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A research team, led by Professor John Robertson, was joined by Professor Herb Sewell as lead collaborator. They developed a blood test that permitted early detection of lung cancer in high risk patients, allowing earlier and more successful treatment. The EarlyCDT-Lung test was commercialised by the university spin-out, Oncimmune, and launched in 2010. It is in clinical use in North and South America, in private clinics in the UK and in some Middle East countries, generating employment and revenues for the company, and is starting to bring mortality and lifestyle benefits to patients and their families.
Research from the University of Nottingham on aminoglycoside antibiotics in cystic fibrosis (CF) has changed clinical practice and improved patient safety internationally. There are over 70,000 people with CF worldwide. Most require frequent and prolonged intravenous courses of aminoglycoside antibiotics (which can cause kidney damage) to treat chronic lung infection with Pseudomonas aeruginosa. This infection may lead to respiratory failure and death. Our research has influenced national and international guidelines, and changed practice, such that once-daily aminoglycosides (less toxic to the kidneys) are now used. We have also stopped the use of gentamicin, in favour of less toxic aminoglycosides.
Research directed by Professor John Robertson at The University of Nottingham led to the launch, in 2009, of the world's first autoantibody blood test for the detection of early-stage lung cancer. The EarlyCDT-Lung test has been commercialised through the spin-out company Oncimmune. [text removed for publication]. EarlyCDT-Lung is now used clinically in North and South America, the UK and the Middle East, generating revenue and saving lives.
New therapies supported by clear evidence from clinical trials have resulted in outstanding improvements in survival and quality of life for people living with cystic fibrosis (CF). Elborn's clinical trials group has delivered a programme of crucial clinical trials which has impacted on clinical practice in CF. From 2009-2012 Elborn co-led a pivotal multicentre trial using Ivacaftor (Kalydeco TM), a transformative new drug which represents a paradigm shift as the first approved therapy that corrects the basic defect in CF. This therapy is an exemplar of personalised medicine and is prescribed for patients with the specific gene mutation in which this drug works.
Systemic sclerosis (SSc) is an important, but uncommon, connective tissue disease with high mortality and has a major non-lethal morbidity. Research at UCL has been instrumental in defining modern management of SSc and has contributed in three main ways. First we have defined the importance of regular proactive screening of cases, secondly we have defined the use of immunosuppression and thirdly we have delineated important clinical and laboratory subsets of SSc that underpin an individualised (or personalised) approach to assessment and treatment. These topics exemplify stepwise progress in management of SSc that also has direct relevance to other more common medical conditions.
Professor Dieter Wolke has led several research programmes that delineate the long-term health effects of prenatal exposure to stress and moderate/late preterm, very preterm, and extremely preterm birth. His research has had a direct impact on international medical guidelines and educational recommendations for babies born preterm. The research has also informed European political debate (via a White Paper for the European parliament) on healthcare policy related to after care for preterm or sick children; has influenced UK policy regarding the education of children born preterm; and has contributed to public and practitioner understanding through media items issued, for example, by the NHS and the Royal College of Obstetricians and Gynaecologists.
Corticosteroids are the traditional mainstay of treatment for inflammatory conditions but their side effects are often severe, especially in children. Professor MacDonald's team researched alternatives to corticosteroids in childhood Crohn's disease. With Nestlé they developed a polymeric, milk-based formula feed (Modulen IBD) that was highly effective in inducing clinical remission. NICE guidance have changed to reflect these findings. The treatment is now first-line therapy for childhood Crohn's in UK and the rest of Europe and recommended in clinical guidelines in USA. We estimate that across Europe alone, 13,000 new cases of childhood Crohn's annually will be spared steroid therapy as a result of this work.
Research led by Professor Shields and colleagues at Queen's University Belfast has resulted in changes in the treatment of children with cough and wheezing disorders and has been a major contributor to International Asthma and Cough Guideline statements.
Wheezing affects up to one third of children. Research studies that demonstrated that viral induced wheezing (VIW) or isolated cough were not associated with persistent airway inflammation led to a change in recommendations for anti-asthma therapy, such that the use of high dose inhaled corticosteroids (ICS) was no longer recommended in such cases. Furthermore, the dangers of very high dose ICS were better recognized and the upper recommended dose of steroids for use in treatment of classical childhood asthma was reduced accordingly.
pGALS (paediatric Gait, Arms, Legs, Spine) is a quick, accurate and child-friendly examination technique that identifies children who need to be referred to a paediatric rheumatology specialist. pGALS has been widely disseminated since 2008 and integrated into both undergraduate medical student teaching and the membership examination for the Royal College of Paediatrics and Child Health. pGALS was developed by Newcastle researchers in response to their findings of a self-reported lack of confidence among clinicians when conducting musculoskeletal examinations of children. Research also showed that delays and inappropriate investigations were being conducted before the child was referred to a specialist. pGALS is now taught in at least 15 of the 32 medical schools in the UK and has been described in a number of leading textbooks. It is becoming known and used worldwide, adapted for local cultural and social contexts.
Research at the University of Nottingham has defined the clinical phenotype and management of lymphangioleiomyomatosis, a rare and often fatal multisystem disease affecting 1 in 200,000 women worldwide. The group has led the development and evaluation of new therapies and diagnostic strategies which are now part of routine clinical care. The research has underpinned the transformation of this previously under recognised and untreatable disease into a condition recognised by respiratory physicians, with international clinical guidelines, patient registries, clinical trials, specific treatments and a UK specialist clinical service.