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This study aims to determine whether the small airways, a site of physiological dysfunction in asthma, can be targeted with bronchodilator therapy, by using a small particle size aerosol that reaches the lung periphery. Current clinical management of patients with asthma includes an array of inhaled therapies. However, there is no consensus relating to the efficacy of different particle sizes for inhalation, despite particle size being the main determinant of where the drug deposits in the airway. Participants with asthma will be invited to participate in two study visits. Both study visits will involve physiological assessments (lung function tests) and ventilation scans completed at baseline and post-bronchodilator. At one visit the standard medication salbutamol will be administered via a conventional vibrating mesh nebuliser (Aerogen solo), at the other visit the salbutamol will be administered via the Aerogen PDAP which will create a fine particle aerosol. The aim is 2 recruit and test 30 participants and compare their response to small and large particle bronchodilator.

This research study is looking at whether the oral supplement TRU NIAGEN®, a form of Vitamin B, can increase the levels of the molecule NAD+ in the blood and heart muscle. NAD+ is essential for energy production in the human body. Research has shown decreased NAD+ levels in the heart muscle of patients with a condition of heart failure known as heart failure with preserved ejection fraction (HFpEF) or stiff heart failure. TRU NIAGEN® has been shown to increase the level of NAD+ in the blood, however whether it can increase NAD+ in the heart muscle is unknown. Replenishing NAD+ in the heart could be beneficial to HFpEF patients and/ or patients whose hearts don’t relax properly. The aim of the study is to see whether taking the oral supplement TRU NIAGEN® for three months can improve your heart function, exercise tolerance, glucose tolerance, and blood pressure.