Imperial College London

DrCarmelStock

Faculty of MedicineNational Heart & Lung Institute

Honorary Research Associate
 
 
 
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c.stock

 
 
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2129Sydney StreetRoyal Brompton Campus

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Summary

 

Publications

Publication Type
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45 results found

Stock CJW, Bray WG, Kouranos V, Jacob J, Kokosi M, George PM, Chua F, Wells AU, Sestini P, Renzoni EAet al., 2023, Serum C-reactive protein is associated with earlier mortality across different interstitial lung diseases, RESPIROLOGY, ISSN: 1323-7799

Journal article

Saunders P, Wu Z, Fahy WA, Stewart ID, Saini G, Smith DJF, Braybrooke R, Stock C, Renzoni EA, Johnson SR, Jenkins RG, Belvisi MG, Smith JA, Maher TM, Molyneaux PLet al., 2023, The burden and impact of cough in patients with idiopathic pulmonary fibrosis: an analysis of the prospective observational PROFILE study, Annals of the American Thoracic Society, Vol: 20, Pages: 1267-1273, ISSN: 1546-3222

RATIONALE: Cough is a commonly reported symptom in idiopathic pulmonary fibrosis (IPF) that negatively impacts patient-reported quality of life. However, both the burden of cough at diagnosis and the behaviour of cough over time have not been systematically described in patients with IPF. OBJECTIVES: By utilising data prospectively collected as part of the PROFILE study we sought to assess cough burden and the impact that this has on quality of life within a cohort of patients with newly diagnosed IPF. We also re-examined the previously described relationship between cough and mortality and the association of cough with the MUC5B promoter polymorphism. METHODS: The PROFILE study is a multicentre, prospective, observational, longitudinal cohort study of incident IPF. Leicester cough questionnaire (LCQ) scores were recorded at baseline in 632 subjects and then repeated 6 monthly in a subset (n=216) of the cohort. RESULTS: The median LCQ at diagnosis was 16.1 (inter-quartile range 6.5). LCQ scores remained stable over the subsequent year in the majority of patients. There was a weak association between LCQ score and baseline lung function with worse cough related quality of life associating with more severe physiological impairment. Cough scores were not associated with subsequent mortality after correcting for baseline lung function. Furthermore, there was no relationship between LCQ score and MUC5B promotor polymorphism status. CONCLUSION: The burden of cough in IPF is high. Although cough is weakly associated with disease severity at baseline, cough-specific QoL as measured by the LCQ, confers no prognostic value. Cough-specific QoL burden remains relatively stable over time and does not associate with MUC5B promotor polymorphism.

Journal article

van der Vis JJ, Prasse A, Renzoni EA, Stock CJW, Caliskan C, Maher TM, Bonella F, Borie R, Crestani B, Petrek M, Wuyts WA, Wind AE, Molyneaux PL, Grutters JC, van Moorsel CHMet al., 2023, MUC5B rs35705950 minor allele associates with older age and better survival in idiopathic pulmonary fibrosis, Respirology, Vol: 28, Pages: 455-464, ISSN: 1323-7799

Background and Objective:The minor T-allele of the MUC5B promoter polymorphism rs35705950 is strongly associated with idiopathic pulmonary fibrosis (IPF). However, conflicting results have been reported on the relationship between the MUC5B minor allele and survival and it is unknown whether a specific subgroup of IPF patients might benefit from MUC5B minor allele carriage. We investigated the association between MUC5B rs35705950, survival and patient characteristics in a real-world population of European IPF patients.Methods:In this retrospective study, 1751 patients with IPF from 8 European centres were included. MUC5B rs35705950 genotype, demographics, clinical characteristics at diagnosis and survival data were analysed.Results:In a multi-variate Cox proportional hazard model the MUC5B minor allele was a significant independent predictor of survival when adjusted for age, sex, high resolution computed tomography pattern, smoking behaviour and pulmonary function tests in IPF. MUC5B minor allele carriers were significantly older at diagnosis (p = 0.001). The percentage of MUC5B minor allele carriers increased significantly with age from 44% in patients aged <56 year, to 63% in patients aged >75. In IPF patients aged <56, the MUC5B minor allele was not associated with survival. In IPF patients aged ≥56, survival was significantly better for MUC5B minor allele carriers (45 months [CI: 42–49]) compared to non-carriers (29 months [CI: 26–33]; p = 4 × 10−12).Conclusion:MUC5B minor allele carriage associates with a better median transplant-free survival of 16 months in the European IPF population aged over 56 years. MUC5B genotype status might aid disease prognostication in clinical management of IPF patients.

