Category: National Heart and Lung Institute

HIV antiretroviral therapy: Getting to the heart of the matter

The HIV landscape has completely transformed since the start of the pandemic. A HIV diagnosis in the 1980s was considered fatal, as people usually progressed to AIDS due to the lack of available treatments. 42 years later, we have an array of different drug options and as a result, people diagnosed with HIV today can now expect to have near-normal life expectancies. Here, Dr Akif Khawaja from the National Heart & Lung Institute (NHLI), highlights the impact of HIV treatment over the last 42 years and how it influences cardiovascular research today.

HIV Treatment: from AZT to U=U

At the start of the pandemic, there were no available treatments. Patients would progress to AIDS and were only offered palliative care. It wasn’t until 1987 that the first antiretroviral drug, zidovudine (AZT), was licenced for the treatment of HIV. A major challenge with HIV treatment soon became apparent, as the virus can rapidly mutate and change its genetic code to become resistant to the drug supressing its replication. This challenge was quickly seen by clinicians as their patients would start to rebound from antiretroviral monotherapy (one drug regimens) as HIV became drug resistant and was able to replicate again. The introduction of combination antiretroviral therapy in 1996 has been monumental to HIV management. A change in treatment guidelines meant that patients who would have previously been given one drug, were now given three drug combinations, each targeting different parts of the HIV life cycle. This approach meant that patients could suppress HIV replication and achieve a sustained undetectable viral load, meaning that the level of virus in their blood is so low, it can no longer be detected by diagnostic tests.

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Professor Sir Peter Barnes knighted for excellence: Reflections on his career in respiratory science

Professor Sir Peter Barnes FRS FMedSci, from the National Heart and Lung Institute (NHLI), was made a Knight Bachelor in this year’s King’s Birthday Honours “for services to respiratory science.” Sir Peter is Professor of Thoracic Medicine at the NHLI and he was Head of Respiratory Medicine at Imperial until 2017. Here he writes about his reaction to his award and describes some of the current research projects in chronic obstructive pulmonary disease (COPD).

A surprise! 

My wife opened the letter “On His Majesty’s Service” as she thought it was a tax demand – I was absolutely shocked to see I had been offered a knighthood. Of course, I was and am delighted with the award. It is very good for respiratory science and medicine, which generally receives little public attention. This is surprising as chronic lung diseases are amongst the most common in the UK, affecting one in seven people and the third ranked cause of death. I would like to dedicate this award to all the brilliant students, post-docs, research fellows, visiting scientists and colleagues that I have worked with at Imperial College London over many decades.  

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Making Waves at the National Heart and Lung Institute

Helen Johnson, Communications and Marketing Manager at the National Heart and Lung Institute (NHLI) discusses her recent project ‘Making Waves’, which set out to update the Department’s imagery across their buildings to better reflect the diversity of NHLI’s community and inspire the next generation.

“Sometimes our stories make us stronger”

This is what one of our contributors said to me during her interview, and I couldn’t have summed up ‘Making Waves’ any better. This project set out to showcase the people behind the great science and teaching that the NHLI is known for. 

We don’t always think about it on a daily basis but when you actually look at who is celebrated in the imagery on our walls, it tends to be people who no longer work for the Department, and they tend to also share characteristics in terms of their age and race. But, then again, it is just a portrait of that person, so we don’t necessarily know their whole story by just looking at an image. Everyone has their own story. 

The founding premise of ‘Making Waves’ was that anyone should be able to look at these new portraits and see themselves. So that everyone can know they are welcome at NHLI  and in science – that they belong. I was tasked with this vision by my Head of Department, Professor Edwin Chilvers, who was keen we brought our imagery more up to date to represent who NHLI is today. The leaky pipeline in science for those holding protected characteristics has been much reported, and is easy to see when you look for instance at the number of Black Professors across not just NHLI, but across the whole of Imperial. One set of portraits will not solve this, but hopefully by showing a greater variety of successful people and their journeys, others will be inspired to continue their own scientific paths.

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Inspirational leadership matters: supporting the next generation of clinical academics

Dr Maddalena Ardissino

This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

The journey to becoming a clinical academic can be long and arduous, with many obstacles. Dr Maddalena Ardissino, from the National Heart and Lung Institute, reflects on her own experiences as a trainee and explains why mentorship is key to supporting the growth and development of young, aspiring clinical academics.

Almost exactly five years ago, I stood amongst a crowd of young academics at a poster session at the Intensive Care Society’s annual conference, experiencing a feeling of anxiety I’ve never known before or since. I was in my fifth year of medical school and standing in front of a group of excellent researchers who were about to listen to me give my first scientific presentation. It seemed unthinkable to me, at the time, to think that they might have the slightest interest in what I had to say.

Since then, my journey through clinical and academic training has been what I can only describe as an adventure. I quickly realised that there isn’t a single defined path for clinical academics, with each individual moulding a slightly different journey. When I look around at my fellow clinical academics at the National Heart and Lung Institute, however, there is one key feature that we all share: enthusiasm. And behind this feature there is one single, common theme: the support of a truly inspirational mentor.

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How long is COVID-19 infectious? Opportunities and challenges in using real-world evidence

New York circa November 2020: Crowd of people walking on the street wearing masks during COVID-19 pandemic. Credit: blvdone / Shutterstock.com.

Providing the most comprehensive picture of COVID-19 infectiousness to date, recent research from Imperial College scientists offered new insights into how long people with COVID-19 are infectious for. Co-author, Dr Seran Hakki, outlines the challenges of collecting real-world evidence in the first-of-its-kind study.

