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Medicine

Professor Graham Roberts DM, FRCPCH, MA, MSc

Professor and Honorary Consultant Paediatrician in Paediatric Allergy and Respiratory Medicine

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Professor Graham Roberts is Professor and Honorary Consultant Paediatrician in Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton.

Graham Roberts qualified in Medicine from the University of Oxford. He undertook his paediatric training in Leeds and London. He completed a 4 year clinical research fellowship in paediatric allergy and respiratory medicine at Imperial College School of Medicine at St Mary’s in Professor Gideon Lack’s group. Graham Roberts was awarded a MSc in Epidemiology from the London School of Hygiene and Tropical Medicine. He completed his doctoral thesis on the safety and efficacy of immunotherapy for childhood allergic asthma. His other research interests included exhaled nitric oxide, quality of life in allergic disease, severe childhood asthma, improving the diagnosis and management of childhood food allergy and, in collaboration with the ALSPAC study, the epidemiology of childhood aeroallergen, food and latex allergy. Graham Roberts completed his training in paediatric respiratory medicine at The London Hospital and the Royal Brompton Hospital.

Graham Roberts took up an appointment as a clinical senior lecturer in paediatric allergy and respiratory medicine in October 2004. He was promoted to Reader in 2007 and to Professor in 2011. He is also the joint Director of the David Hide Asthma and Allergy Research Centre on the Isle of Wight. He is coordinator of the Executive Committee of the European Academy of Allergy and Clinical Immunology (EACCI) Food Allergy and Anaphylaxis Guidelines update. Previously he was on the EACCI Executive Committee and previous Chair of the EACCI Paediatric Section. He was Editor-in-Chief of the journal Clinical and Experimental Allergy (impact factor 4.217) until 2020. 

Graham Roberts has a translational epidemiological research programme. It focuses on the pathogenesis and natural history of childhood and adult asthma and food allergy together with the development of new strategies to improve the management of asthma, particularly in adolescents. This involves studies in Southampton, at the David Hide Asthma and Allergy Research Centre in the Isle of Wight and in collaboration with colleagues at the Evelina Children’s Hospital, St Thomas’s Hospital, London.

Graham Roberts works clinically within the Southampton University Hospital NHS Trust as a paediatrician specialising in allergy and respiratory medicine. Additionally he supervises PhD students, lectures on the Allergy MSc and teaches undergraduate Medicine students.

Qualifications

Doctor of Medicine, University of Oxford (2003)
MSc, Epidemiology, London School Hygiene and Tropical Medicine (2001)
Membership of the Royal College of Physicians (1996)
MA, University of Oxford (1996)
BM BCh, University of Oxford (1993)
BA(Hons) 2i, Physiological Sciences, University of Oxford (1990)

Appointments held

Specialist Registrar, Paediatric Respiratory Medicine, Royal Brompton Hospital, London. September 2003 to September 2004.
Specialist Registrar, Paediatric Respiratory Medicine, Royal London Hospital, London. September 2002 to August 2003.
Clinical Research Fellow, Paediatric Allergy, Asthma and Immunology, Imperial College of Medicine at St Mary’s, London . September 1998 to September 2002.
Specialist Registrar, General Paediatrics and Neonates, West Middlesex University Hospital. September 1997 to September 1998.
Registrar, General Paediatrics, Community and Neonates, St Mary’s University Hospital, London. August 1996 to September 1997.
Paediatric Senior House Officer, St James's University Hospital, Leeds. August 1994 to August 1996.
Paediatric House Surgeon, The Royal Hospital for Sick Children, Glasgow.
February to July 1994.
House Physician, John Radcliffe Hospital, Oxford. August 1993 to January 1994.

Research interests

Asthma and wheeze: pathogenesis and prevention

The factors that come together to lead to the development of asthma in childhood are still not clear. Most children with severe asthma have their origins during the pre-school years. Graham Roberts is investigating this using two cohort studies in collaboration with colleagues in the Isle of Wight and across Europe.
 
Using the iFAAM birth cohort, Graham Roberts has been looking at the prevalence of pre-school wheeze across Europe looking for factors that may explain the huge variation between countries (Selby Thorax 2019).
 
The Southampton and Isle of Wight Mite Allergen Prevention Study (MAPS) interventional cohort and the Immune Tolerance in Early Childhood (ITEC) observational cohort has been reassessed at 6 years of age in a National Institutes of Health funded project. In the first phase of the work, house dust mite sublingual immunotherapy has been shown to reduce the development of allergy sensitisation at 3 years of age (Alviani Allergy 2019) and the development of asthma at 6 years of age (manuscript submitted). In the second phase, the epigenome will be investigated as a potential underlying factor in the development of asthma.
 
Then in the Wellcome Trust funded Breathing Together study (Turner Wellcome Open Res 2018), Graham Roberts is assessing the combined effect of epidemiological, microbiome, transcriptomic and cellular physiological factors in the development of pre-school wheeze. A multi-centre birth cohort has been recruited and is being followed until 3 years of age.
 
Additionally Graham Roberts has been part of the MRC funded STELLAR consortium (Professor Custovic, Imperial College) of UK respiratory birth cohorts. The Consortium has been undertaking combined analyses aiming to understand the phenotypes of childhood wheeze/asthma and how they change over childhood (Oksel Ann Am Thor Soc 2019; Oksel JACI 2019). This work is now continuing as part of the MRC funded UNICORN consortium (Professor Custovic, Imperial College).