Journal article

Stock CJW, Bray W, Kokosi M, Kouranos V, George PM, Molyneaux PL, Chua F, Jenkins GR, Wells AU, Renzoni EAet al., 2022, PROGNOSTIC VALUE OF ROUTINE PERIPHERAL BLOOD MARKERS IN FIBROTIC HYPERSENSITIVITY PNEUMONITIS, Winter Meeting of the British-Thoracic-Society (BTS), Publisher: BMJ PUBLISHING GROUP, Pages: A95-A95, ISSN: 0040-6376

Conference paper

Macaluso C, Boccabella C, Kokosi M, Sivarasan N, Kouranos V, George PM, Margaritopoulos G, Molyneaux PL, Chua F, Maher TM, Jenkins GR, Nicholson AG, Desai SR, Devaraj A, Wells AU, Renzoni EA, Stock CJWet al., 2022, Short-term lung function changes predict mortality in patients with fibrotic hypersensitivity pneumonitis, Respirology, Vol: 27, Pages: 202-208, ISSN: 1323-7799

Background and objectiveA proportion of patients with fibrotic hypersensitivity pneumonitis (fHP) follow a progressive disease course despite immunosuppressive treatment. Little is known about predictors of mortality in fHP. We aimed to investigate the impact of short-term lung function changes in fHP on mortality.MethodsBaseline demographics for 145 consecutive patients with a multi-disciplinary team diagnosis of fHP, as well as baseline and 1-year follow-up of lung function, baseline echocardiographic findings, bronchoalveolar lavage (BAL) cellularity and all-cause mortality were recorded. Changes in forced vital capacity (FVC) ≥ 5% and ≥10%, and diffusion capacity of the lung for carbon monoxide (DLCO) ≥ 10% and ≥15% at 1 year were calculated. Cox proportional hazards analysis was performed to test for associations with mortality.ResultsBaseline lung function severity, age, presence of honeycombing on computed tomography (CT) and echocardiographic pulmonary arterial systolic pressure (PASP) ≥ 40 mm Hg were associated with early mortality, while BAL lymphocytosis was associated with improved survival. A decline in FVC ≥ 5% (hazard ratio [HR]: 3.10, 95% CI: 2.00–4.81, p < 0.001), FVC ≥ 10% (HR: 3.11, 95% CI: 1.94–4.99, p < 0.001), DLCO ≥ 10% (HR: 2.80, 95% CI: 1.78–4.42, p < 0.001) and DLCO ≥ 15% (HR: 2.92, 95% CI: 1.18–4.72, p < 0.001) at 1 year was associated with markedly reduced survival on univariable and multivariable analyses after correcting for demographic variables, disease severity, honeycombing on CT and treatment, as well as BAL lymphocytosis and PASP ≥ 40 mm Hg on echocardiography, in separate models.ConclusionWorsening in FVC and DLCO at 1 year, including a marginal decline in FVC ≥ 5% and DLCO&th