In August, the ATACCC Study (The Assessment of Transmission and Contagiousness of COVID-19 in Contacts) published some of their findings in one of the world’s leading respiratory health journals, The Lancet Respiratory Medicine. Our study was the first to use real-life evidence from naturally acquired infection to assess the duration of COVID-19 infectiousness, its correlation with symptom onset, and how this affects the accuracy of lateral flow tests.

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Empowering women through the Elevat(Her) Podcast

PhD students Salina Nicoleau & Maike Haensel outline their vision for The Elevat(Her) Podcast and share the importance of highlighting positive female role models to empower other women to achieve their full potential.

Look around you – how many women are in senior positions across your university? Lucky you if you can count more than a couple. According to a recent report by the Higher Education Statistics Agency (HESA), women account for only 28% of professors in UK universities in 2020/21 (1). This is a recurring theme within many sectors, not just higher education, where there are fewer women than men in senior positions. In 2021, the number of female Fortune 500 CEOs was only 41. Yes, out of 500 CEOs, 459 were men (2).

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Tips and tricks for a successful mentor/mentee relationship

A figure of a man made from wood walking up stairs


Dr Fouzia Haneef Khan, Teaching Fellow on the MSc Genes, Drugs and Stem Cells – Novel Therapies programme,  outlines her recommendations to create an effective partnership as mentor and mentee.

Over the past seven years, I have had a variety of teaching experiences, some excellent, some awful, and some in between. Thinking about the start of my teaching journey, I remembered feeling slightly unconfident when delivering a teaching session, with a sense of doubt about whether I was reaching my potential to give the best learning experience to students. However, with the help of more experienced colleagues, I feel that I have significantly improved in these areas. These mentors have supported me on my journey by giving specific and useful recommendations about teaching strategies and general career advice.

The most important aspect of this relationship to me is that I know that I can rely on someone who is experienced in the field and has gone through similar challenges as I have. Underlying this mutual respect and trust is a feeling of genuine friendship.

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How can we manufacture the safest possible challenge agents for human infection studies?

Pipettes in a scientific lab
Dr Emma Smith—HIC-Vac Network Manager—explains how specific guidelines for the provenance and manufacture of challenge agents could make human infection studies even safer.

Human infection studies, also known as human challenge studies, are clinical trials where volunteers are intentionally given a carefully considered dose of a pathogen—known as the challenge agent. These models can be used to study host-pathogen interactions and disease progression; identify and test the efficacy of promising vaccines and drugs in development; or be used as proof-of-concept studies for testing novel medications. In this controlled environment it is possible to study infections in ways that aren’t possible in traditional field studies.

One of the first steps towards establishing a challenge study is the selection, isolation, development and production of the challenge agent. However, unlike medicines, the regulation of challenge agent manufacture varies internationally; an area that the research community has identified as a potential weakness in the field. Although human challenge studies have an excellent safety record—a recent literature review identified just 24 Serious Adverse Events (SAE) and zero deaths or cases of permanent damage among 15,046 participants in 308 studies spanning 1980 to 2021— the lack of specific guidelines for the provenance and manufacture of challenge agents warrants attention.

HIC-Vac—an Imperial-led international network of researchers who are developing human infection challenge studies—has been working with the global charitable foundation Wellcome and the company hVIVO to address this unmet need. Our purpose was to promote volunteer safety whilst maximizing access to challenge agents and challenge models globally. (more…)

Why we still need ‘Women in Science’ Awards

Paz Tayal receiving award

Dr Paz Tayal reflects on her experience in the L’Oréal-UNESCO For Women in Science Rising Talent Awards.

Do we even need an award for ‘Women in Science’? Shouldn’t there be a similar award for men in science? Well, depends on how you look at it, but you could argue all awards over the past 1000 years have been for ‘Men in Science’.

The L’Oréal-UNESCO For Women in Science Rising Talent Programme has promoted women in scientific research on a global scale since 1998. The L’Oréal-UNESCO UK and Ireland For Women in Science Programme offer awards from a partnership between L’Oréal-UNESCO UK & Ireland, the UK National Commission for UNESCO and the Irish National Commission for UNESCO, with the support of the Royal Society, to promote, enhance and encourage the contribution of women pursuing their research careers in the UK or Ireland. (more…)

The launch of the UK Anaphylaxis Registry and its importance for UK consumers

Dr Paul Turner, Consultant in Paediatric Allergy and Immunology at Imperial College London, and Ayah Wafi, Allergen Risk Assessor at the Food Standards Agency, introduce a new national reporting platform for allergic reactions. Funded by the Food Standards Agency (FSA) with contributions from Food Standards Scotland (FSS), the UK Anaphylaxis Registry will provide more data on levels of anaphylactic reactions in the UK.

Today sees the launch of the UK Anaphylaxis Registry at the Annual Conference of the British Society for Allergy and Clinical Immunology (BSACI).

The establishment of a registry represents an important step in better understanding anaphylaxis and how allergic reactions impact individuals in the UK.

Understanding anaphylaxis

An anaphylaxis reaction is a serious, and potentially life-threatening allergic reaction. Whilst severe or fatal anaphylaxis is rare, food-allergic reactions due to accidental exposure are common in people with a food allergy.

Until the launch of the registry, we have not had a standardised way of reporting these reactions in the UK. The registry will serve as a platform for clinicians to record details of anaphylaxis incidents, and collate data from across the UK to provide a better picture of the type of reactions, their frequency and their geographic spread.

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