DrDavidAntcliffe

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Critical Medicine

Contact

Location

Intensive Care UnitCharing Cross HospitalCharing Cross Campus

Summary

David Antcliffe is a Clinical Senior Lecturer at Imperial College and an Honorary Consultant in Critical Care at Charing Cross Hospital.

He obtained his degree in medicine in 2003 from University College London and pursued post-graduate training in Acute and Intensive Care Medicine across London. Between 2011 and 2015 he completed a PhD at Imperial College using metabolic profiling to aid in the diagnosis of pneumonia in patients requiring critical care funded by the Imperial College BRC and the Intensive Care Foundation.

After obtaining a dual CCT in Acute and Intensive Care Medicine in 2016 he returned to Imperial College to continue pursuing his academic interests in phenotyping critical illness.

His current research interests involve using a range of profiling techniques, including metabonomic, transcriptomic and inflammatory profiling, to identify sub-phenotypes in sepsis that could predict a patient's responsiveness to specific therapeutic strategies and lead to a personalised approach to sepsis care. This approach has lead to the finding that stratifying patients with septic shock based on the way in which their genes are expressed (sepsis response signature (SRS) transcriptomic endotypes) identified groups who respond differently to corticosteroids in this condition. Ongoing work aims to translate this finding to the bedside to use point of care tests to identify patients who are most likely to benefit from these interventions.

ONGOING PROJECTS:

Corticosteroid Response and Gene Expression in Septic Shock (CRESS)

(Winner of the Intensive Care Society Research Prioritisation Exercise, 2019)

In this project, I aim to translate findings from transcriptomic studies identifying a link between gene expression patterns and outcomes following corticosteroid use for septic shock to the bedside. The ultimate goal is to deliver a large scale, personalised medicine trial in septic shock where gene expression profiles would be used to guide treatment decisions.

Phenotyping the Patient's Journey

Metabolic Phenotyping or Molecular Phenomics uses metabonomic methods to examine 'metabolic fingerprints' of diseases and the way they change in response to treatment. In this, Imperial College BRC supported, project I am using these methods to track the metabolic trajectories of patients with septic shock with the intention of tracking responses to treatments and development of new organ dysfunction. Samples collected from two large, Imperial College run, septic shock randomised controlled trials (VANISH and LeoPARDS) are being used to define and validate metabolic trajectories in this condition and will become one of the largest metabolic data sets in sepsis.

Study Evaluating Acute Dysfunction in balance and postural control after critical illness (StEADy)

Including the Activate- (Muscle activation during early mobility strategies in health) pilot study

In collaboration with the Musculoskeletal laboratory, this project aims to establish patterns of trunk and peripheral muscle activity during recovery from critical illness. We aim to understand changes that occur to the control of balance and posture in response to critical illness. Improving our knowledge in this area may change the way that post critical illness rehabilitation is provided.

Management of severe acute respiratory failure during the COVID-19 pandemic A National Service Evaluation (COVID-ICU)

This collaborative observational cohort study intends to characterise the ICU management of Covid-19 induced Severe Acute Respiratory Failure.
It will document the management of critically ill COVID-19 patients and compare it to current best practice. and will characterize the trajectory of subjects with COVID19-ARDS in terms of respiratory physiology and responsiveness to adjunctive ARDS therapies/manoeuvres.

Selected Publications

Journal Articles

Antcliffe D, Mi Y, Santhakumaran S, et al.Antcliffe D, Mi Y, Santhakumaran S, Burnham K, Prevost AT, Ward J, Marshall T, Bradley C, Al-Beidh F, Hutton P, McKechnie S, Davenport E, Hinds C, O'Kane C, McAuley D, Shankar-Hari M, Gordon A, Knight J close, 2024, Patient stratification using plasma cytokines and their regulators in sepsis: relationship to outcomes, treatment effect and leukocyte transcriptomic sub-phenotypes, Thorax, ISSN:0040-6376

Warner B, Harry A, Wells M, et al.Warner B, Harry A, Wells M, Brett S, Antcliffe D close, 2023, Escalation to intensive care for the older patient. An exploratory qualitative study of patients aged over 65 years and their next of kin during the COVID-19 pandemic: the ESCALATE study, Age and Ageing, Vol:52, ISSN:0002-0729, Pages:1-13

Cleasby C, Marshall T, Gordon AC, et al.Cleasby C, Marshall T, Gordon AC, Antcliffe D close, 2023, The effect of vasopressin and hydrocortisone on cytokine trajectories: exploratory analysis from the VANISH trial, Intensive Care Medicine, Vol:49, ISSN:0342-4642, Pages:241-243

Komorowski M, Green A, Tatham KC, et al.Komorowski M, Green A, Tatham KC, Seymour C, Antcliffe D close, 2022, Sepsis biomarkers and diagnostic tools with a focus on machine learning., Ebiomedicine, Vol:86, ISSN:2352-3964, Pages:1-10