Journal article

Macaluso C, Boccabella C, Kokosi M, Kouranos V, George PM, Margaritopoulos G, Molyneaux PL, Chua F, Maher TM, Jenkins GR, Desai S, Devaraj A, Wells AU, Renzoni EA, Stock CJWet al., 2021, MARGINAL SHORT TERM LUNG FUNCTION CHANGES PREDICT MORTALITY IN PATIENTS WITH FIBROTIC HYPERSENSITIVITY PNEUMONITIS, Publisher: BMJ PUBLISHING GROUP, Pages: A146-A147, ISSN: 0040-6376

Conference paper

Stock C, Kokosi M, Alfieri V, Kouranos V, George P, Molyneaux P, Chua F, Seeliger B, Ong V, Abraham D, Witte T, Denton C, Prasse A, Wells A, Renzoni Eet al., 2021, Evaluation of CCL18 serum levels and genetic variant as prognostic biomarkers in SSc-ILD, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Stock CJW, Hoyles RK, Daccord C, Kokosi M, Visca D, De Lauretis A, Alfieri V, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Chua F, Maher TM, Abraham DJ, Ong V, Donovan J, Sestini P, Denton CP, Wells AU, Renzoni EAet al., 2021, Serum markers of pulmonary epithelial damage in systemic sclerosis-associated interstitial lung disease and disease progression, Respirology, Vol: 26, Pages: 461-468, ISSN: 1323-7799

Background and objectiveThe course of systemic sclerosis‐associated interstitial lung disease (SSc‐ILD) is highly variable, and accurate prognostic markers are needed. KL‐6 is a mucin‐like glycoprotein (MUC1) expressed by type II pneumocytes, while CYFRA 21‐1 is expressed by alveolar and bronchiolar epithelial cells. Both are released into the blood from cell injury.MethodsSerum KL‐6 and CYFRA 21‐1 levels were measured in a retrospective (n = 189) and a prospective (n = 118) cohort of SSc patients. Genotyping of MUC1 rs4072037 was performed. Linear mixed‐effect models were used to evaluate the relationship with change in lung function parameters over time, while association with survival was evaluated with Cox proportional hazard analysis.ResultsIn both cohorts, KL‐6 and CYFRA 21‐1 were highest in patients with lung involvement, and in patients with extensive rather than limited ILD. KL‐6 was higher in patients carrying the MUC1 rs4072037 G allele in both cohorts. In patients with SSc‐ILD, serum KL‐6, but not CYFRA 21‐1, was significantly associated with DLCO decline in both cohorts (P = 0.001 and P = 0.004, respectively), and with FVC decline in the retrospective cohort (P = 0.005), but not the prospective cohort. When combining the cohorts and subgrouping by severity (median CPI = 45.97), KL‐6 remained predictive of decline in DLCO in both milder (P = 0.007) and more severe disease (P = 0.02) on multivariable analysis correcting for age, gender, ethnicity, smoking history and MUC1 allele carriage.ConclusionOur results suggest serum KL‐6 predicts decline in lung function in SSc, suggesting its clinical utility in risk stratification for progressive SSc‐ILD.

Journal article

Stock C, Renzoni E, 2021, Telomeres in interstitial lung diseases, Journal of Clinical Medicine, Vol: 10, ISSN: 2077-0383

Interstitial lung diseases (ILD) encompass a group of conditions involving fibrosis and/or inflammation of the pulmonary parenchyma. Telomeres are repetitive DNA sequences at chromosome ends which protect against genome instability. At each cell division, telomeres shorten, but the telomerase complex partially counteracts progressive loss of telomeres by catalysing the synthesis of telomeric repeats. Once critical telomere shortening is reached, cell cycle arrest or apoptosis are triggered. Telomeres progressively shorten with age. A number of rare genetic mutations have been identified in genes encoding for components of the telomerase complex, including telomerase reverse transcriptase (TERT) and telomerase RNA component (TERC), in familial and, less frequently, in sporadic fibrotic ILDs. Defects in telomerase result in extremely short telomeres. More rapidly progressive disease is observed in fibrotic ILD patients with telomere gene mutations, regardless of underlying diagnosis. Associations with common single nucleotide polymorphisms in telomere related genes have also been demonstrated for various ILDs. Shorter peripheral blood telomere lengths compared to age-matched healthy individuals are found in a proportion of patients with fibrotic ILDs, and in idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (HP) have been linked to worse survival, independently of disease severity. Greater susceptibility to immunosuppressant-induced side effects in patients with short telomeres has been described in patients with IPF and with fibrotic HP. Here, we discuss recent evidence for the involvement of telomere length and genetic variations in the development, progression, and treatment of fibrotic ILDs.

