Translational research comprises two components, both of which are addressed by the Translational Research Unit in the Centre for Primary Care and Public Health, led by Prof Chris Griffiths.
"Bench to community translation" (T1 research) is covered by the MRC Asthma UK Centre’s component of the Unit, while "implementation research" (T2 research ) is covered by the Complex Interventions for Chronic Conditions group.
T1 research (bench to community translation)
MRC Asthma UK Centre in Allergic Mechanisms of Asthma Translational Research Unit
Infection and Immunity Programme, led by Dr Adrian Martineau and Professor Chris Griffiths
Translational Aspects of Genetics, led by Professor Robert Walton
Environment and respiratory health, led by Professor Chris Griffiths
Life course and respiratory health, led by Professor Seif Shaheen
T2 research (implementation research)
Infection and immunity
The Infection and Immunity group has expanded rapidly. Vitamin D is the subject of a number of our studies. Asthma UK funded a collaborative trial with Professor Hawrylowicz (MRC Asthma UK Centre) testing whether calcitriol, the active form of vitamin D, can reverse corticosteroid resistance in severe asthma. This trial is underway and led by Dr Alex Nanzer. In a further collaboration with researchers at the MRC Asthma UK Centre, is leading a £2m NIHR Programme Grant (OViD) examining the effects of vitamin D supplementation on respiratory infections. This five year programme includes three large randomised trials, a qualitative study, meta-analysis and policy work.
Tuberculosis was treated with Vitamin D in the pre-antibiotic era, but its potential was never tested in a controlled study. With a grant from the British Lung Foundation we are testing its effects in patients with active pulmonary tuberculosis. The trial (ADJUvit, led by ) is now complete and analysis begun. Following on from our work on TB screening in primary care, we are collaborators in a major Health Technology Assessment programme grant, led by the Health Protection Agency. We will set up a large cohort of migrants and TB contacts to compare the predictive value of tuberculin skin testing with new interferon gamma release assays.
HIV screening is now being promoted in primary care. With funding from City and Hackney PCT we will establish a trial testing the introduction of rapid, point of care HIV testing in general practices. Other infection work includes piloting screening for Strongyloides infection in Tower Hamlets (led by Dr Mike Brown of the London School of Hygiene and Tropical Medicine), screening for hepatitis infection in Newham practices, led by Professor Graham Foster, and a collaborative multicentre trial testing the effect of montelukast to prevent episodes of wheeze in pre-school children, led by Professor Jonathan Grigg and funded by NIHR Efficacy and Mechanisms programme.
Translational aspects of genetics
Prof Robert Walton
The Translational Aspects of Genetics Unit is led by Professor Robert Walton and is a nascent group. Work examining gene environment interactions relating to the effects of pollution on children’s health are already underway. Personalised medicine – tailoring treatments to individuals based on their genetic makeup – will be a focus of the groups’ work, with initial applications for funding underway to set up trials of tailored dosing of nicotine replacement therapy for smoking cessation.
Environment and respiratory health
London experiences some of the worst traffic pollution in Europe, with emissions breaching EU regulations. The introduction of the Low Emission Zone by the Mayor of London provides the setting for a unique experiment to test whether reductions in emissions can improve respiratory health in children. The EXHALE programme is funded by a Biomedical Research Centre programme grant. Additional funding is provided by City and Hackney PCT and a generous personal donation from Mr H Lee via the MRC Asthma UK Centre. We have completed the first of a series of annual cross-sectional assessments of respiratory health in 8 year old children in Tower Hamlets and Hackney Schools. One especially rewarding aspect of this work is the active engagement in science of children during the schools visits.
Life course and respiratory health
This collaborative programme of epidemiological research is focused on understanding how environmental exposures such as diet and analgesic use, across the life course, influence the development and severity of asthma and chronic obstructive pulmonary disease (COPD).
There are two main strands:
- Investigating the early life origins of childhood respiratory and atopic disorders, especially asthma. Much of this work, in collaboration with colleagues at Bristol University, involves analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) [http://www.bristol.ac.uk/alspac/]. Genetic epidemiology (exploring gene-environment interactions and using a Mendelian randomisation approach) is being used to strengthen causal inference.
- Investigating the relation between exposures across the life course and the development of impaired adult lung function and chronic obstructive pulmonary disease (COPD), in collaboration with colleagues at Southampton University (using data from the Hertfordshire Cohort Study [http://www.mrc.soton.ac.uk/herts/]), and colleagues at University College London (using data from the National Survey of Health and Development [http://www.nshd.mrc.ac.uk/nshd/]).
New collaborations with colleagues in Sweden (Karolinska Institute, Stockholm) and Norway (Institute of Public Health, Oslo) recently got underway.
Complex Interventions for Chronic Conditions
We are interested in complex, principally non-pharmacological interventions for serious, chronic, disabling conditions - particularly amongst frail or vulnerable adults. We conduct pragmatic clinical trials, mixed methods research, and statistical and economic modelling of community-based interventions aimed at improving quality of life and reducing healthcare resource use.
COPERS - A NIHR funded programme grant piloting and evaluating a novel, evidence based self management intervention for patients with chronic musculoskeletal pain.
PRISMS- A NIHR funded study to undertake a rapid, systematic overview of the evidence for self-management support interventions in people with long-term conditions (LTCs) to inform commissioners and healthcare providers on the evidence about what works, for whom, in what contexts and why.
IRIS - A collaborative trial, testing an intervention to improve identification and referral of women experiencing domestic violence, is nearing completion.
OPERA - A large, HTA funded cluster randomised controlled trial of the promotion of increased physical activity amongst older adults in residential care to alleviate depression.
Recently completed projects
BELLA - A RfPB funded feasibility and pilot study of a disease specific self management intervention for moderate to severe chronic obstructive pulmonary disease. This study has bee recently completed but further economic and statistical modelling are underway.
See all staff in the Centre for Primary Care and Public Health
Centre for Primary Care and Public Health
Barts and The London School of Medicine and Dentistry
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020 7882 2509