Respiratory Medicine is centred around two research units; the Respiratory Medicine Unit (RMU), led by Professor Ian Pavord and managed by Samantha Thulborn and The Oxford Respiratory Trials Unit (ORTU), led by Professor Najib Rahman and managed by Melissa Dobson.
Additional areas of interest Idiopathic Pulmonary Fibrosis / interstitial lung disease headed by Ling-pei Ho and based at the WIMM and Obstructive Sleep Apnoea headed by John Stradling based at the Churchill Hospital.
Over the last 20 years treatment guidelines for common respiratory conditions including COPD and asthma have encouraged generic one-size-fits-all treatment. We believe that this leads to poor targeting of treatment, underestimation of potential treatment effects, and unnecessary treatment associated cost and toxicity. Our overall vision is to develop a new, mechanism-based classification of common respiratory diseases to allow more accurate assessment and more focused and effective treatments.
The Respiratory Medicine Unit (RMU) is a specialist centre based at the John Radcliffe Hospital which focuses on COPD and asthma research. In previous research we have shown that eosinophilic airway inflammation is a readily identifiable and important treatable feature in patients with severe asthma and COPD, and that specific inhibition of this process with mepolizumab is associated with important clinical benefits in patients with this type of airway inflammation. Subsequent studies led by the theme leader have shown that, in patients with a highly eosinophilic profile, mepolizumab given in addition to standard care is associated with an 80% reduction in the frequency of asthma attacks and large improvements in lung function, symptoms and quality of life. Mepolizumab was approved for use in severe eosinophilic asthma in 2015 and is the first new class of treatment for asthma for 20 years. This work has been the catalyst for the successful clinical development of six other medicines targeting eosinophilic inflammation in airways disease.
Following the approach used in this successful case study this subtheme aims to further investigate established mechanistic pathways of airway disease by:
- Investigating the key driving factors responsible for dysregulated IL-5 production in the airways of a subgroup of patients with severe eosinophilic airway disease and to determine novel ways to inhibit this process.
- Investigating the use of the blood eosinophil count as a means of stratifying patients with acute wheezing illness for targeted treatment with oral corticosteroids and biological agents.
- Developing novel and specific methods to identify and treat persistent airway infection with the bacterium Haemophilus influenza, which we have shown to be the most important potentially treatable aspect in patients with non-eosinophilic airway disease.
- Testing the hypothesis that deficiency of a recently discovered airway epithelial damping mechanism is a key driving factor in the development of asthma.
The Oxford Respiratory Trials Unit (ORTU) is a specialist centre based at the Churchill Hospital which has expertise in the design, set-up, management, delivery and reporting of clinical trials and studies in respiratory disease, including multicentre studies and of all phases. ORTU is one of the few Clinical Trials Units in the UK specialising in respiratory research. The Unit runs both national and international trials related to our own work, commercial and academic studies, and support trials led by other teams.
The work within the ORTU is funded by various agencies including the National Institute for Health Research (NIHR), the Medical Research Council, National Cancer Research Institute and the British Heart Foundation. The Unit coordinates the Respiratory Specialty Interest Group of the Thames Valley and South Midlands Local Research Network. ORTU's portfolio of studies currently include the following disease areas: asthma; chronic cough; COPD; cystic fibrosis; idiopathic pulmonary fibrosis (IPF)/ interstitial lung disease (ILD); novel imaging and physiological techniques in respiratory disease; obstructive sleep apnoea; and pleural disease, including malignant pleural effusion, mesothelioma, pleural infection and pneumothorax.
The ORTU and RMU are members of the NIHR Translational Research Partnership.