SCOTTISH CENTRE FOR RESPIRATORY RESEARCH
This is a group which I set up with my own funding in 1991 which now enjoys an international reputation for research excellence in the field of clinical airway research. I have clinical and research expertise in respiratory and cardiovascular medicine, along with my original background in clinical pharmacology and therapeutics. This places me in a unique position in terms of my research profile, and particularly with respect to attracting peer reviewed and industry funding.
I have good collaborative relationships with several International pharmaceutical companies and with other universities in Europe and USA. I have brought in 6.6 M in the last 5 years. I have signed up as commercial research champion with the Tayside Medical Science Centre and am now recruiting into numerous Pharmaceutical sponsored multicenter clinical trials.
To date, clinical research fellows under my supervision have resulted in 22 MD or PhD theses. I take my mentoring role of young fellows very seriously.
It gives me immense pride and satisfaction that three of my research fellows have been appointed to UK chairs – Nigel Wheeldon (Sheffield), David Kiely (Sheffield), Andrew Wilson (Norwich).
Significance of Research for NHS
- Research studies using using health informatics data linkage has identified a defined small airway asthma phenotype which is associated with impaired control (Manoharan et al Eur Respir J 2014; 44: 1353–1355; Lipworth et al Lancet RM 2014;2: 497–506;Jabbal et al J Allergy Clin Immunol 2016;138:601-603)
- A genotyped database showed a adverse interaction between beta-2 receptor Arg16Gly genotype and use of long-acting beta-2 agonists (Lee et al. Br J Clin Pharmacol 2004:57:68-75, Palmer et al. Thorax 2006;61:940-44, Basu et al. J Allergy Clin Immunol 2009;124:1188-94; Turner et al J Allergy Clin Immunol 2016;138:107-113). This led to the first RCT showing a personalised genotyped based approach to prescribing (Lipworth et al Clin Sci 2013;124:521-528)
- A meta-analysis evaluated potential adverse reactions to NSAIDs and COX2 inhibitors in patients with asthma (Morales et al J Allergy Clin Immunol 2014;134:40-45; Morales et al Allergy 2015;70:828-8)
- Health informatics demonstrated the potential for adverse effects of beta-blockers in asthma and concomitant cardiovascular disease (Morales et al BMC Medicine 2017;doi:10.1186/s12916-017-0781-0; Morales et al Br J Clin Pharmacol 2016;82:814-822; Morales et al Chest 2014;145:779-786)
- Using a national database, I also showed underuse of beta-blockers in patients with heart failure and COPD, indicating a clinically relevant unmet need in such patients (Lipworth et al Heart 2016;102:1909-1914).In addition I showed that beta-blockers are safe to use in COPD with any beta-2 receptor mediated adverse effects on lung function mitigated by concomitant long acting muscarinic antagonists (Jabbal et al QJM 2017;110:785-792) .This in turn led to an NIHR funded randomized controlled trial to evaluate the effects of bisoprolol on exacerbations in COPD on which I am co-chief applicant
- We showed the impact of the smoking ban on health in bar workers, and received international media coverage (Menzies et al JAMA 2006;296:1742-1748) with an accompanying editorial emphasizing its importance
- I have also shown that a novel osmotic bronchial challenge test with mannitol is well tolerated in primary care, to assess airway inflammation, resulting in better long term asthma control (Lipworth et al Chest 2010;141:607-15). A screening programme involving bronchial challenge testing was employed to identify potential overtreatment of patients with adult asthma in the community (Manoharan et al Clin Exp Allergy 2014;44:1240-1245)
- Research into the role of the unified allergic airway (Barnes et al Allergy 2007:62:73-80) and the role of medical polypectomy (Vaidyanathan et al Ann Intern Med 2011;154:293-302) has driven setting up of a unique one stop combined medical/surgical rhinology service
I have played a major role in the implementation and development of the new medical curriculum in Dundee. In my capacity as system convener for respiratory teaching (1991-2014), I have been responsible for complete restructuring of the teaching delivered in this area, in which I have always had a significant hands on component. New innovations include the drawing up of an electronic study guide and web based teaching aids.
