Irish Thoracic Society Podcast Productions

Breathwork: A Career in Cystic Fibrosis with Professor Edward McKone

In this episode, with Professor Edward McKone, we dive deep into the essentials of cystic fibrosis, exploring its underlying mechanisms, diagnostic challenges, and the revolutionary impact of CFTR modulators. Led by expert insights, this discussion highlights how evolving treatments are transforming patient outcomes and what lies ahead in CF care. In this episode - The genetics and pathophysiology of CF, including CFTR function and the impact on lungs and other organs - Advances in diagnosis, especially the role of newborn screening, sweat tests, and genetic sequencing - How CFTR modulators are changing the management landscape and their long-term effects - The future of CF treatment: reducing treatment burden and personalised medicine - The importance of holistic, multidisciplinary care and transition from paediatric to adult services Guest Professor Edward McKone is a leading respiratory physician and clinical professor based in Dublin, specialising in cystic fibrosis and respiratory disease. As a Consultant at St. Vincent’s University Hospital, he works at Ireland’s National Referral Centre for Adult Cystic Fibrosis, combining frontline care with clinical trials research. He has played a pivotal role in advancing cystic fibrosis treatment both in Ireland and internationally, including leadership roles with the Cystic Fibrosis Registry of Ireland and the European CF Registry. Alongside his clinical and research work, Professor McKone is deeply committed to medical education, currently serving as Dean of the Institute of Medicine and Co-Director of the Irish Clinician Educator Track. Hosts Email: edofficer@irishthoracicsociety.com Dr Barry Harnedy is a respiratory specialist trainee in Ireland. He graduated from National University of Ireland Galway. He is the current Irish Thoracic Society co Educational Officer. He is passionate about digital innovation and airways assessment. Sandra Green is an Irish-trained respiratory fellow with a strong track record in climate advocacy and multidisciplinary sustainable initiatives, as co-founder of Irish Doctors for the Environment. She has an MSc in Leadership and Innovation in Healthcare at the Royal College of Surgeons Ireland (2023–2025). With Marisssa, she co-founded the Irish Thoracic Society Podcast Productions, launching the platform in 2024 to share knowledge, insights, and innovations in respiratory care. LinkdIn - linkedin.com/in/dr-sandra-green-2a9536199 [linkedin.com/in/dr-sandra-green-2a9536199] Chapters 0:00 - Introduction 0:30 - Rapid Fire Round on cystic fibrosis. 6:02 - Cystic Fibrosis Pathophysiology 9:20 - Discussion on newborn screening and diagnostic steps. 11: 42 - Sweat test procedure 13:37 - Milder cases in adulthood and associated symptoms. 15:29 - CF in non-Caucasian populations and genetic testing. 17:25 - Referral to CF Centres 18.25 – Transition from Paediatric to Adult Care 22:13 - Overview of the mainstays of management and treatment within CF. 26:16 - Impact of CFTR Modulators 31:28 - The future challenges and management of aging CF patients. 38:57 - How socioeconomic status impacts CF outcomes in the era of modulators. 41:43 - Key message for clinicians and patients. 42:56 - Episode wrap-up and acknowledgments. Resource Links 1. Irish Cystic Fibrosis Society Website [https://www.cfireland.ie/] 2. Newborn Screening Information 3. Cystic Fibrosis Foundation [https://www.cff.org/] 4. European Cystic Fibrosis Society [https://www.ecfs.eu/] 5. Genetic Testing for CF [https://www.ncbi.nlm.nih.gov/gtr/] 6. CFTR Modulators Information [https://www.cff.org/managing-cf/cftr-modulators] 7. Transitioning from Pediatric to Adult Care

Inspire: A Career in Cystic Fibrosis: From Registry Data to Transformative Therapies with Professor Edward McKone (Part 1)