Journal article

Stock CJ, Conti C, Montero-Fernandez Á, Caramori G, Molyneaux PL, George PM, Kokosi M, Kouranos V, Maher TM, Chua F, Rice A, Denton CP, Nicholson AG, Wells A, Sestini P, Renzoni EAet al., 2020, Interaction between the promoter MUC5B polymorphism and mucin expression: is there a difference according to ILD subtype?, Thorax, Vol: 75, Pages: 901-903, ISSN: 0040-6376

The MUC5B promoter variant rs35705950 is associated with idiopathic pulmonary fibrosis (IPF). MUC5B glycoprotein is overexpressed in IPF lungs. We examined immunohistochemical expression of MUC5B in different interstitial lung disease patterns according to rs35705950 T-allele carriage. We observed increased expression of MUC5B in T-allele carriers in both distal airways and honeycomb cysts in patients with IPF (n=23), but no difference in MUC5B expression according to T-carrier status in the distal airways of patients with idiopathic non-specific interstitial pneumonitis (n=17), in scleroderma-associated non-specific interstitial pneumonitis (n=15) or in control lungs (n=20), suggesting that tissue overexpression in MUC5B rs35705950 T-carriers is specific to IPF.

Journal article

Stock C, Molyneaux P, Saunders P, Kokosi M, George P, Kouranos V, Chua F, Wells A, Maher T, Renzoni Eet al., 2020, MUC2MUC5B and TOLLIP variants: no association with disease progression and survival in an IPF cohort, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Kokosi M, Trachalaki A, Stock C, Donovan J, Tsitoura E, Kouranos V, George PM, Molyneaux PL, Chua F, Maher TM, Renzoni EA, Tzanakis N, Wells AU, Antoniou Ket al., 2020, Serum KL-6 identifies ILD patients with a progressive fibrosing phenotype, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Yaseen B, Lopez H, Taki Z, Zafar S, Rosario H, Abdi BA, Vigneswaran S, Xing F, Arumalla N, Black S, Ahmad S, Kumar K, Gul R, Scolamiero L, Morris S, Bowman A, Stainer A, Rice A, Stock C, Renzoni E, Denton CP, Venturini C, Brown M, O'Reilly S, Stratton Ret al., 2020, Interleukin-31 promotes pathogenic mechanisms underlying skin and lung fibrosis in scleroderma, RHEUMATOLOGY, Vol: 59, Pages: 2625-2636, ISSN: 1462-0324

Journal article

Stock CJW, De Lauretis A, Visca D, Daccord C, Kokosi M, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Nihtyanova S, Chua F, Maher TM, Ong V, Abraham DJ, Denton CP, Wells AU, Wain LV, Renzoni EAet al., 2020, Defining genetic risk factors for scleroderma-associated interstitial lung disease : IRF5 and STAT4 gene variants are associated with scleroderma while STAT4 is protective against scleroderma-associated interstitial lung disease, Clinical Rheumatology, Vol: 39, Pages: 1173-1179, ISSN: 0770-3198