I have previously been involved in teaching and examining for the MRCP PACES, Glasgow postgraduate respiratory medicine course; respiratory education for the Royal College of Physicians of Edinburgh. I also give regular postgraduate educational lectures to primary and secondary care doctors, both in the UK and abroad.
'Inhaled triple therapy in chronic obstructive pulmonary disease' The Lancet, vol. 392, no. 10153, pp. 1112-1113.
'Current appraisal of single inhaler triple therapy in COPD' International Journal of Chronic Obstructive Pulmonary Disease, vol. 2018, no. 13, pp. 3003-3009.
'Improved lung function and patient-reported outcomes with co-suspension delivery technology glycopyrrolate/formoterol fumarate metered dose inhaler in COPD: a randomized Phase III study conducted in Asia, Europe, and the USA' International Journal of Chronic Obstructive Pulmonary Disease, vol. 13, pp. 2969-2984.
'Is small airways dysfunction related to asthma control and type 2 inflammation?' Annals of Allergy, Asthma & Immunology.
'Anti-interleukin 13 for asthma: stick or twist?' The Lancet Respiratory Medicine.
'Pulmonary arterial stiffening in COPD and its implications for right ventricular remodelling.' European Radiology, vol. 28, no. 8, pp. 3464-3472.
'What can we learn about COPD from impulse oscillometry?' Respiratory Medicine, vol. 139, pp. 106-109.
'Adrenal suppression with inhaled corticosteroids: the seed and the soil' The Lancet Respiratory Medicine, vol. 6, no. 6, pp. e19.
'Disconnection of pulmonary and systemic arterial stiffness in COPD' International Journal of Chronic Obstructive Pulmonary Disease, vol. 13, pp. 1755-1765.
'Does the asthma visual analogue scale relate to the asthma control questionnaire?' Annals of Allergy, Asthma & Immunology.
'Asthma Step-Down Strategies: Perhaps the Patient Should Decide?' The Journal of Allergy and Clinical Immunology: In Practice, vol. 6, no. 2, pp. 644-645.
'Effects of contrast administration on cardiac MRI volumetric, flow and pulse wave velocity quantification using manual and software-based analysis' British Journal of Radiology, vol. 91, no. 1084, 20170717.
'Sensitivity of lung resistance and compliance to beta-blocker induced bronchoconstriction and long acting beta-agonist withdrawal in COPD' Lung.
'Cardiopulmonary interactions with beta-blockers and inhaled therapy in COPD' QJM : an International Journal of Medicine, vol. 110, no. 12, pp. 785-792.
'Blood eosinophils: The forgotten man of inhaled steroid dose titration ' Clinical and Experimental Allergy.
'Un-diagnosing persistent adult asthma' European Respiratory Journal, vol. 50, no. 5, 1701433.
'FULFIL: an Unmet Need in Chronic Obstructive Pulmonary Disease ' American Journal of Respiratory and Critical Care Medicine, vol. 196, no. 8, pp. 1082-1082.
'Tolerability of Bisoprolol on Domiciliary Spirometry in COPD' Lung.
'A pragmatic approach to simplifying inhaler therapy for COPD' The Lancet Respiratory Medicine, vol. 5, no. 9, pp. 679-681.
'Bronchoprotective tolerance with indacaterol is not modified by concomitant tiotropium in persistent asthma' Clinical and Experimental Allergy, pp. 1-7.
'Drug-device interaction for systemic effects of fluticasone in patients with asthma' Annals of Allergy, Asthma & Immunology, vol. 119, no. 2, pp. 194.
'TLR3 Blockade in Rhinovirus-Induced Experimental Asthma Exacerbations: A Randomized Controlled Study' Journal of Allergy and Clinical Immunology.
'Does size really matter: relationship of particle size to lung deposition and exhaled fraction' Journal of Allergy and Clinical Immunology, vol. 139, no. 6, pp. 2013-2014.e1.
'Reappraising the clinical impact of mepolizumab' Lancet, vol. 5, no. 6, e20.
'Erratum to: Comparative lung bioavailability of fluticasone/salmeterol via a breath-actuated spacer and conventional plastic spacers' European Journal of Clinical Pharmacology, vol. 73, no. 6, pp. 793-793.
