Characterising, understanding and better treatment for acute deteriorations
Lead: Professor Ian Pavord
When tackling airways disease, we believe we should move away from a description of the condition and focus more on the underlying process. It is now clear that there are many sub-types of asthma and COPD. Professor Ian Pavord defined one sub-type, type-2 eosinophilia, which is dominated by immune cell called eosinophils. This biomarker can be identified with a simple blood test. We are now working on identifying the mechanisms driving other non-eosinophil – or non-type 2 – airways disease.
Being able to tell which patient has T2 inflammation meant we could design more specific and efficient clinical trials and target new drugs to these patients. Using this biomarker, we showed that a new drug, Mepolizumab, works in severe eosinophilic asthma, and this has led to four new drugs being developed, a major step forward in the treatment of severe asthma globally.
In this BRC, we are aiming to better understand the role eosinophils play in causing acute deterioration in asthma and COPD patients. We are also testing the use of Benralizumab, a monoclonal antibody as treatment for acute exacerbations in COPD patients (the ABRA study)
We are aiming to map the clinical characteristics of early airways disease and acute deterioration in COPD: using digital technology, we are assessing biological changes in the patient to see if we can predict when a deterioration might happen; we are also testing a new laser-gas assessment of the lungs as a way of predicting early type-2 airway inflammation, in order to prevent it progressing.
We are investigating the role of non-T2 mechanisms in driving airways disease using a variety of methods, including using single-cell epigenomics, transcriptomics and whole genome sequencing of the airway and blood.
We will also study why some type-2 inflammation does not respond to inhaled corticosteroid, and investigate the effectiveness of the drug Azithromycin, an antibiotic with anti-inflammatory properties.