Although several genetic associations with scleroderma (SSc) are defined, very little is known on genetic susceptibility to SSc-associated interstitial lung disease (SSc-ILD). A number of common polymorphisms have been associated with SSc-ILD, but most have not been replicated in separate populations. Four SNPs in IRF5, and one in each of STAT4, CD226 and IRAK1, selected as having been previously the most consistently associated with SSc-ILD, were genotyped in 612 SSc patients, of European descent, of whom 394 had ILD. The control population (n = 503) comprised individuals of European descent from the 1000 Genomes Project. After Bonferroni correction, two of the IRF5 SNPs, rs2004640 (OR (95% CI)1.30 (1.10-1.54), pcorr = 0.015) and rs10488631 (OR 1.48 (1.14-1.92), pcorr = 0.022), and the STAT4 SNP rs7574865 (OR 1.43 (1.18-1.73), pcorr = 0.0015) were significantly associated with SSc compared with controls. However, none of the SNPs were significantly different between patients with SSc-ILD and controls. Two SNPs in IRF5, rs10488631 (OR 1.72 (1.24-2.39), pcorr = 0.0098), and rs2004640 (OR 1.39 (1.11-1.75), pcorr = 0.03), showed a significant difference in allele frequency between controls and patients without ILD, as did STAT4 rs7574865 (OR 1.86 (1.45-2.38), pcorr = 6.6 × 10-6). A significant difference between SSc with and without ILD was only observed for STAT4 rs7574865, being less frequent in patients with ILD (OR 0.66 (0.51-0.85), pcorr = 0.0084). In conclusion, IRF5 rs2004640 and rs10488631, and STAT4 rs7574865 were significantly associated with SSc as a whole. Only STAT4 rs7574865 showed a significant difference in allele frequency in SSc-ILD, with the T allele being protective against ILD.Key points• We confirm the associations of the IRF5 SNPs rs2004640 and rs10488631, and the STAT4 SNP rs7574865, with SSc as a whole.&b

Journal article

Stock CJW, DeLauretis A, Visca D, Daccord C, Kokosi M, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Chua F, Maher TM, Abraham DJ, Denton CP, Ong V, Wells AU, Renzoni EAet al., 2019, VERIFICATION OF GENETIC ASSOCIATIONS WITH SCLERODERMA ASSOCIATED INTERSTITIAL LUNG DISEASE, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A46-A46, ISSN: 0040-6376

Conference paper

Stock CJW, Visca D, DeLauretis A, Daccord C, Kokosi M, Alfieri V, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Chua F, Maher TM, Ong V, Abraham DJ, Denton CP, Wells AU, Renzoni EAet al., 2019, SERUM BIOMARKERS IN SSC-ILD: ASSOCIATION WITH PRESENCE, SEVERITY AND PROGNOSIS, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A56-A56, ISSN: 0040-6376

Conference paper

Alfieri V, Crisafulli E, Visca D, Chong WH, Stock C, Mori L, de Lauretis A, Tsipouri V, Chua F, Kouranos V, Kokosi M, Hogben C, Molyneaux PL, George PM, Maher TM, Chetta AA, Sestini P, Wells AU, Renzoni EAet al., 2019, Physiological predictors of exertional oxygen desaturation in patients with fibrotic interstitial lung disease, European Respiratory Journal, Vol: 55, Pages: 1-4, ISSN: 0903-1936

Journal article

Stock C, De Lauretis A, Visca D, Daccord C, Kokosi M, Alfieri V, Kouranos V, Margaritopoulos G, George P, Molyneaux P, Chua F, Maher T, Ong V, Abraham D, Denton C, Wells A, Renzoni Eet al., 2019, Serum biomarkers in SSc-ILD: association with presence, severity and prognosis, International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Stock C, De Lauretis A, Visca D, Daccord C, Kokosi M, Alfieri V, Kouranos V, Margaritopoulos G, George P, Molyneaux P, Chua F, Maher T, Abraham D, Denton C, Ong V, Wells A, Renzoni Eet al., 2019, Verification of genetic associations with Seleroderma associated Interstitial Lung Disease, International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Stock CJW, Michaeloudes C, Leoni P, Durham AL, Mumby S, Wells AU, Chung KF, Adcock IM, Renzoni E, Lindahl GEet al., 2019, Bromodomain and extra-terminal (BET) protein inhibition restores redox balance and inhibits myofibroblast activation, BioMed Research International, Vol: 2019, ISSN: 2314-6133