In this episode of Inspire, we are joined by Professor Edward McKone, Consultant Respiratory Physician at St. Vincent’s University Hospital and a leading figure in cystic fibrosis care. Drawing on his experience of clinical medicine, research, and leadership, he reflects on the evolution of CF management and the breakthroughs that have transformed patient outcomes. Alongside this, he shares insights from a dynamic career spanning clinical medicine, clinical trials, and the advancement of medical education. In this episode: Discover Professor McKone's path to specialising in respiratory medicine and cystic fibrosis. Explore the role of registries in improving patient outcomes and advancing standards. Learn about the challenges and successes in advocating for cystic fibrosis treatments. Understand the importance of medical education and the development of the Irish Clinical Educator Training program. Gain insights into the future of postgraduate medical training in Ireland. Hear Professor McKone's reflections on his career and advice for aspiring medical professionals. Guest: Professor Edward McKone is a leading respiratory physician and clinical professor based in Dublin, specialising in cystic fibrosis and respiratory disease. As a Consultant at St. Vincent’s University Hospital, he works at Ireland’s National Referral Centre for Adult Cystic Fibrosis, combining frontline care with clinical trials research. He has played a pivotal role in advancing cystic fibrosis treatment both in Ireland and internationally, including leadership roles with the Cystic Fibrosis Registry of Ireland and the European CF Registry. Alongside his clinical and research work, Professor McKone is deeply committed to medical education, currently serving as Dean of the Institute of Medicine and Co-Director of the Irish Clinician Educator Track. Hosts: Dr Barry Harnedy is a respiratory specialist trainee in Ireland. He graduated from National University of Ireland Galway. He is the current Irish Thoracic Society co Educational Officer. He is passionate about digital innovation and airways assessment. Sandra Green is an Irish-trained respiratory fellow with a strong track record in climate advocacy and multidisciplinary sustainable initiatives, as co-founder of Irish Doctors for the Environment. She has an MSc in Leadership and Innovation in Healthcare at the Royal College of Surgeons Ireland (2023–2025). With Marisssa, she co-founded the Irish Thoracic Society Podcast Productions, launching the platform in 2024 to share knowledge, insights, and innovations in respiratory care. LinkdIn linkedin.com/in/dr-sandra-green-2a9536199 Email - edofficer@irishthoracicsociety.com Chapters 00:00 – Intro & Guest Overview Overview of CF episode and Professor McKone’s background 02:15 – The Night That Changed a Career First on-call experience → choosing respiratory medicine 05:30 – Accidental Entry into Cystic FibrosisFrom “not knowing CF” to lifelong focus 09:00 – Medical Education & Leadership Pathways Role of National Specialty Director & training structures 11:30 – Rethinking Postgraduate Training in IrelandChallenges in BST → move toward broader exposure 17:00 – Building the Clinician-Educator (ICET Programme) Why medical education needs formal training pathways 23:00 – The Power of Registries From epidemiology → benchmarking → pharmacovigilance 27:30 – Registries as Regulatory Tools Landmark shift: EMA recognising CF registries for Phase IV studies 30:00 – How to Build a Registry (Practical Insights) Buy-in, minimal datasets, sustainability 32:15 – CFTR Modulators: Cost vs Value Clinical promise vs health economics reality 33:30 – The Sweat Chloride Moment (Key Turning Point) Why modulators changed everything 34:50 – Career Advice and reflections Career advice: focus, mentorship, and collaboration 36:30 – Closing Reflections References: O’Connor A. OPTIMISE: Optimisation and Progression of Training in Internal Medicine – In Search of Excellence (Interim Report). Dublin: Royal College of Physicians of Ireland; 2023. Corey M, McLaughlin FJ, Williams M, Levison H. A comparison of survival, growth, and pulmonary function in patients with cystic fibrosis in Boston and Toronto. J Clin Epidemiol. 1988;41(6):583-91. doi: 10.1016/0895-4356(88)90063-7. PMID: 3260274. Ramsey, B. W., et al. (1999). Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. New England Journal of Medicine.