What makes asthma severe?

Graham Roberts has led the paediatric cohort of the U-BIOPRED project (EU IMI) (Fleming ERJ 2015). The study is taking an unbiased approach to the challenge of severe asthma in children, teenagers and adults. The cohort will also allow the observations to be extended into adult asthma providing additionally confirmatory evidence (Shaw ERJ 2015). There are clear clinical clusters of severe adult asthma (Lefaudeuz JACI 2018) and there are clear transcriptomics signals in severe adult asthma (Bigler AJRCCM 2017). Additionally there are clear differences in allergic sensitisation between severe and mild/moderate asthma (Roberts JACI 2020).

This work is now being used in the EU IMI2 funded 3TR project. This aims to determine ‘omic signals that will predict which patients will and will not response biological therapies across a range of therapies, including severe asthma. Professor Roberts’s group is working on determining the best outcome measures to use.

Improving the management of asthma

Graham Roberts has led an Asthma UK funded adolescent asthma study called It’s My Asthma. It has assessed whether we are able to improve the way that adolescents self-manage their asthma to improve their asthma control and quality of life.

A systematic review (Holley Ped Pul 2017) and qualitative study (Holley Clin Exp Allergy 2018) has led to the development and validation of an adolescent asthma self-efficacy questionnaire (AASEQ) (Holley Eur Resp J 2019) and a pilot interventional randomised controlled trial. This work has now developed into the NIHR RfPB funded BREATHE4T study were we are developing a web-based, breathing retraining intervention for adolescents with asthma.

In other studies, Graham Roberts is working with colleagues to improve the management of childhood asthma. In the NIHR RfPB funded, multi-centre HiFlo study (Dr Seddon, Brighton), the potential benefit of high flow, humidified air in the context of acute severe wheeze is being assessed. Then in the NIHR EME funded, multi-centre TREAT study (Professor Saglani, Imperial College), the relative effectiveness of omalizumab and mepolizumab for childhood severe asthma are being compared.

Food allergy: pathogenesis and prevention

Epidemiological observations suggest that exposure to high doses of allergen such as peanut is associated with less allergy. So in the US Immune Tolerance Network funded LEAP study (Professor Lack KCL), Graham Roberts tested the hypothesis that the early introduction of peanut will reduce the risk of peanut allergy (DuToit JACI 2013).  The study demonstrated that the early introduction of peanuts into the diet effectively prevents peanut allergy developing (DuToit NEJM 2015, 2016). This impact is allergen specific (Du Toit JACI 2018). We are now testing other hypotheses in this data set, such as the relationship between the microbiome and the development of food allergy (Tsilochristou JACI 2019).

Although we now understand how peanut allergy develops, there remain questions about the pathogenesis of other food allergies. Our original Food Standard Agency Europrevall cohort (Grimshaw JACI 2013, Grimshaw Ped 2013, Grimshaw JACliP 2020) has now been followed up at 7-8 years within the FP7 funded iFAAM Project (Grabenhenrich Allergy 2020) (led by Professor Claire Mills). Graham Roberts is looking at early like factors (such as nutrition and food allergy) to understand how they contribute to the development of food allergy and asthma.

Department(s)

Human Development and Health

Affiliate Department(s)

Clinical and Experimental Sciences, Human Development and Physiology

Research project(s)

BREATHE4T (Breathing REtraining for Asthma Trial of Home Exercises for Teenagers)

Postgraduate student supervision

2019 Anna Selby DM
2015 Florian Gahleitner DM
2010 Katy Pike PhD
2009 Tom Blyth MD
2009 Bhupi Sihra DM
2009 Heather McKenzie PhD 

Current

Cherry Alviani DM student
Freddie Speyer PhD student
Anna Rattu PhD student
Stephanie Easton PhD student
Jess Jarvis PhD student

Faculty of Medicine

MSc allergy scholarships and bursaries sub-committee - member
Child health research seminars - organiser

National and International responsibilities

Editorial

Editor-in-Chief, Clinical and Experimental Allergy
Editorial Board member, Pediatric Allergy and Immunology

Guidelines and task forces

Coordinator, European Academy of Allergy and Clinical Immunology Food Allergy and Anaphylaxis Guidelines update
Chair European Academy of Allergy and Clinical Immunology Adolescent and Young Adult Guideline Task Force
Chair European Academy of Allergy and Clinical Immunology Anaphylaxis Guideline Task Force
Member of SIGN/BTS Asthma Guidelines Group

Board membership

Council member, British Society of Allergy and Clinical Immunology
Paediatric Allergy Board member, British Society of Allergy and Clinical Immunology

Clinical trials

Chair, EAT-On study Trial Steering Group
Chair PRESTO study Trial Steering Group

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Articles

Book Chapters

Conferences

Letters/Editorials

Reviews

MSc Allergy. Contribute to lecture programme and regularly supervise student project.

BM5 and BM4. Deliver small group teaching for undergraduates.

BMedSc. Regularly supervises students focusing on epidemiological or qualitative studies into childhood allergy and asthma.

Personal tutor to BM undergraduate students.

Professor Graham Roberts
Phone: (023) 8120 6160 Fax: (023) 8087 8847 Email: g.c.roberts@southampton.ac.uk

Room Number: SGH/LF75A/MP803

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