Background and Objective. Progressive pulmonary fibrosis is the main cause of death in patients with systemic sclerosis (SSc) with interstitial lung disease (ILD) and in those with idiopathic pulmonary fibrosis (IPF). Transforming growth factor-β (TGF-β) and NADPH oxidase- (NOX-) derived reactive oxygen species (ROS) are drivers of lung fibrosis. We aimed to determine the role of the epigenetic readers, bromodomain and extraterminal (BET) proteins in the regulation of redox balance in activated myofibroblasts. Methods. In TGF-β-stimulated fibroblasts, we investigated the effect of the BET inhibitor JQ1 on the mRNA expression of the prooxidant gene NOX4 and the antioxidant gene superoxide dismutase (SOD2) by quantitative RT-PCR, the antioxidant transcription factor NF-E2-related factor 2 (Nrf2) activity by a reporter assay, and intracellular ROS levels by dichlorofluorescein staining. Myofibroblast activation was determined by α-smooth muscle actin immunocytochemistry. The role of specific BET protein isoforms in NOX4 gene regulation was studied by siRNA silencing and chromatin-immunoprecipitation. Results and Conclusions. Affymetrix gene array analysis revealed increased NOX4 and reduced SOD2 expression in SSc and IPF fibroblasts. SOD2 silencing in non-ILD control fibroblasts induced a profibrotic phenotype. TGF-β increased NOX4 and inhibited SOD2 expression, while increasing ROS production and myofibroblast differentiation. JQ1 reversed the TGF-β-mediated NOX4/SOD2 imbalance and Nrf2 inactivation and attenuated ROS production and myofibroblast differentiation. The BET proteins Brd3 and Brd4 were shown to bind to the NOX4 promoter and drive TGF-β-induced NOX4 expression. Our data indicate a critical role of BET proteins in promoting redox imbalance and pulmonary myofibroblast activation and support BET bromodomain inhibitors as a potential therapy for fibrotic lung disease.

Journal article

Stock CJW, Hoyles R, D'accord C, Kokosi M, Alfieri V, Campochiaro C, Donovan J, Mori L, Maher TM, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Chua F, Abraham DJ, Ong V, Denton CP, Wells AU, Renzoni EAet al., 2018, SERUM CYFRA 21-1 AS A PROGNOSTIC MARKER IN SCLERODERMA-ASSOCIATED INTERSTITIAL LUNG DISEASE, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A89-A90, ISSN: 0040-6376

Conference paper

Lota HK, Stock CJ, Renzoni EA, Wells AU, Leiper JMet al., 2018, A NOVEL DIMETHYLARGININE DIMETHYLAMINOHYDROLASE 1 (DDAH1) GENETIC VARIANT ASSOCIATED WITH LOWER ASYMMETRIC DIMETHYLARGININE (ADMA) LEVELS PREDICTS ACCELERATED LUNG FUNCTION DECLINE AND MORTALITY IN IDIOPATHIC PULMONARY FIBROSIS, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A88-A88, ISSN: 0040-6376

Conference paper

Visca D, Mori L, Tsipouri V, Fleming S, Firouzi A, Bonini M, Pavitt MJ, Alfieri V, Canu S, Bonifazi M, Boccabella C, De Lauretis A, Stock CJW, Saunders P, Montgomery A, Hogben C, Stockford A, Pittet M, Brown J, Chua F, George PM, Molyneaux PL, Margaritopoulos GA, Kokosi M, Kouranos V, Russell AM, Birring SS, Chetta A, Maher TM, Cullinan P, Hopkinson NS, Banya W, Whitty JA, Adamali H, Spencer LG, Farquhar M, Sestini P, Wells AU, Renzoni EAet al., 2018, Effect of ambulatory oxygen on quality of life for patients with fibrotic lung disease (AmbOx): a prospective, open-label, mixed-method, crossover randomised controlled trial, Lancet Respiratory Medicine, Vol: 6, Pages: 759-770, ISSN: 2213-2600

