MRCP, MRCP, MRCP, MRCP
I work in the Department of Respiratory Medicine within the Nuffield Department of Medicine as a Senior Clinical Researcher in the field of Airways Disease, particularly chronic obstructive pulmonary disease (COPD). My research interests are investigating the mechanisms and therapeutic strategies aligned to using phenotypes of COPD and in particular during exacerbations. Broadly there are two inflammatory phenotypes of COPD that are identified by measurements of inflammation in the airway; eosinophilic and neutrophilic. These phenotypes are clinically indistinguishable but have different treatment responses. Initially working with sputum we have identified that during exacerbations of COPD approximately 30% have eosinophilic inflammation. The peripheral blood eosinophil count is an excellent surrogate of eosinophilic airway inflammation in COPD and can identify sub-groups of patients that respond to corticosteroid therapy and those patients that have increased harm. The majority of COPD patients with neutrophilic inflammation were found to have increased detection levels of bacteria namely H. influenzae. These phenotypes have different treatment responsive disease, but little is known about the basic mechanisms of these COPD disease phenotypes, despite clinical similarities.
My ongoing research focus will be to develop a further understanding of the pathophysiology of COPD as determined by these identified clinical phenotypes and to deliver therapeutic strategies to patients working across the translational spectrum of this important airway disease. As part of my fellowship, I will seek to characterise patients with milder COPD disease and utilise near-patient point of care testing to provide improved stratified medicine personalised care with an aim of the right patient receiving the right treatment at the right time.
Reduced risk of clinically important deteriorations by ICS in COPD is eosinophil dependent: a pooled post-hoc analysis
Bafadhel M. et al, (2020), Respiratory Research, 21
Chronic obstructive pulmonary disease: management of chronic disease
Ramakrishnan S. et al, (2020), Medicine, 48, 333 - 336
Blood Eosinophil Counts in Clinical Trials for Chronic Obstructive Pulmonary Disease
Singh D. et al, (2020), American Journal of Respiratory and Critical Care Medicine
The CICERO (Collaboration In COPD ExaceRbatiOns) Clinical Research Collaboration.
Janssens W. et al, (2020), The European respiratory journal, 55
An expert consensus framework for asthma remission as a treatment goal.
Menzies-Gow A. et al, (2020), The Journal of allergy and clinical immunology, 145, 757 - 765