Research Strengths within Adult Respiratory Medicine

1
Research Strengths within Adult Respiratory
Medicine

• Mike Morgan
• University Hospitals of Leicester

2
Research networks and respiratory disease

• Common problem
• No National Strategy
• No topic specific network
• Historically poor research funding (reasons)
• No local pedigree
• No local HEFCE funding
• All academic activity NHS funded

3
The spectrum of Adult lung disease
Asthma
Lung cancer Mesothelioma
TB
Chronic cough
COPD
Pneumonia Sleep apnoea Respiratory
failure Paediatric lung disease
Bronchiectasis
Interstitial lung disease
4
The spectrum of adult lung disease
5.2 million sufferers in the UK (1.1 million
children)
Asthma
Lung cancer Mesothelioma
TB
Chronic cough
COPD
Pneumonia Sleep apnoea Respiratory
failure Paediatric lung disease
Bronchiectasis
Interstitial lung disease
5
The spectrum of adult lung disease
Asthma
Lung cancer Mesothelioma
3.7 million affected in UK 1 million
symptomatic 30,000 deaths 1 million hospital
inpatient days/annum 89 population unaware
TB
Chronic cough
COPD
Pneumonia Sleep apnoea Respiratory
failure Paediatric lung disease
Bronchiectasis
Interstitial lung disease
6
The spectrum of adult lung disease
Asthma
Lung cancer Mesothelioma
TB
Chronic cough
COPD
Pneumonia Sleep apnoea Respiratory
failure Paediatric lung disease
Bronchiectasis
Interstitial lung disease
7
Research groupings

• Pathogenesis of asthma
• Prof A Wardlaw
• Prof P Bradding
• Airway inflammation
• Prof I Pavord
• Prof C Brightling
• Chronic cough
• Prof I Pavord
• Prof C Brightling
• COPD
• Profs Pavord, Brightling, Morgan Dr M Steiner
• Pulmonary Rehabilitation
• Prof M Morgan, Prof S Singh, Dr M Steiner
• Lung cancer and Mesothelioma
• Mr D Waller Dr M Peake

8
Publications, Impact and funding record

• Publications in the last ten years gt300
• 3 NEJM, 3 FASEB,7 Lancet
• 16 Am J Respir Crit Care Med, 16 Chest,58 Thorax
• Impact
• NICE, BTS, ATS/ERS Guidelines
• NSF development
• Funding
• MRC, Wellcome, EU Framework 7, BLF, Asthma UK
• CLAHRC
• Commercial trials
• gt50 since 1993

9
N Engl J Med 20023461699-705.
10
(No Transcript)
11
(No Transcript)
12
Randomised Controlled Trial of Dietary Creatine
as an Adjunct Therapy to Physical Training in
COPD Deacon SJ, Vincent EE, Greenhaff PL, Fox J,
Steiner MC, Singh SJ, Morgan MD. Am J Respir
Crit Care Med. 2008 Apr 17 Epub ahead of print
13
Molecular Approaches to Reversing Skeletal Muscle
Wasting in COPD. The Role of Resistance Training
and Protein Supplementation.
MRC experimental medicine research grant 750,000
Muscle gene and protein expression Muscle
function and mass Whole body exercise Circulating
inflammatory cytokines
14
Pulmonary rehabilitation in chronic heart failure
15
(No Transcript)
16
Back to the future or déjà vu?

• Uphill Struggle
• Bureaucratic obstacles
• Unattractive to trainees
• Innovation stifled
• Focus on laboratory and cyber research
• Movement away from translational or clinical
  research
• Success judged by income rather than output.

• NIHR Comprehensive research network aims
• Enable participation by all healthcare
  professionals and patients
• Remove the barriers
• Streamline and assist administrative processes
• Strengthen collaborations with industry
• Integrate health research and patient care

17
COPD political awakening and new research
priorities