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
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
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