'The case for impulse oscillometry in the management of asthma in children and adults' Annals of Allergy, Asthma & Immunology, vol. 118, no. 6, pp. 664-671.
'Debate on long-acting β agonists for asthma: they think it's all over' The Lancet Respiratory Medicine, vol. 5, no. 3, pp. e14-e15.
'Inhaled corticosteroid dose-response in asthma: Should we measure inflammation?' Annals of Allergy, Asthma & Immunology, vol. 118, no. 2, pp. 179-185.
'Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study' BMC Medicine, vol. 15, 18.
'Obesity and asthma – do we need expensive therapies?' Thorax.
'An algorithm recommendation for the pharmacological management of allergic rhinitis in the UK: a consensus statement from an expert panel ' NPJ Primary Care Respiratory Medicine, vol. 27, 3, pp. 1-8.
'Impact of Spacers on Therapeutic Ratio with Inhaled Corticosteroids' The Journal of Allergy and Clinical Immunology: In Practice, vol. 5, no. 4, pp. 1163.
'ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle' Clinical and Translational Allergy, vol. 6, 47, pp. 1-14.
'Implication of alternative minimal clinically important difference threshold estimation on technology assessment' International Journal of Technology Assessment in Health Care, vol. 32, no. 6, pp. 371-375.
'Underuse of β-blockers in heart failure and chronic obstructive pulmonary disease' Heart, vol. 102, no. 23, pp. 1909-1914.
'It is important to distinguish between HFr EF and HFp EF when interpreting these data' Heart (British Cardiac Society), vol. 102, no. 23, 1934.
'The burden of chronic obstructive pulmonary disease associated with maintenance monotherapy in the UK' International Journal of Chronic Obstructive Pulmonary Disease, vol. 11, no. 1, pp. 2851-2858.
'LATE-BREAKING ABSTRACT: Real life impact of long acting beta-2-agonist withdrawal in controlled step 3 asthma patients' European Respiratory Journal, vol. 48, no. Suppl60.
'Assessment of proximal pulmonary arterial stiffness using magnetic resonance imaging: effects of technique, age and exercise' BMJ Open Respiratory Research, vol. 3, no. 1, e000149.
'Real-life effect of long-acting β2-agonist withdrawal in patients with controlled step 3 asthma' Annals of Allergy, Asthma & Immunology, vol. 117, no. 4, pp. 430-431.
'Beta-blockers in COPD: time for reappraisal' European Respiratory Journal, vol. 48, no. 3, pp. 880-888.
'Respiratory effect of beta-blocker eye drops in asthma: population-based study and meta-analysis of clinical trials' British Journal of Clinical Pharmacology, vol. 82, no. 3, pp. 814-822.
'Utility of impulse oscillometry in patients with moderate to severe persistent asthma' Journal of Allergy and Clinical Immunology, vol. 138, no. 2, pp. 601-603.
'Improvements with sublingual house dust mite immunotherapy in allergic rhinitis' Journal of Allergy and Clinical Immunology, vol. 138, no. 2, pp. 634-635.
'Inhaled treatment for chronic obstructive pulmonary disease: what’s new and how does it fit? ' QJM : an International Journal of Medicine, vol. 109, no. 8, pp. 505-512.
'Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)' Clinical and Translational Allergy, vol. 6, 29, pp. 1-18.
'Childhood asthma exacerbations and the Arg16 β2-receptor polymorphism: A meta-analysis stratified by treatment' Journal of Allergy and Clinical Immunology, vol. 138, no. 1, pp. 107-113.
'Effects of the inverse alpha-agonist doxazosin in allergic rhinitis' Clinical and Experimental Allergy, vol. 46, no. 5, pp. 696-704.
'Comparing pace and speed in the pulmonary circulation?' American Journal of Physiology: Heart and Circulatory Physiology, vol. 310, no. 7, H949.
'Effects of adding Tiotropium or Aclidinium as triple therapy using impulse oscillometry in COPD' Lung, vol. 194, no. 2, pp. 259-266.
'Is Gly16Arg β2 Receptor Polymorphism Related to Impulse Oscillometry in a Real-Life Asthma Clinic Setting?' Lung, vol. 194, no. 2, pp. 267-271.
