1. Breath Analysis in Respiratory Disease:
I lead a research theme investigating the clinical utility of metabolomic profiling of volatile organic compounds in the exhaled breath of patients with respiratory disease.
We have developed a methodology for targeted sampling of the exhaled breath, enabling the breath profile to be mapped using expiratory pressure, We obtained proof of principle in asthma and COPD (published in Thorax and Respiratory Research)
Through an internal UoM grant (MIMIT) I led the refinement of this sampler and we produced a prototype with the design consultancy Butters Innovation. We have further refined the prototype for use in acutely ill inpatients with stroke, funded by Moulton (internal collaboration – Smith, Goodacre). In parallel we have developed a separate system suitable for use in critically ill ventilated patients on ICU (collaborators Goodacre, Dark, Felton). The pilot work was funded by RCUK and UMIP and has resulted in us being awarded prestigious grants from NIHR i4i (CI) and Marie Curie (Industrial Academic Partnership Programme with Philips Research, Eindhoven, Amsterdam Medical Centre and University of Twente) to develop the sampling methodology further and investigate potential markers for ventilator associated pneumonia.
The complex areas of breath gas sample analysis, and metabolomic data analysis, have been progressed in close collaboration with Manchester Institute of Biotechnology. Through this productive inter-faculty partnership we now are building critical mass with the aim of providing a clinical research service in breath analysis, and forging new collaborations both in and outside the university.
In addition to the NIHR and EU-funded work in critical care, ongoing breath analysis work is investigating markers for Idiopathic Pulmonary Fibrosis (funded by Boehringer Ingelheim), and sarcoidosis (British Lung Foundation-SarcoidosisUK), both in collaboration with Prof Andrew Wilson at the University of East Anglia and the regional interstitial lung disease service (Chaudhuri / Leonard) at Wythenshawe Hospital.
We are continuing to study the applications of breath analysis in asthma, in relation to circadian rhythm (Durrington) and exacerbations / bronchial challenge testing (again with Prof Wilson at UEA). We are about to undertake several major studies in asthma and COPD as part of the NIHR Manchester Biomedical Research Centre (Simpson / Vestbo).
My clinical interest and expertise lies in asthma and airways diseases. I am investigating the application of breath analysis in this as noted above, but also undertaking other (mainly clinical) research to aid understanding and treatment in this area, including:
* I am clinical PI for Manchester in the €22m UBIOPRED IMI consortium, which aims to characterise and discover novel phenotypes in severe asthma.
* I am PI for Manchester in a consortium awarded €4.5m (EC Horizon 2020) to investigate home monitoring / sensing in asthma in collaboration with computer modelling experts (CERTH - Center for Research & Technology Hellas), clinical researchers (Chung, Usmani at Imperial and Sont in Leiden) and industry (Aerocrine, Allertec and IHP Microelectronics)
* I lead clinical research into the neglected conditions of inducible laryngeal obstruction (vocal cord dysfunction) and breathing pattern disorder, which we hope to drive forward over the short to medium term