Medicine

Luca Richeldi

MD, PhD

Primary position:
Professor of Respiratory Medicine, Chair of Interstitial Lung Disease

Background

The University of Southampton

Born and bred in Modena, northern Italy, Luca Richeldi obtained his MD degree from the School of Medicine of the University of Modena in 1988. During his PhD program in Rome, he developed a scientific interest in the area of interstitial lung diseases (ILD), a group comprising several acute and chronic lung disorders, characterized by a poor prognosis and the lack of effective treatments so far. Over the following years, Luca continued to be active in this field through international collaborations and participating in different studies dealing with diagnosis and treatment of ILD, with a particular interest for idiopathic pulmonary fibrosis (IPF), the most common and most lethal among all ILD. In 2005, as Associate Professor of Respiratory Medicine at the University Hospital of Modena, he founded and led the Centre for Rare Lung Disease.

His research activity started with a study exploring the genetic susceptibility factors involved in the development of a rare occupational form of progressive ILD, chronic beryllium disease. This led to the publication in Science of the association between a single genetic polymorphism and the disease. The interest for fibrotic lung disorders continued with the study of the effects of pharmacologic treatments in IPF. By using the methodologies of the evidence-based medicine and the statistical tool of meta-analysis, Luca published, as leading author, two Cochrane systematic reviews, critically assessing the low level of evidence for pharmacologic treatments empirically used until then. He has also been involved in the production of evidence-based international guidelines, endorsed by all major international respiratory scientific societies, focusing on the management of patients with IPF and the classification of idiopathic interstitial pneumonias. These documents form the basis for the current diagnostic and therapeutic management of patients with ILD and for the design of randomized clinical trials in this rapidly expanding area of respiratory medicine. More recently, Luca led the publication of one of the most promising phase II clinical trials in IPF, published in The New England Journal of Medicine. He also had an interest in lung infections, particularly tuberculosis. In this field he contributed to the development and the evaluation of a new generation of diagnostic tests for latent tuberculosis: these results were published as leading author in The Lancet. He is on the editorial board of the American Journal of Respiratory and Critical Care Medicine and is an associate editor for the European Respiratory Journal. Luca is member of the Fleischner Society.

Appointments held
  • Associate Professor of Respiratory Medicine, University of Modena and Reggio Emilia (Italy)
  • Director of the Centre for Rare Lung Diseases, University Hospital of Modena (Italy)
Professor Luca Richeldi's photo

Research

The research activities of Luca Richeldi are mainly focused in the area of interstitial lung diseases (ILD), with a particular interest for idiopathic pulmonary fibrosis (IPF).

ILD is a relatively unexplored and rapidly evolving area of respiratory medicine: with more than 200 different clinical entities, these disorders pose a significant challenge in terms of both diagnostic procedures and therapeutic approaches. Patients with ILD represent a major unmet medical need and there is a huge demand for clinical and basic research in this area. In particular, translational approaches seem to be particularly promising and potentially capable of delivering new diagnostic tools combined with effective treatments. The research interests of Luca Richeldi are mainly focused on early diagnosis, biomarkers and effective treatments for ILD.

Computed tomography

Chest high resolution computed tomography of a patient with idiopathic pulmonary fibrosis

Computed tomography

With regard to early diagnosis, he is leading a project exploring the potential of a combination of electronic lung sound detection and chest high resolution computed tomography imaging to achieve a correct diagnosis of ILD, in particular IPF, when the disease is still in a pre-clinical stage. Lung sounds have never been properly assessed in the diagnostic algorithm of ILD patients, although they are still widely used in daily clinical practice. By taking advantage of the possibilities offered by the technology of electronic stethoscopes, this study will tease out potential of automatic acoustic pattern recognition in the early detection of ILD. In combination with the targeted application of chest high-resolution computed tomography, the sensitivity and the specificity of this innovative diagnostic approach will be prospectively evaluated in a multicentre, multinational setting. The study will benefit from the collaboration with the renewed Institute of Sound and Vibration Research at the University of Southampton. It is expected that the results will help to identify patients with ILD at very early stages of their disease, at a time when the effect of drugs slowing down the pathogenetic process in their lung will be maximized.

Reliable biomarkers are one of the missing components in the management of patients with ILD. In particular, the search for reliable, predictive and reproducible non-invasive biomarkers is active at many research centres worldwide. The availability of a reliable biomarker would immensely help in the management of patients with ILD and in the design of clinical trials. Luca is coordinating a multicentre study assessing the reliability and the prognostic value of fibrocytes, circulating in the peripheral blood of patients with IPF: these cells are similar to stem cells and are produced in the bone marrow. Modern flow cytometry techniques allow the identification and the quantification of these cells in small samples of peripheral blood, which can be stored and shipped overnight. It is expected that the results of this study will confirm the feasibility and the usefulness of this non-invasive biomarker in the clinical management of IPF patients.

Until very recently, the therapy for ILD patients has been largely empiric and based on very little scientific evidence. Until recently, a combination of corticosteroid and immunosuppressors has been widely used: however, a controlled clinical trial showed that this combination of drugs is not only ineffective, but most likely harmful inn patients with IPF. Over the last decade an increasing number of drugs have been tested in patients with IPF in the context of properly designed large randomized clinical trials. Luca has been actively involved in most of these trials and he has developed an interest for designing and conducting adequate clinical trials, focusing in particular on the choice of the most relevant clinical endpoints and the most appropriate statistical analyses. In this context, he is also involved in the assessment of comprehensive care for patients with ILD, with a special interest for the development of patient support groups and the use of mindfulness-based stress reduction as a tool to increase the quality of life in this patient population.

Primary research group:  Clinical and Experimental Sciences

Responsibilities

Second supervisor, PhD programme, Dr. Mark Jones.

Contact

Professor Luca Richeldi
Faculty of Medicine
University of Southampton
Southampton General Hospital
Mailpoint 801
South Academic Block
Tremona Road
Southampton
SO16 6YD
or
Faculty of Medicine
University of Southampton
Building 85
Life Sciences Building
Highfield Campus
Southampton
SO171BJ

Room Number: SGH/LE75/MP813

Telephone: (023) 8120 6663
Facsimile: (023) 8051 1761
Email: L.Richeldi@soton.ac.uk