'Effects of formoterol or salmeterol on impulse oscillometry in persistent asthma' Journal of Allergy and Clinical Immunology, vol. 137, no. 3, pp. 727-733.e1.
'Of mice and men-the curious tale of β blockers in asthma' The Lancet Respiratory Medicine, vol. 4, no. 2, pp. 89-91.
'Inhaled corticosteroid dose-response on blood eosinophils in asthma' The Lancet Respiratory Medicine, vol. 4, no. 1, pp. e1.
'From mouse to man: predicting biased effects of beta-blockers in asthma' British Journal of Pharmacology, vol. 173, no. 1, pp. 248-249.
'MACVIA-ARIA Sentinel Networ K for allergic rhinitis (MASK-rhinitis): The new generation guideline implementation' Allergy, vol. 70, no. 11, pp. 1372-1392.
'The role of pulmonary arterial stiffness in COPD' Respiratory Medicine, vol. 109, no. 11, pp. 1381-1390.
'Impact of left ventricular hypertrophy on survival in chronic obstructive pulmonary disease' Lung, vol. 193, no. 4, pp. 487-495.
'Biomarkers to predict inhaled corticosteroid response' Journal of Allergy and Clinical Immunology, vol. 136, no. 2, pp. 515.
'NSAID exacerbated respiratory disease: a meta-analysis evaluating prevalence, mean provocative dose of aspirin and increased asthma morbidity' Allergy, vol. 70, no. 7, pp. 828-835.
'Nasal endoscopy to characterize sinonasal disease' Journal of Allergy and Clinical Immunology, vol. 136, no. 1, pp. 212.
'Usefulness of impulse oscillometry for the assessment of airway hyperresponsiveness in mild-to-moderate adult asthma' Annals of Allergy, Asthma & Immunology, vol. 115, no. 1, pp. 17-20.
'β2-Adrenergic receptor Gly16Arg polymorphism and impaired asthma control in corticosteroid-treated asthmatic adults' Annals of Allergy, Asthma & Immunology, vol. 114, no. 5, pp. 421-423.
'Tiotropium in asthma' The Lancet Respiratory Medicine, vol. 3, no. 5, pp. e16-e17.
'Assessment of spirometry and impulse oscillometry in relation to asthma control' Lung, vol. 193, no. 1, pp. 47-51.
'Clinical relevance of house dust mite immunotherapy' Journal of Allergy and Clinical Immunology, vol. 135, no. 1, pp. 288-288.
'The inverse agonist propranolol confers no corticosteroid-sparing activity in mild-to-moderate persistent asthma' Clinical Science, vol. 127, no. 11, pp. 635-643.
'Small airway dysfunction is associated with poorer asthma control' European Respiratory Journal, vol. 44, no. 5, pp. 1353-1355.
'Impact of long-acting bronchodilators and exposure to inhaled corticosteroids on mortality in COPD: a real-life retrospective cohort study' Lung, vol. 192, no. 5, pp. 649-652.
'The potential role of direct and indirect bronchial challenge testing to identify overtreatment of community managed asthma' Clinical and Experimental Allergy, vol. 44, no. 10, pp. 1240-1245.
'Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: meta-analysis of controlled clinical trials' Journal of Allergy and Clinical Immunology, vol. 134, no. 1, pp. 40-45.e10.
'Adrenal suppression with mometasone furoate/formoterol' CHEST, vol. 145, no. 5, pp. 1175-1176.
'Adverse respiratory effect of acute beta-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials' CHEST, vol. 145, no. 4, pp. 779-786.
'Lack of clinically relevant differences between combination therapy and monotherapy in COPD' European Respiratory Journal, vol. 43, no. 4, pp. 1204.
'Tadalafil in patients with chronic obstructive pulmonary disease: a randomised, double-blind, parallel-group, placebo-controlled trial' The Lancet Respiratory Medicine, vol. 2, no. 4, pp. 293-300.
'Reply: pharmacological obfuscation of clinical relevance' American Journal of Respiratory and Critical Care Medicine, vol. 189, no. 3, pp. 360-361.
'Effects of intravenous and oral β-blockade in persistent asthmatics controlled on inhaled corticosteroids' Heart (British Cardiac Society), vol. 100, no. 3, pp. 219-223.
