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Impact: Changed public health policy by quantifying the level of asymptomatic vCJD infection in the population and the mechanism of its transmission, and by identifying cases of human-human transmission of vCJD via blood products.
Significance: UoE work informed the public and policy-makers of the risk of vCJD transmission, which resulted in policy changes and the implementation of precautions to prevent vCJD transmission and to limit the chance of a self-sustaining blood- or tissue-contamination-related secondary epidemic.
Beneficiaries: Patients, the NHS and healthcare delivery organisations, government, policy-makers.
Attribution: The work was carried out at UoE in the National Creutzfeldt-Jakob Disease Research and Surveillance Unit (NCJDRSU) and the Roslin Institute UoE (Roslin) with UK collaborators.
Reach: International, particularly UK and North America.
Research led by Dr Watson has demonstrated that chronic pancreatitis (CP) is more common and clinically significant in dogs than veterinary surgeons previously recognised, with strong breed predispositions. Prior to this work, the veterinary profession believed that dogs had a single attack of acute pancreatitis which did not result in the development of exocrine pancreatic insufficiency (EPI) and/or endocrine insufficiency (diabetes mellitus (DM)). The work by Watson has shown the importance of chronic disease and has altered the long term treatment of affected dogs across the profession. It has also prompted companies in the UK, Europe and the USA to increase their focus on low-fat dietary management, pancreatic enzyme supplementation and analgesia improving the quality of life of affected dogs.
Invasive pulmonary aspergillosis (IPA) is a frequently fatal disease of haematological malignancy patients, caused by fungi from the genus Aspergillus. Dr Christopher Thornton has developed and commercialised a novel point-of-care test for the diagnosis of IPA with an Aspergillus-specific monoclonal antibody (mAb) JF5 generated using hybridoma technology. Using this mAb, he has developed a lateral-flow device (LFD) for the rapid detection of Aspergillus antigen in human serum and bronchoalveolar lavage fluids (BALf) that signifies active infection. Commercial exploitation of the patented technology has been met through the establishment of a University of Exeter spin-out company, Isca Diagnostics Limited.
Meningococcal meningitis is a life-threatening acute disease affecting 1.2 million people every year. Accurate and rapid diagnosis is essential for optimal patient response; however, bacterial culture tests are slow and undermined by the immediate administration of antibiotics, resulting in sterile cultures.
The Surrey team developed a rapid, non-culture-based diagnostic test for meningitis and septicaemia: this test is now routinely used for diagnosis of meningococcal disease worldwide, and was also instrumental in the implementation and monitoring of control measures for the disease, such as life-saving vaccination campaigns. Together these have contributed to the halving of adult mortality rates from meningitis worldwide.
The MRC Prion Unit was established at UCL in 1998 to address national public health issues posed by bovine spongiform encephalopathy (BSE) and variant Creutzfeldt-Jakob disease (vCJD). One of our key strategic priorities has been to create a validated blood test for vCJD in order to protect public health through the screening of donated blood and organs for transplantation. The blood test we have developed has been demonstrated to detect infection in over 70% of patients with vCJD with, to date, 100% specificity and is now in use at the National Prion Clinic for evaluation.
Meningococcal disease (MCD) is a major cause of morbidity and mortality worldwide. Underpinning research by Dr Carrol and colleagues at the University of Liverpool (1997-1999), has led to improved diagnosis and case confirmation, establishing Polymerase Chain Reaction (PCR) of meningococcal DNA as a gold standard test for diagnosis. The result is better management and therefore, impact on health and welfare of patients, and on practitioners. The work was conducted in collaboration with the Meningococcal Reference Unit, which provides a national diagnosis and surveillance service. The test was recommended in NICE guidelines in 2010, thereby impacting public policy.
Research at the University of Liverpool (UoL) has demonstrated the importance of intestinal tapeworm infection as an important and hitherto unrecognised risk factor for a major life-threatening acute intestinal disease (colic) in the horse. A novel serological test for exposure to the tapeworm infection was developed at UoL to provide a diagnostic tool for research and clinical applications. As a result, "best practice" equine preventive healthcare programmes now include anti-helminth and tapeworm control protocols and anti-tapeworm anthelmintics are licensed for use in the horse and marketed throughout the world. This research has had a major impact on equine health resulting in welfare and economic benefits for horses, their owners, veterinary practices and industry.
Our biomarker research and underpinning technologies have commercially impacted upon the global R&D strategies of Unilever, Philips and Mars, realising new market areas for them, resulting in several million GBP invested in related R&D as well as "claim support" for products both in development and already available on shelves. Unilever have adopted biomarker outcomes as endpoints in clinical trials of new products, and Philips and Mars are developing with us saliva-based near-patient diagnostic tests for the human and small animal markets. We have also spun out two SME's: A) Oral Health Innovations (OHI) Ltd has developed online risk and disease analysis software for oral conditions, which was piloted, adopted and launched by Denplan, the UKs largest dental capitation plan operator (accessing 6500 dentists and 1.8 million patients), at the 2013 annual British Dental Association conference; and B) GFC Diagnostics makes SmokeScreen™ a non-invasive, sensitive and objective saliva test developed from our biomarker research at Birmingham University. Both technologies have already provided demonstrable social and commercial impact and given their uptake to date, will also deliver economic, environmental and health impacts.
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.
Impact: Health and welfare; policy and guidelines. Anderson and colleagues demonstrated that cryopreservation of ovarian tissue could be used for preservation of fertility following cancer therapy. This step-change has been incorporated into guideline documents internationally and has been adopted into clinical practice world-wide.
Significance: Ovarian tissue has been preserved from many hundreds of women; this is now translating into a growing number of babies born worldwide (currently 24 in nine countries).
Beneficiaries: Women at risk of fertility loss including pre-pubertal girls newly diagnosed with cancer; clinicians; the NHS and healthcare delivery organisations.
Attribution: The underpinning research was performed entirely at UoE.
Reach: Worldwide: UK, Europe, US, Australia.