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Research at the University of Manchester (UoM) has changed the landscape of medical care and research in fungal infections internationally. The impacts include: the world's first commercialised molecular diagnostic products for aspergillosis and Pneumocystis pneumonia (£10m investment); pivotal contributions to the preclinical development (£35m investment), clinical developments and registrations of 3 new antifungals with combined market share of ~$2 billion; one (voriconazole, 2012 sales >$750m worldwide) now first line therapy for invasive aspergillosis with improved survival of 15-20%; and internationally validated methods to detect azole resistance in Aspergillus (an emerging problem partly related to environmental spraying of azole fungicides for crop protection).
Falls are a common (30-40% >65 year olds fall each year) and important age-related health problem costing the NHS and social care >£5.6m each day. University of Manchester research has contributed to reducing the burden of falls worldwide.
We demonstrated that falls are better predictors of fracture than bone mineral density. We developed an effective intervention, reducing falls amongst older people by 30%; identified barriers to service use, and approaches to increasing uptake and adherence; and developed a fear of falling instrument (FES-I), now translated into 30+ languages and widely used in clinical practice.
By 2012, 54% NHS Trusts used training programmes based on our research. It moulded service provision nationally and internationally, changing the emphasis of how falls prevention services are presented, from "reducing risk" to "improving/maintaining independence".
15m people have a stroke each year worldwide. In England alone, stroke generates direct care costs of £3bn and a wider economic burden of £8bn. Service users report high levels of unmet need in relation to cognitive dysfunction (e.g. concentration). Improving cognition was the number one priority agreed by users and providers (James Lind Alliance, Lancet Neurology 2012). Research led by the University of Manchester (UoM) underpins recommendations in several recent clinical guidelines for stroke management and rehabilitation in the UK and internationally. Our 2012 aphasia trial and qualitative study made key contributions to the recommendations in the recent NICE (2013) and Intercollegiate Stroke Working Party (2012) guidelines. UoM-led Cochrane reviews (e.g., neglect, apraxia, perception) have directly influenced recommendations in guidelines produced by the Scottish Intercollegiate Guidelines Network, the European Stroke Organization and the Australian National Stroke Foundation.
40% of all cancer patients, who are cured of their disease, receive radiotherapy as part of their treatment. The number of cancer cures could be increased if the application of radiotherapy could be improved. Research at the University of Manchester (UoM) has: led the way in identifying, validating and exemplifying the value of predictive/prognostic biomarkers of response to radiotherapy; and demonstrated, in clinical trials, the therapeutic efficacy of combining molecularly targeted agents with radiotherapy. Further, the pharmaceutical industry has incorporated these concepts into drug development programs, accelerating clinical drug development, and thus saving them time and money.
Although, by definition, individually rare, the cumulative burden of `rare disease' is significant, with as many as 3m affected individuals in the UK. The University of Manchester (UoM) has an exceptional record in rare disease gene identification, with 29 such genes defined since 1993. This research paved the way for clinical diagnostic testing for patients and their families, demonstrating the immediate translational impact of gene discovery. The research has resulted in a reduced diagnostic burden for patients and health services and has enabled the provision of more effective counselling. Testing for genes identified at UoM is now offered in more than 140 laboratories in more than 30 countries worldwide. More than 1,100 patients have been tested for mutations in TCOF1, BEST1, IRF6, SAMHD1 and C9ORF72 in UK NHS laboratories alone.
Extensible fibrillin-rich microfibrils support elastic fibres that endow tissues with elastic recoil. We showed that microfibrils are degraded in photodamaged skin, causing loss of elasticity and wrinkling. We developed a rapid in vivo assay, `The Manchester Patch Test Assay', which predicts the potential of anti-ageing products to restore microfibrils in photoaged skin. The assay was used to demonstrate the efficacy of a Boots Healthcare anti-ageing product, showcased on BBC Horizon in 2007. Impacts include: dramatically increased sales for Boots, investment and changes to product development strategies of international personal care companies, who now use `The Manchester Patch Test Assay' to support product claims.
People who develop psychosis (1% of population) typically experience lengthy delays (months to years) before treatment. Researchers at the University of Manchester (UoM) established a concrete and significant association between delay in treatment of the first episode of psychosis and outcome. We demonstrated that outcome of psychosis could be improved considerably if these lengthy delays were reduced. This research influenced policy and practice in the UK and abroad. Policy changes included the establishment of early psychosis teams dedicated to early detection and treatment (50 in England alone). Practice changes included amendments to clinical guidelines in the UK and abroad that now require clinicians to respond urgently to a first episode of psychosis. These changes to clinical practice have increased the proportion of patients with a short DUP from 55.6 to 77.4%.
One in ~1,000 children has significant short stature that needs medical evaluation, one in ~4,000 has growth hormone deficiency and one in ~≥10,000 has a genetic growth disorder. Research at the University of Manchester (UoM) has impacted on clinicians worldwide who manage growth disorders. UoM researchers have: characterised growth disorder phenotypes to ensure the right tests are used for the right child and verified the accuracy of diagnostic biochemical tests; discovered new genes associated with a primordial growth disorder and introduced new molecular diagnostic tests for international use; and generated clinical practice guidelines adopted by the worldwide paediatric endocrine community.
Schizophrenia affects 1 in 100 people, with costs to society of £12 billion in England alone. Prevalence is similar across the world, with two thirds of people experiencing relapses despite medical treatment. Researchers at the University of Manchester (UoM) pioneered and disseminated psychological interventions for schizophrenia and related mental health problems which have led to improved outcomes for patients and families (e.g. 20% improvement in symptoms over standard treatment). We have implemented and delivered our intervention protocols, outcome measures, treatment manuals, and training programmes (with over 200 training courses delivered across the UK, Europe, USA, Asia, Australia and Africa). The impact of the research has been commended nationally and internationally by professional bodies (e.g., British Psychological Society, American Association of Behavior Therapy).
The need to manage, analyse and interpret the volumes of data and literature generated by modern high-throughput biology has become a major barrier to progress. Research at the University of Manchester on interoperability and advanced interfaces has resulted in innovative software (Utopia Documents) that links biomedical data with scientific literature. The software has been adopted by international publishing houses (Portland Press, Elsevier, Springer, etc.), allowing them to explore new business models, and by pharmaceutical companies (e.g. AstraZeneca, Roche), providing new opportunities to explore more efficient, cost-effective methods for exploiting and sharing in-house data and knowledge. The research also led to a spin-out company, Lost Island Labs, in 2012, which expects a profit [text removed for publication] in its first year.