A5019054480- Immune Response and Inflammation
- Sepsis Diagnosis and Treatment
- Enhanced Recovery After Surgery
- Blood transfusion and management
- Respiratory Support and Mechanisms
- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Bacterial Identification and Susceptibility Testing
- Cancer, Stress, Anesthesia, and Immune Response
- Adrenal Hormones and Disorders
- Cardiac, Anesthesia and Surgical Outcomes
- S100 Proteins and Annexins
- Traumatic Brain Injury and Neurovascular Disturbances
- Thermal Regulation in Medicine
- Cytokine Signaling Pathways and Interactions
- Inflammation biomarkers and pathways
- Iron Metabolism and Disorders
- Inflammasome and immune disorders
- Acute Kidney Injury Research
- Cardiac and Coronary Surgery Techniques
- Cardiovascular and exercise physiology
- COVID-19 Clinical Research Studies
- MicroRNA in disease regulation
- Infective Endocarditis Diagnosis and Management
- Trace Elements in Health
St. Vincent's University Hospital
2018-2023
Barts Health NHS Trust
2013-2018
Royal London Hospital
2014-2018
William Harvey Research Institute
2014-2018
Queen Mary University of London
2012-2018
National and Kapodistrian University of Athens
2015
Royal College of Surgeons of England
2015
Transnational Press London
2015
Education Trust
2015
GTx (United States)
2015
Objective: Early identification of causative microorganism(s) in patients with severe infection is crucial to optimize antimicrobial use and patient survival. However, current culture-based pathogen slow unreliable such that broad-spectrum antibiotics are often used insure coverage all potential organisms, carrying risks overtreatment, toxicity, selection multidrug-resistant bacteria. We compared the results obtained using a novel, culture-independent polymerase chain reaction/electrospray...
Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries high mortality and morbidity rate adversely affects long-term health outcomes. Contemporary management is entirely supportive, no specific therapeutics have been shown be effective in reducing incidence or severity. The pathogenesis remains unclear, several models are proposed, such as excessive inflammation,...
Patient response to acute bacterial infection is highly variable. Differing outcomes in this setting may be related variations the immune an infectious insult. Using quantitative real-time polymerase chain reaction, we quantified gene expression of tumor necrosis factor alpha(TNFalpha), interferon gamma (IFNgamma), and interleukin 10 (IL10), IL12p35, IL4 genes 3 patient groups. These groups consisted intensive care unit (ICU) cohort who presented with severe sepsis or septic shock, a group...
The aim of this study was to evaluate the role interleukin (IL)-6 pathways in postoperative immune suppression and assess reversibility phenomenon.The period is characterized by increased IL-6 production features suppression. In vitro, mediates anti-inflammatory effects through inhibition interferon gamma (IFN-γ) pathways. significance immunomodulatory clinical setting remains unclear.Patients over 45 years old undergoing elective surgery, involving gastrointestinal tract, were recruited....
Abstract Introduction Asymmetrical dimethyl arginine (ADMA) is an endogenous non-selective inhibitor of nitric oxide synthase that may influence the severity organ failure and occurrence shock secondary to infectious insult. Levels be genetically determined by a promoter polymorphism in regulatory gene encoding dimethylarginine dimethylaminohydrolase II (DDAH II), which functions metabolising ADMA citrulline. The aim this study was examine association between levels severe sepsis also assess...
In Brief Objective: To explore the hypothesis that blood transfusion contributes to an immunosuppressed phenotype in severely injured patients. Background: Despite trauma patients using disproportionately large quantities of and products, immunomodulatory effects this group are inadequately described. Methods: A total 112 ventilated polytrauma were recruited. Messenger RNA (mRNA) was extracted from PAXGene tubes collected within 2 hours trauma, at 24 hours, 72 hours. T-helper cell subtype...