'Proof of concept evaluation of trough airway hyper-responsiveness following regular racemic or levosalbutamol in genotype-stratified steroid-treated persistent asthmatic patients' Clinical Science, vol. 126, no. 1, pp. 75-83.
'Emerging role of long acting muscarinic antagonists for asthma' British Journal of Clinical Pharmacology, vol. 77, no. 1, pp. 55-62.
'Influence of β2-adrenoceptor 16 genotype on propranolol-induced bronchoconstriction in patients with persistent asthma' Annals of Allergy, Asthma & Immunology, vol. 112, no. 5, pp. 475-476.
'Unlocking the quiet zone: the small airway asthma phenotype' The Lancet Respiratory Medicine, vol. 2, no. 6, pp. 497-506.
'β-Adrenoceptor genotype and bronchoprotective subsensitivity with long-acting β-agonists in asthma' American Journal of Respiratory and Critical Care Medicine, vol. 188, no. 12, pp. 1386-1387.
'Systemic safety of fluticasone furoate/vilanterol combination' Thorax, vol. 68, no. 12, pp. 1165.
'Uncorrected nitric oxide levels in mild asthmatics produce flawed interpretation' Journal of Allergy and Clinical Immunology, vol. 132, no. 5, pp. 1255.
'Adverse effects of long-acting Beta-agonists on airway hyperresponsiveness' American Journal of Respiratory Cell and Molecular Biology, vol. 49, no. 3, pp. 501-502.
'Author response' Annals of Allergy, Asthma & Immunology, vol. 111, no. 3, pp. 234.
'Relationship of large and small airway response with inhaled corticosteroid to asthma control' Annals of Allergy, Asthma & Immunology, vol. 111, no. 2, pp. 140-142.
'Randomised Placebo-controlled Trial to Evaluate Chronic Dosing Effects of Propranolol in Asthma' American Journal of Respiratory and Critical Care Medicine, vol. 187, no. 12, pp. 1308-1314.
'Tailored second-line therapy in asthmatic children with the Arg16 genotype' Clinical Science, vol. 124, no. 8, pp. 521-528.
'Targeting the small airways asthma phenotype: if we can reach it, should we treat it?' Annals of Allergy, Asthma & Immunology, vol. 110, no. 4, pp. 233-239.
'Adrenal suppression with fluticasone furoate' Annals of Allergy, Asthma & Immunology, vol. 110, no. 3, pp. 213.
'Influence of β2-adrenergic receptor polymorphism on methacholine hyperresponsiveness in asthmatic patients' Annals of Allergy, Asthma & Immunology, vol. 110, no. 3, pp. 161-164.
'Left Ventricular Hypertrophy in COPD Without Hypoxemia: The Elephant in the Room?' CHEST, vol. 143, no. 1, pp. 91-97.
'Inhaled and Systemic Corticosteroid Response in Severe Asthma Assessed by Alveolar Nitric Oxide: a randomised crossover pilot study of add-on therapy' British Journal of Clinical Pharmacology, vol. 75, no. 1, pp. 93-102.
'Explaining differential effects of tiotropium on mortality in COPD' Thorax, vol. 68, no. 6, pp. 589-590.
'Tiotropium in asthma' New England Journal of Medicine, vol. 367, no. 26, pp. 2552.
'Inhaled corticosteroid dose response using domiciliary exhaled nitric oxide in persistent asthma: the FENOtype trial' CHEST, vol. 142, no. 6, pp. 1553-61.
'Sensitivity of impulse oscillometry and spirometry in beta-blocker induced bronchoconstriction and beta-agonist bronchodilatation in asthma' Annals of Allergy, Asthma & Immunology, vol. 109, no. 6, pp. 412-5.
'Effects of Extra-Fine Inhaled and Oral Corticosteroids on Alveolar Nitric Oxide in COPD' Lung, vol. 190, no. 4, pp. 395-401.
'Prospective Follow-Up of Novel Markers of Bone Turnover in Persistent Asthmatics Exposed to Low and High Doses of Inhaled Ciclesonide over 12 Months' Journal of Clinical Endocrinology & Metabolism, vol. 97, no. 6, pp. 1929-1936.