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Professor Paul Elkington BA, BM, BCh, PhD, FRCP, MBE

Professor of Respiratory Medicine

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Paul Elkington is Professor of Respiratory Medicine at the University of Southampton within Medicine. He leads a research group studying pulmonary tuberculosis, specifically identifying how infection destroys the lungs and how this can lead to new diagnostic tests and treatments to combat the global pandemic.

Tuberculosis continues to kill four thousand people every single day. We conduct cross-disciplinary research using bioengineering approaches to identify new diagnostic and therapeutic strategies

Professor Elkington trained in medicine at Oxford and then worked in various London teaching hospitals, in addition to Zambia, and completed his training in respiratory and general medicine in 2007.

His research into lung destruction in tuberculosis started in Jon Friedland’s group at Imperial College London with a Wellcome Trust Clinical research training fellowship (2002 – 2005), followed by a NIHR Clinician Scientist Award (2006 – 2011), and then a HEFCE Clinical Senior Lecturer Award (2011 - 2016). He moved to Southampton University in June 2012 to develop a research programme centred on the role of proteases in the pathology of pulmonary infection. Current active funding is from MRC, EPSRC, Rosetrees Trust and PHE.

Professor Elkington is a member of NAMRIP, the University's Network for Antimicrobial Resistance and Infection Prevention strategic research group. He has co-directed the development of the personal respirator project during the COVID19 pandemic (PeRSo) and also the developing world programme to improve provision of personal protective equipment in the developing world.

He was awarded an MBE in the Queen's Birthday Honours for this work.



Research interests

My research interest is how airborne pathogens cause damage to patients' lungs, primarily focusing on tuberculosis. Tuberculosis continues to kill almost 1.5 million people a year in the developing world, and lung disease not only causes spread from person to person but also causes most mortality and morbidity.

Our research approach is to integrate analysis of clinical samples with bioengineering techniques to understand the mechanisms of disease. My research focuses on how enzymes called matrix metalloproteinases drive lung cavitation to develop new diagnostic and therapeutic approaches. TB diagnosis in the developing world relies on a technique 100 years old and TB treatment has remained unchanged for the last 30 years.

We 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.

The key questions that we are currently working on are:

- Can inhibiting excess MMP activity reduce deaths from tuberculosis and allow new shorter course treatments?

- How does the extracellular matrix regulate the host immune response to TB?

- Are matrix degradation products novel biomarkers of pulmonary TB that can be developed into tests for population screening?

- Can the bioengineering model we have developed be used to identify new antibiotics?

Previous and current funders include the Wellcome Trust, NIHR (UK), MRC, HHMI, NC3Rs, EPSRC, Colciencias, PHE and NIH (US). Informal enquiries about research possibilities are welcome.

PhD supervision

PhDs awarded

  • Tara Sathyamoorthy, MRC Clinical training fellow
  • Basim Al Shammari, King Abdullah Fellowship
  • Andre Kubler, Imperial PhD Studentship
  • Naomi Walker, Wellcome Clinical Research training fellowPatience Brace, Southampton PhD StudentshipAndrew Chancellor, PHE Studentship
  • Diana Garay, COLCIENCIAS Studentship
  • Elena Konstantinopoullou, University VC Award

Current PhD Students

  • Michaela Reichmann - Rosetrees Award
  • Hannah Schiff - MRC Clinical Research Training Fellowship
  • AhRam Yoon - University President's Award
Extensive lung destruction in patient with TB
Tuberculosis cavity on CT scan

Research group

Clinical and Experimental Sciences

Chair of Southampton Containment level 3 laboratories users committee, 2013 -
Faculty of Medicine ATHENA SWAN self-assessment team, 2012 –
Portfolio lead, Clinical academic careers, ATHENA Swan Committee, 2015 –
Vice-Chair, Faculty Equality, Diversity and Intersectionality Committee, 2017 -
Network for Antimicrobial Resistance and Infection Prevention Steering group, 2017 –
University GCRF Steering Group, 2017 –

Committee Member, Acid Fast Club, 2016 –

Secretary, Acid Fast Club, 2020 -


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Book Chapters




Lecturing on infection for BM5 programme

BMedSci and MMedSci student supervision

TB teaching to FY1, FY2, CMT and ST doctors

Professor Paul Elkington
Faculty of Medicine, Room AB215, Mailpoint 801, South Academic Block, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD

Room Number : SGH/LE75/MP811

Telephone: (023) 8120 5928

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