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, chronic obstructive pulmonary disease (COPD) and pneumonia are the main cause of winter pressures on 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 three to five years from diagnosis. Pleural infection has a mortality of 20 per cent and average hospital stay of two weeks.
Respiratory diseases are the third most common cause of death in the UK. 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 NIHR Oxford BRC Respiratory Theme 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 bacterium, 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.
We will investigate new immunological, imaging and physiological biomarkers of mechanisms known to be important drivers of the diseases discussed above.
We will investigate the mechanisms and pathways responsible for pneumonia and progression to empyema.