PulmPeeps / Irish Thoracic Society collaboration: Understanding Refractory Chronic Cough: Insights from Experts

In this episode, we explore the complex and often overlooked world of refractory chronic cough—a condition that can significantly impact patients’ quality of life, yet is frequently misunderstood or underdiagnosed. Featuring insights from leading respiratory specialists in Ireland and the United States, we examine the latest approaches to diagnosis, management, and emerging treatments aimed at improving patient outcomes and supporting clinicians in navigating this challenging area of respiratory medicine. Our guests, Professor Lorcan McGarvey and Professor Brendan Canning—both internationally recognised leaders in respiratory medicine and cough research—share their expertise on the neurobiology of chronic cough, the substantial morbidity experienced by patients, and strategies for more effective diagnostic investigation. We also discuss current treatment options and promising therapies on the horizon, as chronic cough increasingly gains recognition as a disease in its own right rather than merely a symptom. Whether you are a clinician, researcher, or simply interested in advances in respiratory medicine, this episode offers valuable insights into a condition that is finally receiving the attention it deserves. -- Guests Professor Lorcan McGarvey Professor of Respiratory Medicine at the University of Belfast, with a focus on the neurobiology of cough. His research has significantly advanced understanding of cough hypersensitivity syndrome and contributed to the development of new therapeutic strategies. He is widely respected for his collaborative work and dedication to improving respiratory health. Professor Brendan Canning Distinguished researcher at Johns Hopkins University, specialising in the mechanisms of cough and airway diseases. His pioneering studies on neural pathways and receptor targets have helped pave the way for novel treatments in refractory chronic cough. He is recognised as a key figure in efforts to redefine chronic cough management. Hosts Dr Marissa O’Callaghan Irish-trained respiratory fellow currently undertaking a postdoctoral fellowship at Erasmus MC Rotterdam in the Netherlands. She completed her training in Respiratory and Internal Medicine, along with her PhD, in 2025. Her interests include interstitial and rare lung diseases, as well as clinical research, medical education, and innovation. She co-founded the ITS Podcast Series in June 2024 alongside Sandra Green. Dr Sandra Green Irish-trained respiratory fellow with a strong background in climate advocacy and multidisciplinary sustainability initiatives. She is co-founder of Irish Doctors for the Environment and completed an MSc in Leadership and Innovation in Healthcare at the Royal College of Surgeons in Ireland (2023–2025). Alongside Marissa O’Callaghan, she co-founded Irish Thoracic Society Podcast Productions in 2024 to share knowledge and innovation in respiratory care.

Breathwork: Alpha-1 Antitrypsin Deficiency: Insights from Professor Gerry McElvaney (Part 2)

This episode explores Alpha-1 Antitrypsin Deficiency, focusing on diagnosis, pathophysiology, and evolving treatments. Professor Gerry McElvaney discusses prevalence in Ireland, the impact on lung and liver disease, and why early detection significantly improves outcomes. Key topics include: Prevalence and genotypes (ZZ, MZ, SZ) Lung and liver disease, plus manifestations like panniculitis and vasculitis Diagnostic challenges: levels vs genotype/phenotype and need for multimodal testing Importance of early detection, smoking cessation, and targeted intervention Emerging therapies: RNA editing, gene silencing, and potential cures Screening strategies, including newborn screening and cost-benefit considerations Role of polymers in disease progression Gaps in treatment access and need for healthcare reform Professor Gerry McElvaney is a global leader in Alpha-1 research, founder of the Alpha-1 Foundation of Ireland, and Director of the Cystic Fibrosis Unit at Beaumont Hospital. His work has positioned Ireland at the forefront of Alpha-1 detection and research. Hosts: Dr Barry Harnedy – Respiratory trainee, Irish Thoracic Society Educational Officer Sandra Green – Respiratory fellow, co-founder of Irish Doctors for the Environment and ITS Podcast Productions Contact: edofficer@irishthoracicsociety.com Chapters (highlights): 00:05 Intro | 01:00 Vaping & inflammation | 02:00 Diagnosis pitfalls 03:20 Future therapies | 04:50 Screening importance | 07:00 Treatment advances 10:00 Genetics explained | 12:00 Smoking impact | 13:40 Newborn screening 16:00 Gene therapies | 17:30 Key takeaways Key message: Test comprehensively, detect early, intervene early, and remain optimistic about emerging therapies. References: Fraughen DD, et al. Am J Respir Crit Care Med. 2023;208:964–974. McElvaney NG, et al. Lancet Respir Med. 2017;5:51–60. Molloy K, et al. Am J Respir Crit Care Med. 2014;189:419–427. Franciosi AN, et al. Am J Respir Crit Care Med. 2020;202:73–82. Leacy EJ, et al. Am J Respir Crit Care Med. 2025;211:2408–2410. McElvaney OJ, et al. Med (N Y). 2022;3:233–248. Franciosi AN, et al. COPD. 2021;18:76–82.