BACKGROUND: In fibrotic interstitial lung diseases, exertional breathlessness is strongly linked to health-related quality of life (HRQOL). Breathlessness is often associated with oxygen desaturation, but few data about the use of ambulatory oxygen in patients with fibrotic interstitial lung disease are available. We aimed to assess the effects of ambulatory oxygen on HRQOL in patients with interstitial lung disease with isolated exertional hypoxia. METHODS: AmbOx was a prospective, open-label, mixed-method, crossover randomised controlled clinical trial done at three centres for interstitial lung disease in the UK. Eligible patients were aged 18 years or older, had fibrotic interstitial lung disease, were not hypoxic at rest but had a fall in transcutaneous arterial oxygen saturation to 88% or less on a screening visit 6-min walk test (6MWT), and had self-reported stable respiratory symptoms in the previous 2 weeks. Participants were randomly assigned (1:1) to either oxygen treatment or no oxygen treatment for 2 weeks, followed by crossover for another 2 weeks. Randomisation was by a computer-generated sequence of treatments randomly permuted in blocks of constant size (fixed size of ten). The primary outcome, which was assessed by intention to treat, was the change in total score on the King's Brief Interstitial Lung Disease questionnaire (K-BILD) after 2 weeks on oxygen compared with 2 weeks of no treatment. General linear models with treatment sequence as a fixed effect were used for analysis. Patient views were explored through semi-structured topic-guided interviews in a subgroup of participants. This study was registered with ClinicalTrials.gov, number NCT02286063, and is closed to new participants with all follow-up completed. FINDINGS: Between Sept 10, 2014, and Oct 5, 2016, 84 patients were randomly assigned, 41 randomised to ambulatory oxygen first and 43 to no oxygen. 76 participants completed the trial. Compared with no oxygen, ambulatory oxygen was ass

Journal article

Stock C, Hoyles R, D'Accord C, Kokosi M, Alfieri V, Campochiaro C, Donovan J, Mori L, Maher TM, Kouranos V, Margaritopoulos G, George PM, Molyneaux PL, Chua F, Ong V, Denton CP, Wells AU, Renzoni EAet al., 2018, Serum KL-6 as a marker of disease progression in SSc-ILD, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Boccabella C, Macaluso C, Kokosi M, Alfieri V, Stock C, Kouranos V, Margaritopoulos G, Mori L, Barnett J, Molyneaux P, George P, Chua F, Maher T, Desai S, Jacob J, Devaraj A, Wells A, Renzoni Eet al., 2018, Pulmonary function trends predict mortality in patients with hypersensitivity pneumonitis, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Stock CJW, Renzoni EA, 2018, Genetic predictors of systemic sclerosis-associated interstitial lung disease: a review of recent literature, European Journal of Human Genetics, Vol: 26, Pages: 765-777, ISSN: 1018-4813

The interplay between genetic and environmental factors is likely involved in the pathogenesis of systemic sclerosis (SSc). Interstitial lung disease associated in the context of SSc (SSc-ILD) is associated with significant morbidity, and is the leading cause of death in SSc. The spectrum of SSc-ILD severity is wide, ranging from patients with only limited and inherently stable pulmonary involvement, to those with extensive and progressive pulmonary fibrosis. In order to provide accurate prognostic information for patients, and to initiate appropriate monitoring and treatment regimens, the ability to identify patients at risk of developing severe ILD early in the disease course is crucial. Identification of genetic variants involved in disease pathogenesis can not only potentially provide diagnostic/prognostic markers, but can also highlight dysregulated molecular pathways for therapeutic targeting. A number of genetic associations have been established for susceptibility to SSc, but far fewer studies have investigated genetic susceptibility to SSc-ILD specifically. In this review we present a summary of the studies assessing genetic associations with SSc-ILD.

