our CF Basic Science core in NCRC led by Dr Judith Coppinger. The team has discovered that there are small capsules within cells called exosomes. These exosomes are released by lung cells from people with CF and can help regulate inflammation. Exosomes form part of a cell-to-cell communication system used by most cells to send messages across the human body. Understanding their role promises to improve our understanding of many diseases and how we treat them. These small exosomes are carriers of proteins and other signals that can impact neighbouring inflammatory cells in the fight against infection and may offer the potential to be markers of lung disease in CF. From our research we have discovered that CF cells produce more of these exosomes than healthy cells. Using state of the art scientific technologies, we examined what protein molecules are contained in these exosomes and found many proteins are involved in immune cell function and inflammation. We are now using samples collected through SHIELD CF in children of different ages, some of whom are on new CF modifier drugs to understand this phenomenon in greater detail and how exosomes may cause disease in CF and respond to treatment strategies. We hope to determine in the future whether certain exosomes will help us to non-invasively determine how patients are doing in terms of lung inflammation and damage.

Baseline LCI OF Children With OR without CF (BLOC WORC)

Understanding early lung disease in CF is an international focus to try and tailor treatment to slow or prevent decline in lung function. In Ireland, we currently have limited capacity to formally assess early lung disease in this group. In recent years, there has been a move towards closer monitoring and active treatment in younger patients with CF, in an effort to improve long term survival. Lung Clearance Index (LCI) is a lung function measurement performed using the multiple breath washout (MBW) method. The MBW technique is an effort independent, low-risk, non-invasive procedure performed on spontaneously breathing children. The LCI is a value that is used to indicate the performance of the lungs, particularly the smaller airways. LCI is much more sensitive than other established tests for CF lung disease and can be performed in younger children. It is therefore a very helpful test for doctors looking after children with CF. We have recently acquired the equipment for MBW testing (N2) and wish to validate the test in a population of healthy Irish children and in children with CF, both when well and unwell and to compare our results with established values using this equipment.



The list of publications below is automatically derived from MEDLINE/PubMed. As a result, there may be incorrect or missing publications.