Inspire: From Bench to Bedside: The Journey of Professor Gerry McElvaney in Alpha-1 Research (Part 1)

In this episode, we explore the remarkable career of Professor Gerry McElvaney, a world-leading figure in Alpha-1 antitrypsin deficiency research and translational medicine. Gerry shares his journey from clinical medicine to pioneering discovery science, revealing how curiosity, perseverance, and strategic thinking can drive real-world clinical breakthroughs. From building a research laboratory from scratch to establishing Ireland’s first national targeted detection programmes, Gerry reflects on the challenges of advocacy, diagnostics, and innovation. He discusses pioneering therapeutic development, lessons from high-profile research failures, and how unexpected influences—such as Dolly the sheep—shaped scientific understanding of protein therapies and treatment design. The conversation spans early detection, personalised medicine, gene editing, and the future of genetic lung disease, while also highlighting the human side of science: mentorship, multidisciplinary teamwork, patient-centred foundations, and the power of listening to clinical questions as the spark for transformative research. This episode is a masterclass in translational medicine—connecting bedside observations to laboratory discovery and back again—offering invaluable insight for clinicians, researchers, and early-career innovators. • Transition from clinical medicine to translational research • Establishing Ireland’s first Alpha-1 diagnostic and detection programmes • Advocacy with hospitals and government agencies • Lessons from gene therapy and research setbacks • Dolly the sheep and protein half-life discoveries • Funding strategies and research sustainability • Multidisciplinary team building • Patient foundations and community engagement • Future visions: early detection, AI, and gene editing • Translating ward-round questions into research breakthroughs Professor Gerry McElvaney is a world-renowned expert in Alpha-1 antitrypsin deficiency. He founded the Alpha-1 Foundation of Ireland and established Europe’s first national targeted detection programme. He is Director of the Cystic Fibrosis Unit at Beaumont Hospital, where his work spans cystic fibrosis, Alpha-1 antitrypsin deficiency, infection, and immunity. His leadership has transformed Ireland into a global hub for Alpha-1 research and patient care. Dr Barry Harnedy – Respiratory specialist trainee, digital innovation advocate, and current co-Educational Officer of the Irish Thoracic Society. Sandra Green – Irish-trained respiratory fellow, climate advocate, co-founder of Irish Doctors for the Environment, MSc in Leadership & Innovation in Healthcare at Royal College of Surgeons Ireland, and co-founder of Irish Thoracic Society Podcast Productions. 00:00 Welcome & introduction 05:46 National detection & screening journey 09:34 Dolly the sheep & protein research 12:30 Translational research in action 17:21 Gender differences in CF outcomes 27:05 Alpha-1 Foundation & community impact 30:30 Future visions: AI & gene editing 33:23 Advice for early-career clinicians