People & Patients
This strategy to link groups is prioritised in 3 areas. Cohort development, clinical trials and training.
1. Cohort Development
Cohort studies were originally anchored in IBD, but have now broadened to incorporate the other diseases indicated above, now totalling several thousand patients. Funding from the CRUK cancer centre in particular and through the BRC has been committed to biobanking. The ethical framework which supports this is led by Simon Leedham and supported by an exceptional team of Biobankers.. Overall we are committed to an ethos that the TGLU creates and maintains the cohorts and sampling framework for investigator led studies, with a single oversight committee and maximising accessibility within a robust (and sustainable) framework. We are very keen to maintain patient input and engagement (PPIE) in this cohort structure through patient representatives.
2. Clinical Trials
This is an important aspect of the work since the time of Sidney Truelove. We have well functioning trials units for hepatology trials and gastroenterology trials with key studies across a range of diseases.
3. Training
An emphasis on training is very important and despite the very many changes in the funding landscape for clinical fellows, we aim to provide a range of opportunities for local clinical trainees to do a PhD/MD with us. We also aim to train the very best basic/translational scientists, and having a good balance of clinicians and basic scientists at the lab meetings is a real bonus of the current unit set up – in fact breaking down these barriers is a priority as is breaking down barriers between specialties. We have strong links not only with the Peter Medawar Building for the virology work, but also with the Kennedy Institute, where Fiona Powrie is leading a broader set of studies on tissue inflammation, WIMM, which also includes work on skin, Respiratory medicine, with whom we share space at the JR and with the Centre for Human Genetics, led by Holm Uhlig. The TGLU is now a very important beacon for tissue-based, patient-centred immunology studies locally and we do aim to maintain this and train future translational scientists in this approach.
We currently 4 clinical lecturers supported across the unit, Tarun Gupta (luminal gastroenterology/IBD), Tamsin Cargill (hepatology), Laween Meran (IBD/Gastro) and also Ali Amini (from an ID background), and two Wellcome Career Development Award recipients, Nick Provine and Matthias Friedrich (a highly competitive scheme, and hopefully the first of many such fellows).
2. Cancer development and therapy
Cancer pathogenesis: Simon Leedham is focused in this area, defining molecular pathways that link regeneration and cancer, has a major CRUK funding and leads the key GI cancer cohorts and biobank so this is a clear priority. Ellie Barnes also has a CRUK funding (DELIVER) to look at HCC risk in the liver and early detection, which is an emerging area of interest in collaboration with oncology and clearly an issue for the future as this disease increases. Work on advanced imaging by Michael Pavlides also supports this aim.
Endoscopic surveillance of colonic (James East), gastric (Jan Bornschein) and oesophageal (Elizabeth Bird-Lieberman, Adam Bailey) precancer remains a key focus for Oxford academic endoscopists, with advanced imaging and machine learning innovation undertaken in collaboration with Jens Rittscher.
Gastro-intestinal cancers are at the heart of the Oxford Cancer Centre strategy and the TGLU biobank cohort provides research substrate for a wide range of cancer researchers across the university.
Impact of checkpoint inhibitors: Better integration with cancer also includes support for studies of Oliver Brain in Checkpoint Colitis. His initial paper in this area is a great starting point for future studies and the link between anti-cancer effects and tissue side-effects is being explored. A new joint CRUK programme grant with Ben Fairfax has cemented collaborations around this set of studies.
