HIV and global health
The impact of antiretroviral therapy (ART)
Infectious disease research at the University of Southampton which is particularly relevant to global health includes influenza, TB, HIV, meningitis, pneumonia, chlamydia HCV and diagnostics.
The ResIn study
How is research investment money from public and charity sources spent?
Sexual behaviour and HIV
Relationship dynamics in the era of HIV treatment
An estimated 9 million people contract TB every year
1.5 million, world-wide, die from the disease yet treatment has remained largely unchanged in the last 30 years. Researchers, Dr Paul Elkington and Dr Marc Tebruegge, are investigating patients with active and latent TB with the aim of identifying new diagnostic and therapeutic approaches.The team have shown that tuberculosis up-regulates multiple proteases, in particular MMP-1, which degrades collagen fibers within the lung. These proteases are suppressed in advanced HIV infection, explaining why these patients do not develop lung cavitation. Current research is investigating whether inhibiting excess MMP activity can reduce deaths from TB and allow new shorter course treatments. The research is also looking at novel biomarkers of pulmonary TB with potential for use in population screening. Collaborations within the University include Spiro Garbis and Paul Skipp (proteomics), Christopher Woelk (Bioinformatics), Christine Curry (mathematical modelling) and Salah Mansour (CD1-restricted T cells). Externally, clinical research on diagnosis and treatment of TB is carried out in collaboration with Imperial College London, University College London, the University of Glasgow, the University of Edinburgh, the University of Melbourne (Australia), the Kwa-Zulu-Natal Research Institute for TB and HIV (K-RITH) in Durban (South Africa) and the University of Cape Town (South Africa). Currently active funding for TB research includes HEFCE, MRC, NIHR, US NIH, Innovate UK/TSB, Colciencias, EPSRC and PHE. Previous funders include the Wellcome Trust, HHMI and the NHMRC Australia.
Pneumonia
Current pneumonia research focuses on the epidemiology of pneumococcal carriage and molecular epidemiology and disease in relation to polysaccharide conjugate vaccines. Dr Stuart Clarke, with Professor Marie-Louise Newell and Dr Michael Head, was recently awarded a Gates grant to report on investment in global research in infectious diseases, particularly pneumonia and maternal and neonatal infections. The Research Investments in Global Health (ResIn) study will comprehensively map the research investment to institutions in the G20 countries. Alongside disease burden data, it will chart spending within disease areas, highlight the investment by each country (relative to the disease burden), demonstrate the impact of research funding and highlight research gaps globally and nationally. Dr Clarke has research links with the National University of Singapore and the University of Malaya Medical School, Kuala Lumpur.
The University also has international expertise in meningococcal disease. Experience and capability with human challenge studies is facilitating study of the cellular immunology of colonisation with the aim of developing new approaches to prevention. Recent research showed that commensals directly compete with bacteria responsible for meningitis and this suggests potential new preventive strategies for resource-poor areas with high attack rates of meningitis such as sub-Saharan Africa. This expertise is also being applied to research to improve vaccines against B.pertussis to tackle the current global resurgence of whooping cough. Professor Robert Charles Read and a team of researchers are leading human challenge studies as part of a pan-European consortium funded by the EU.
Chlamydia, Hepatitis C and Chronic Obstructive Pulmonary Disease
Chlamydia trachomatis is the most common bacterial sexually transmitted infection worldwide and a leading cause of pelvic inflammatory disease (PID) and female infertility. The University has a research programme on chlamydia supported by the Wellcome Trust. The group, led by Professor Ian Clarke, is developing a biobank of C.trachomatis in collaboration with the Wellcome Sanger Institute in Cambridge. Current work includes a point of care test and a long term plan is to develop a vaccine to C.trachomatis. The group also collaborates with Ben Gurion University, Israel, and Midwestern University and the University of Arizona, USA.
Hepatitis C (HCV) is the most common blood borne virus causing chronic liver disease globally. Professor Salim Khakoo investigates novel strategies to manipulate the natural immume response to prevent infection and disease progression.
Chronic Obstructive Pulmonary Disease (COPD) is a disease of global importance and is predicted to become the third greatest cause of worldwide mortality by 2020. Patients with this disease are particularly susceptible to the effects of infection in the lung and both acute and chronic infections contribute significantly to the enormous burden of this disease. The Southampton COPD group, led by Dr Tom Wilkinson has established uniquely large clinical cohorts to determine the mechanisms underpinning the dynamics and susceptibility to infection. It is the hub for a 5 year collaboration with GSK to develop new vaccines for this patient population.