Infection and immunity
Dr Adrian Martineau
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, Dr Adrian Martineau 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 Dr Adrian Martineau) 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
Prof Chris Griffiths
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.
Impact of the London Low Emission Zone on Children’s Respiratory Health
Complex Interventions for Chronic Conditions
Prof Stephanie Taylor
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 managemement 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.