To study innate immune pathways in patients undergoing hepatopancreaticobiliary surgery to understand mechanisms leading enhanced inflammatory responses and identifying biomarkers of adverse clinical consequences.Patients major abdominal are at risk life-threatening systemic response syndrome (SIRS) sepsis. Early identification at-risk would allow tailored postoperative care improve survival.Two separate cohorts were studied (combined n = 69). Bloods taken preoperatively, on day 1 2...
Acute Kidney Injury (AKI) complicating major trauma is associated with increased mortality and morbidity. Traumatic AKI has specific risk factors predictable time-course facilitating diagnostic modelling. In a single centre, retrospective observational study we developed prediction models for after based on data around intensive care admission. Models predicting were using from 830 patients, reduction followed by logistic regression, independently validated in further 564 patients. occurred...
Patient response to acute bacterial infection is highly variable. Differing outcomes in this setting may be related variations the immune an infectious insult. Using quantitative real-time polymerase chain reaction (QRT-PCR) we quantified gene expression of Tumour Necrosis Factor-alpha (TNFα), Interferon-Gamma (IFNγ), Interleukin-10 (IL-10), IL-12p35 and IL-4 genes 3 patient groups. These groups consisted Intensive Care Unit (ICU) cohort who presented with severe sepsis or septic shock, a...
Blood transfusion in the perioperative period has frequently been associated with an excess of nosocomial infections. Whilst transfused whole blood induces specific host immune alteration that may predispose to infections, immunomodulating properties leukodepleted remain incompletely understood. In this study, we explore hypothesis allogeneic during or following major gastrointestinal surgery is immunosuppressed phenotype, which turn postoperative infectious complications.Patients aged over...
Hereditary Hemochromatosis (HH) is a genetic disease associated with iron overload, in which individuals homozygous for the mutant C282Y HFE allele are at risk development of range disorders particularly liver disease. Conformational diseases class expression misfolded protein. protein that does not fold correctly and consequently retained Endoplasmic Reticulum (ER). In this context, we sought to identify ER stress signals expression, may have role molecular pathogenesis HH.
Post-operative infections occur frequently following major surgery. The magnitude of the post-operative immune response is associated with an increased risk infections, although mechanisms driving immune-dysfunction and potential reversibility this stimulants are not well understood. This study aims to describe immediate surgery establish links both infection functional aspects dysregulation. We also investigate clinically available reverse features immune-dysfunction.Patients over 45 years...
Transfusion of packed red blood cells (PRBCs) is associated with an increased incidence nosocomial infections and risk death. The duration storage before transfusion may influence these outcomes. Here, we explore the association between age transfused PRBCs specific patterns inflammatory gene expression in severely injured trauma patients.Severely patients requiring intensive care unit treatment receiving within 24 hours injury were recruited. Blood samples obtained 2 trauma, at hours, 72...
Objective: Cytokine response after cardiac surgery may be genetically influenced. A study was carried out to investigate the relation between cytokine gene expression in peripheral blood mononuclear cells, genotype, and clinical events surgery. Design: case-control performed. Setting: Cardiac intensive care unit a university hospital. Subjects: total of 82 patients having elective were divided into those uncomplicated recovery (n = 48) or complicated by hyperlactatemia requirement for...
In Brief BACKGROUND: Cytokine-mediated inflammation and coagulopathy may occur after cardiac surgery. this study we investigated the temporal pattern of plasminogen activator inhibitor-1 (PAI-1) gene expression surgery its relation with PAI genotype, obtained preliminary data regarding to perioperative morbidity. METHODS: The relative change in PAI-1 mRNA 1, 6, 24 h cardiopulmonary bypass (CPB) was measured from mononuclear cells 82 patients undergoing elective DNA analyzed for carriage...
BACKGROUND Posttraumatic nosocomial pneumonia is a common complication resulting in significant morbidity. Trauma-induced immunocompromise associated with an enhanced susceptibility to pneumonia. In this study, we explore the hypothesis that posttranscriptional epigenetic regulation of gene expression may be important factor determining immune phenotype. We describe pattern production microRNAss (miRs) and their association following severe trauma. METHODS A convenience sample 30 ventilated...