Cano-Gamez E, Burnham KL, Goh C, et al.Cano-Gamez E, Burnham KL, Goh C, Allcock A, Malick ZH, Overend L, Kwok A, Smith DA, Peters-Sengers H, Antcliffe D, GAinS Investigators, McKechnie S, Scicluna BP, van der Poll T, Gordon AC, Hinds CJ, Davenport EE, Knight JC, Webster N, Galley H, Taylor J, Hall S, Addison J, Roughton S, Tennant H, Guleri A, Waddington N, Arawwawala D, Durcan J, Short A, Swan K, Williams S, Smolen S, Mitchell-Inwang C, Gordon T, Errington E, Templeton M, Venatesh P, Ward G, McCauley M, Baudouin S, Higham C, Soar J, Grier S, Hall E, Brett S, Kitson D, Wilson R, Mountford L, Moreno J, Hall P, Hewlett J, McKechnie S, Garrard C, Millo J, Young D, Hutton P, Parsons P, Smiths A, Faras-Arraya R, Soar J, Raymode P, Thompson J, Bowrey S, Kazembe S, Rich N, Andreou P, Hales D, Roberts E, Fletcher S, Rosbergen M, Glister G, Cuesta JM, Bion J, Millar J, Perry EJ, Willis H, Mitchell N, Ruel S, Carrera R, Wilde J, Nilson A, Lees S, Kapila A, Jacques N, Atkinson J, Brown A, Prowse H, Krige A, Bland M, Bullock L, Harrison D, Mills G, Humphreys J, Armitage K, Laha S, Baldwin J, Walsh A, Doherty N, Drage S, Ortiz-Ruiz de Gordoa L, Lowes S, Higham C, Walsh H, Calder V, Swan C, Payne H, Higgins D, Andrews S, Mappleback S, Hind C, Garrard C, Watson D, McLees E, Purdy A, Stotz M, Ochelli-Okpue A, Bonner S, Whitehead I, Hugil K, Goodridge V, Cawthor L, Kuper M, Pahary S, Bellingan G, Marshall R, Montgomery H, Ryu JH, Bercades G, Boluda S, Bentley A, Mccalman K, Jefferies F, Knight J, Davenport E, Burnham K, Maugeri N, Radhakrishnan J, Mi Y, Allcock A, Goh C close, 2022, An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression., Science Translational Medicine, Vol:14, ISSN:1946-6234, Pages:1-15

Warner B, Harry A, Brett S, et al.Warner B, Harry A, Brett S, Wells M, Antcliffe D close, 2022, The end is just the beginning: involvement of bereaved next of kin in qualitative research, Bmj Supportive & Palliative Care, Vol:12, ISSN:2045-4368

Jones T, Janani L, Gordon A, et al.Jones T, Janani L, Gordon A, Al-Beidh F, Antcliffe D close, 2022, A novel role for cytochrome P450 epoxygenase metabolites in septic shock, Critical Care Explorations, Vol:4, ISSN:2639-8028

Patel BV, Haar S, Handslip R, et al.Patel BV, Haar S, Handslip R, Auepanwiriyakul C, Lee TM-L, Patel S, Harston JA, Hosking-Jervis F, Kelly D, Sanderson B, Borgatta B, Tatham K, Welters I, Camporota L, Gordon AC, Komorowski M, Antcliffe D, Prowle JR, Puthucheary Z, Faisal AA close, 2021, Natural history, trajectory, and management of mechanically ventilated COVID-19 patients in the United Kingdom, Intensive Care Medicine, Vol:47, ISSN:0342-4642, Pages:549-565

Antcliffe DB, Gordon AC, 2019, Why Understanding Sepsis Endotypes Is Important for Steroid Trials in Septic Shock, Critical Care Medicine, Vol:47, ISSN:0090-3493, Pages:1782-1784

Antcliffe DB, Santhakumaran S, Orme RML, et al.Antcliffe DB, Santhakumaran S, Orme RML, Ward JK, Al-Beidh F, O’Dea K, Perkins GD, Singer M, McAuley DF, Mason AJ, Cross M, Ashby D, Gordon AC close, 2019, Levosimendan in septic shock in patients with biochemical evidence of cardiac dysfunction: a subgroup analysis of the LeoPARDS randomised trial, Intensive Care Medicine, Vol:45, ISSN:0342-4642, Pages:1392-1400

Antcliffe D, Burnham K, Al-Beidh F, et al.Antcliffe D, Burnham K, Al-Beidh F, Santhakumaran S, Brett S, Hinds C, Ashby D, Knight J, Gordon AC close, 2019, Transcriptomic signatures in sepsis and a differential response to steroids: from the VANISH randomized trial, American Journal of Respiratory and Critical Care Medicine, Vol:199, ISSN:1073-449X, Pages:980-986

Antcliffe D, Wolfer A, O'Dea K, et al.Antcliffe D, Wolfer A, O'Dea K, Takata M, Holmes E, Gordon AC close, 2018, Profiling inflammatory markers in patients with pneumonia on intensive care, Scientific Reports, Vol:8, ISSN:2045-2322

Antcliffe D, Jimenez B, Veselkov K, et al.Antcliffe D, Jimenez B, Veselkov K, Holmes E, Gordon AC close, 2017, Metabolic profiling in patients with pneumonia on intensive care, Ebiomedicine, Vol:18, ISSN:2352-3964, Pages:244-253

Gordon AC, Antcliffe D, 2016, Metabonomics and intensive care, Critical Care, Vol:20, ISSN:1364-8535

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