O'Sullivan KJ, Collins L, McGrath D, Linnane B, O'Sullivan L, Dunne CP, 2018 Jul, Children With Cystic Fibrosis May Be Performing Oscillating Positive Expiratory Pressure Therapy Incorrectly. Chest, DOI: 10.1016/j.chest.2018.03.057
Linnane B, McNally P, 2018 Jul 20, Six-lobe bronchoalveolar lavage in children with cystic fibrosis. Lancet Respir Med, DOI: 10.1016/S2213-2600(18)30295-9
O'Sullivan DM, Linnane B, 2018 Apr 26, Recurrent haemoptysis in a child with advanced cystic fibrosis lung disease. BMJ, DOI: 10.1016/S2213-2600(18)30295-9
O'Sullivan D, Linnane B, Mostyn A, Jonathan N, Lenihan M, O'Connell NH, Dunne CP, 2018 Mar 23, Detection of Neisseria meningitidis in a paediatric patient with septic arthritis using multiplexed diagnostic PCR targeting meningitis/encephalitis (ME). Ann Clin Microbiol Antimicrob, DOI: 10.1186/s12941-018-0268-7
McNally P, O'Rourke J, Fantino E, Chacko A, Pabary R, Turnbull A, Grant T, O'Sullivan N, Wainwright C, Linnane B, Davies JC, Sly PD, 2018 May, Pooling of bronchoalveolar lavage in children with cystic fibrosis does not adversely affect the microbiological yield or sensitivity in detecting pulmonary inflammation. J Cyst Fibros, DOI: 10.1016/j.jcf.2017.10.016
Barben J, Castellani C, Dankert-Roelse J, Gartner S, Kashirskaya N, Linnane B, Mayell S, Munck A, Sands D, Sommerburg O, Pybus S, Winters V, Southern KW, 2017 Mar, The expansion and performance of national newborn screening programmes for cystic fibrosis in Europe. J Cyst Fibros, DOI: 10.1016/j.jcf.2016.12.012
Fitzgerald C, Heery E, Conneally N, Linnane B, George S, Fitzpatrick P, 2017 Feb, An evaluation of pregnant women's knowledge and attitudes about newborn bloodspot screening. Midwifery, DOI: 10.1016/j.midw.2016.11.007
Power RF, Linnane B, Martin R, Power N, Harnett P, Casserly B, O'Connell NH, Dunne CP, 2016 Apr 22, The first reported case of Burkholderia contaminans in patients with cystic fibrosis in Ireland: from the Sargasso Sea to Irish Children. BMC Pulm Med, DOI: 10.1186/s12890-016-0219-z
Linnane B, Kiernan MG, O'Connell NH, Kearse L, Dunne CP, 2015, Anti-RSV prophylaxis efficacy for infants and young children with cystic fibrosis in Ireland. Multidiscip Respir Med, DOI: 10.1186/s40248-015-0029-9
Linnane B, Kearse L, O'Connell NH, Fenton J, Kiernan MG, Dunne CP, 2015 Oct 6, A case of failed eradication of cystic fibrosis-related sinus colonisation by Pseudomonas aeruginosa. BMC Pulm Med, DOI: 10.1186/s12890-015-0113-0
Linnane B, Clarke D, Murray P, O'Sullivan N, Dunne C, McNally P, 2015 Oct, The benefit of taking a control sample when performing bronchoalveolar lavage. Thorax, DOI: 10.1136/thoraxjnl-2015-207319
Renwick J, McNally P, John B, DeSantis T, Linnane B, Murphy P, SHIELD CF., 2014, The microbial community of the cystic fibrosis airway is disrupted in early life. PLoS One, DOI: 10.1371/journal.pone.0109798
Linnane B, Vaish S, Clarke D, O'Sullivan N, McNally P, 2015 Apr, The findings of a clinical surveillance bronchoalveolar lavage programme in pre-school patients with cystic fibrosis. Pediatr Pulmonol, DOI: 10.1002/ppul.23118
Ringholz FC, Buchanan PJ, Clarke DT, Millar RG, McDermott M, Linnane B, Harvey BJ, McNally P, Urbach V, 2014 Aug, Reduced 15-lipoxygenase 2 and lipoxin A4/leukotriene B4 ratio in children with cystic fibrosis. Eur Respir J, DOI: 10.1183/09031936.00106013
Blau H, Linnane B, Carzino R, Tannenbaum EL, Skoric B, Robinson PJ, Robertson C, Ranganathan SC, 2014 Jan, Induced sputum compared to bronchoalveolar lavage in young, non-expectorating cystic fibrosis children. J Cyst Fibros, DOI: 10.1016/j.jcf.2013.05.013
Linnane B, McNally P, 2011 Oct 26, Bronchoalveolar lavage-directed therapy in children with cystic fibrosis and Pseudomonas aeruginosa infection. JAMA, DOI: 10.1001/jama.2011.1518
Pillarisetti N, Williamson E, Linnane B, Skoric B, Robertson CF, Robinson P, Massie J, Hall GL, Sly P, Stick S, Ranganathan S, Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF)., 2011 Jul 1, Infection, inflammation, and lung function decline in infants with cystic fibrosis. Am J Respir Crit Care Med, DOI: 10.1164/rccm.201011-1892OC
Pillarisetti N, Linnane B, Ranganathan S, AREST CF., 2010 Aug, Early bronchiectasis in cystic fibrosis detected by surveillance CT. Respirology, DOI: 10.1111/j.1440-1843.2010.01765.x
Stick SM, Brennan S, Murray C, Douglas T, von Ungern-Sternberg BS, Garratt LW, Gangell CL, De Klerk N, Linnane B, Ranganathan S, Robinson P, Robertson C, Sly PD, Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF)., 2009 Nov, Bronchiectasis in infants and preschool children diagnosed with cystic fibrosis after newborn screening. J Pediatr, DOI: 10.1016/j.jpeds.2009.05.005
Linnane BM, Hall GL, Nolan G, Brennan S, Stick SM, Sly PD, Robertson CF, Robinson PJ, Franklin PJ, Turner SW, Ranganathan SC, AREST-CF., 2008 Dec 15, Lung function in infants with cystic fibrosis diagnosed by newborn screening. Am J Respir Crit Care Med, DOI: 10.1164/rccm.200804-551OC
Linnane B, Robinson P, Ranganathan S, Stick S, Murray C, 2008 Sep, Role of high-resolution computed tomography in the detection of early cystic fibrosis lung disease. Paediatr Respir Rev, DOI: 10.1016/j.prrv.2008.05.009
Ranganathan S, Linnane B, Nolan G, Gangell C, Hall G, 2008 Sep, Early detection of lung disease in children with cystic fibrosis using lung function. Paediatr Respir Rev, DOI: 10.1016/j.prrv.2008.05.002
Linnane B, Hafen GM, Ranganathan SC, 2006 Aug, Diameter of paediatric sized flexible bronchoscopes: when size matters. Pediatr Pulmonol, DOI: 10.1002/ppul.20463
Linnane BM, Canny G, 2006 Oct, Congenital broncho-esophageal fistula: A case report. Respir Med, DOI: 10.1016/j.rmed.2006.01.027