Journal article

Molyneaux PL, Willis Owen SA, Cox MJ, James P, Cowman S, Loebinger M, Blanchard A, Edwards LM, Stock C, Daccord C, Renzoni EA, Wells AU, Moffatt MF, Cookson WO, Maher TMet al., 2017, Host-microbial interactions in idiopathic pulmonary fibrosis, American Journal of Respiratory and Critical Care Medicine, Vol: 195, Pages: 1640-1650, ISSN: 1535-4970

RATIONALE: Changes in the respiratory microbiome are associated with disease progression in Idiopathic pulmonary fibrosis (IPF). The role of the host response to the respiratory microbiome however remains unknown. OBJECTIVES: To explore the host-microbial interaction in IPF. METHODS: Sixty patients diagnosed with IPF were prospectively enrolled, together with 20 matched controls. Subjects underwent bronchoalveolar lavage (BAL) and peripheral whole blood was collected into PAXgene tubes for all subjects at baseline. For IPF subjects additional samples were taken at 1, 3, and 6 months and (if alive) a year. Gene expression profiles were generated using Affymetrix Human Gene1.1ST Arrays. MEASUREMENTS AND MAIN RESULTS: Network analysis of gene expression data identified two gene modules that strongly associate with a diagnosis of IPF, BAL bacterial burden (determined by 16S quantitative PCR) and specific microbial OTUs, as well as lavage and peripheral blood neutrophilia. Genes within these modules that are involved in the host defence response include NLRC4, PGLYRP1, MMP9, DEFA4. The modules also contain two genes encoding specific antimicrobial peptides (SLPI and CAMP). Many of these particular transcripts were associated with survival and showed longitudinal over expression in subjects experiencing disease progression, further strengthening their relationship with disease. CONCLUSIONS: Integrated analysis of the host transcriptome and microbial signatures demonstrates an apparent host response to the presence of an altered or more abundant microbiome. These responses remain elevated on longitudinal follow up, suggesting that the bacterial communities of the lower airways may be acting as persistent stimuli for repetitive alveolar injury in IPF.

Journal article

Stock C, Hubank M, Michaeloudes C, Chung F, Wells A, Adcock I, Renzoni E, Lindahl Get al., 2016, Microarray Analysis Maps Global Effects of Epigenetic Bromodomain Inhibitor JQ1 on Gene Expression in Transforming Growth Factor-β-Stimulated Adult Lung Fibroblasts, British Society for Rheumatology, British Health Professionals in Rheumatology and the British Society for Paediatric and Adolescent Rheumatology Annual Meeting 2015, Publisher: Oxford University Press (OUP), Pages: 164-165, ISSN: 1462-0332

Conference paper

Conti C, Montero-Fernandez A, Borg E, Osadolor T, Viola P, De Lauretis A, Stock CJ, Bonifazi M, Bonini M, Caramori G, Lindahl G, Blasi FB, Nicholson AG, Wells AU, Sestini P, Renzoni Eet al., 2016, Mucins MUC5B and MUC5AC in Distal Airways and Honeycomb Spaces: Comparison among Idiopathic Pulmonary Fibrosis/Usual Interstitial Pneumonia, Fibrotic Nonspecific Interstitial Pneumonitis, and Control Lungs, American Journal of Respiratory and Critical Care Medicine, Vol: 193, Pages: 462-464, ISSN: 1535-4970

Journal article

Saunders P, Stock CJ, Molyneaux PL, Kokosi M, Kingston S, Belvisi MG, Wells AU, Renzoni EA, Maher TMet al., 2015, MUC5B GENOTYPE DOES NOT INFLUENCE COUGH SEVERITY IN IPF, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A29-A29, ISSN: 0040-6376

Conference paper

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