Division of Respirology

Fred Hargreave

MD, MB, FRCPC, FRCP

Professor Emeritus, Division of Respirology, Department of Medicine

St. Joseph's Healthcare

 

 

Education and Professional Standing

Dr. F. E. Hargreave, in his training as clinical researcher with Jack Pepys and his subsequent collaboration with Jerry Dolovich, has been a pioneer in the improved understanding and treatment of asthma and its association with chronic cough and COPD. This has been achieved by the use of objective measurements of airway inflammation, airway responsiveness and airflow limitation.

Research Interests

With allergen inhalation tests, Dr. Hargreave validated the occurrence of late asthmatic responses, showed that they were common, that they could result from the combination of allergen with IgE antibodies, that they were associated with allergen-induced increases in airway responsiveness to non-allergic stimuli and with airway inflammation and that they could be (and were subsequently) used to study the anti-inflammatory effect of new drugs. He also standardized and evaluated measurements of non-allergic airway responsiveness to histamine and methacholine. He showed that these are the most sensitive measurements to identify the presence of current asthma when symptoms are present but spirometry is normal and that they are important determinants of the degree of variable airflow limitation. They are now widely used in research and clinical practice.

Dr. Hargreave also introduced sputum induction and refined the processing of sputum, to measure airway inflammation relatively non-invasively. He evaluated the measurements and applied them to study the pathogenesis, pathophysiology and treatment of asthma, chronic cough and COPD. The observations emphasize the occurrence of different types of airway inflammation, their different causes and different response to treatment.

Sputum inflammatory markers are now being increasingly used in research and in practice.

Selected Publications

  1. Cockcroft DW, Killian DN, Mellon JJA, Hargreave FE. Bronchial reactivity to inhaled histamine: A method of clinical survey. Clin Allergy 1977; 7:235-43. [A”CITATION CLASSIC”, Current Contents (Clinical Medicine) 1991; 19 (No. 32):10].
  2. Cockcroft DW, Ruffin RE, Dolovich J, Hargreave FE. Allergen-induced increase in non-allergic bronchial reactivity. Clin Allergy 1977; 7:503-13. [A”CITATION CLASSIC”, Current Contents (Clinical Medicine) 1993; 21 (No. 8):8].
  3. O’Byrne PM, Dolovich J, Hargreave FE. Late asthmatic responses. Am Rev Respir Dis 1987; 136:740-51.
  4. Pizzichini E, Pizzichini MMM, Efthimiadis A, Evans S, Morris MM, Squillace D, Gleich G, Dolovich J, Hargreave FE. Indices or airway inflammation in induced sputum: reproducibility and validity of cell and fluid phase measurements. Am J Respir Crit Care Med 1996; 154:308-17.
  5. Jayaram L, Pizzichini MM, Cook RJ, Boulet L-P, Lemiere C, Pizzichini E, Cartier A, Hussack P, Goldsmith CH, Laviolette M, Parameswaran K, Hargreave FE. Determining asthma treatment by monitoring sputum cell counts: effect on exacerbations. Eur Resp J 2006; 27:483-94.
  6. Hargreave FE, Nair P.  The definition and diagnosis of Asthma.  Clin Exp Allergy. 2009 Jul 20. 39: 1652-8
  7. Nair PK, Pizzichini MM, Kjarsgaard M, Inman MD, Efthimiadis A, Pizzichine E, Hargreave FE, O’Byrne PM.  Mepolizumab for prednisone-dependent asthma with sputum eosinophilia.  N Engl J Med. 2009 Mar 5; 360:985-93