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Background

Patients in the UK have amongst the worst asthma outcomes in developed countries and non-malignant respiratory conditions are responsible for 62 million prescriptions, 1 million admissions and costs of £6.6 billion per year. Asthma, COPD and pneumonia are the main cause of the winter bed squeeze that blights the NHS. Idiopathic pulmonary fibrosis (IPF) is a distinctive and progressive fibrotic disease of the lungs with exceptionally severe prognosis and a median survival of 3-5 years from diagnosis. Pleural infection has a mortality of 20% and average hospital stay of 2 weeks. Respiratory disease are the third most common cause of death. Unlike many other chronic health conditions, key outcomes for these conditions have not improved over the last 10 years, and, until recently, there have been few genuine therapeutic advances.

The view of the Oxford Respiratory BRC is that progress has been slow and outcomes have stalled because treatment guidelines have encouraged generic one-size-fits-all treatment. This has led to poor targeting of treatment. Our overall vision is to develop a new, mechanism-based stratification to allow more accurate assessment and more effective treatments.

How will we do this?

  • We have shown that dysregulated IL-5 production in the airway is of central  importance in a subgroup of patients with severe eosinophilic airway disease. We will investigate the key driving factor and novel ways to inhibit this process.
  • We have shown that persistent airway infection with a bacteria called Haemophilus influenza. is the most important potentially treatable aspect in patients with non-eosinophilic airway disease. We will develop novel and specific methods to identify and treat it.
  • Investigate new immunological, imaging and physiological biomarkers of mechanisms known to be important drivers of the diseases discussed above.
  • Investigate the mechanisms and pathways responsible for pneumonia and progression to empyema.