Name:Professor Paul McNally
Department Consultant in Paediatric Respiratory Medicine
Institution:Our Lady’s Children’s Hospital Crumlin
Name:Dr Des Cox
DepartmentConsultant in Paediatric Respiratory Medicine
Institution:Our Lady’s Children’s Hospital Crumlin
Name:Professor Patricia Fitzpatrick
Position:Full Professor of Epidemiology & Biomedical Statistics
Role:Head of Subject: Public Health UCD School of Public Health, Physiotherapy & Sports Science Consultant in Preventative Medicine, St Vincent's University Hospital, Dublin Chair, Steering Committee for Healthy UCD Director of UCD Centre for Health Services Research
Name:Dr Paul Cotter
Position: Head of Department, Food Biosciences
Role:Principal Research Officer, Teagasc Food Research Centre Principal Investigator, APC Microbiome Institute Adjunct Lecturer, Cork Institute of Technology
Country:Moorepark, Cork Ireland
Name:Professor Colum Dunne
Position:Director of Research
Institution:Graduate Entry Medical School University of Limerick
Country:Ireland
Name:Dr Leonard O’Sullivan FIES, FCIEHF, MIOSH, MIDI
DepartmentDesign Factors Research group/School of Design & Health Research Institute
Institution:University of Limerick
Country:Ireland
Name:Dr Peter Greally
Position:Consultant in Paediatric Respiratory Medicine
Email:peter.greally@amnch.ie
Role:Dr Greally is CF centre director in Tallaght Hospital. He is an active clinical researcher and local principle investigator on several international clinical trials.
DepartmentConsultant in Paediatric Respiratory Medicine
Name:Dr David Rea
Position:Consultant Paediatric Radiologist
Email:david.rea@olchc.ie
Role:Dr Rea is a consultant paediatric radiologist in OLCHC. He is lead radiologist for the SHIELD CF network. Dr Rea leads the imaging analysis aspects of SHIELD CF. OLCHC is part of the SciFi network – an international imaging network for children with CF.
Name:Dr Michael McDermott
Position: Consultant Paediatric Pathologist
Email:Michael.mcdermott@olchc.ie
Role:Dr McDermott is a consultant paediatric pathologist in OLCHC. He is lead pathologist for the SHIELD CF network, and leads the optimization of techniques for cell imaging and analysis for SHIELD CF.

Current Trials & Studies

Study NameStudy TitleStudy TypeSponsorSponsor Type
SHIELD CFThe Study of Host Immunity and Early Lung Disease in Children with CFNon-Interventional StudyNCRCAcademic - Investigator Led
VX14-661-110A Phase 3, Open-label, Rollover Study to Evaluate the Safety and Efficacy of Long Term Treatment With VX-661 in Combination With Ivacaftor in Subjects Aged 12 Years and Older With Cystic Fibrosis, Homozygous or Heterozygous for the F508del-CFTR MutationClinical TrialVertexIndustry Sponsored
VOICE: VX14-CFR-107Observational Registry of Cystic Fibrosis Patients in EuropeNon-interventional studyVertexIndustry Sponsored
VX15-770-126A Phase 3, 2-Arm, Open-label Study to Evaluate the Safety and Pharmacodynamics of Long-term Ivacaftor Treatment in Subjects With Cystic Fibrosis Who Are Less Than 24 Months of Age at Treatment Initiation and Have a CFTR Gating Mutation.Clinical TrialVertexIndustry Sponsored
CUBS (CF Urinary biomarker study)CF Urinary biomarker studyNon-interventional studyNCRCAcademic - Investigator Led
PALM StudyPALM study (Protease activity: Lung measurement) – a longitudinal study in children with CF to establish spectrum and influence of protease antiprotease activity in CF Starting in JulyNon-Interventional StudyNCRCAcademic - Investigator Led

Previous Trials & Studies

Study NameStudy TitleStudy TypeSponsorSponsor Type
The POOL studyInflammatory and Microbiological Implications of Pooling of Bronchoalveolar Lavage samples in Preschool Children with Cystic FibrosisNon-Interventional StudyNCRCAcademic - Investigator Led