Imperial College London

ProfessorPallavShah

Faculty of MedicineNational Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
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Contact

 

+44 (0)20 7351 8021pallav.shah

 
 
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Location

 

Fulham RoadRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

346 results found

McCarthy LP, Orton CM, Watson NA, Gregson FKA, Haddrell AE, Browne WJ, Calder JD, Costello D, Reid JP, Shah PL, Bzdek BRet al., 2021, Aerosol and droplet generation from performing with woodwind and brass instruments, AEROSOL SCIENCE AND TECHNOLOGY, ISSN: 0278-6826

Journal article

Vijayakumar B, Shah PL, 2021, Not All Parenchymal Changes on CT are ILD., Ann Am Thorac Soc

Journal article

Born J, Beymer D, Rajan D, Coy A, Mukherjee VV, Manica M, Prasanna P, Ballah D, Guindy M, Shaham D, Shah PL, Karteris E, Robertus JL, Gabrani M, Rosen-Zvi Met al., 2021, On the role of artificial intelligence in medical imaging of COVID-19, PATTERNS, Vol: 2, ISSN: 2666-3899

Journal article

van Dijk M, Sue R, Criner GJ, Gompelmann D, Herth FJF, Hogarth DK, Klooster K, Kocks JWH, de Oliveira HG, Shah PL, Valipour A, Slebos D-Jet al., 2021, Expert Statement: Pneumothorax Associated with One-Way Valve Therapy for Emphysema: 2020 Update, RESPIRATION, ISSN: 0025-7931

Journal article

Vijayakumar B, Shah PL, 2021, Is Fibrosis Really Fibrosis?, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 203, Pages: 1440-1442, ISSN: 1073-449X

Journal article

Horby PW, Landray MJ, 2021, Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial, The Lancet, Vol: 397, Pages: 2049-2059, ISSN: 0140-6736

BackgroundMany patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19.MethodsThis randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.FindingsBetween May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of pati

Journal article

Lam S, Shah PL, 2021, Bronchoscopic Diagnosis of Peripheral Lung Lesions, RESPIRATION, ISSN: 0025-7931

Journal article

Klooster K, Valipour A, Marquette C-H, Boutros J, Mal H, Marceau A, Shah PL, Conway F, Deslee G, Bourdin A, Pison C, Grah C, Hetzel M, Schumann C, Kessler R, Huebner R-H, Skowasch D, Darwiche K, Hammerl P, Stanzel F, Bezzi M, Dutau H, Herth FJF, Slebos D-Jet al., 2021, Endobronchial Coil System versus Standard-of-Care Medical Management in the Treatment of Subjects with Severe Emphysema, RESPIRATION, ISSN: 0025-7931

Journal article

Horby PW, Landray MJ, 2021, Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial, The Lancet, Vol: 397, Pages: 1637-1645, ISSN: 0140-6736

BackgroundIn this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.MethodsThis randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).FindingsBetween April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ra

Journal article

Chaudhuri R, Rubin A, Sumino K, Lapa E Silva JR, Niven R, Siddiqui S, Klooster K, McEvoy C, Shah PL, Simoff M, Khatri S, Barbers R, Mark Grubb G, McMullen EA, Olson JL, Laviolette M, BT10 Study Groupet al., 2021, Safety and effectiveness of bronchial thermoplasty after 10 years in patients with persistent asthma (BT10+): a follow-up of three randomised controlled trials., Lancet Respir Med, Vol: 9, Pages: 457-466

BACKGROUND: Bronchial thermoplasty is an endoscopic treatment for uncontrolled asthma. Previous randomised clinical trials have shown that bronchial thermoplasty reduces severe exacerbations in people with asthma. However, the long-term efficacy and safety of bronchial thermoplasty beyond 5 years is unknown. The BT10+ study aimed to investigate the efficacy and safety of bronchial thermoplasty after 10 or more years of follow-up. METHODS: BT10+ was an international, multicentre, follow-up study of participants who were previously enrolled in the AIR, RISA, and AIR2 trials and who had 10 or more years of follow-up since bronchial thermoplasty treatment. Data on patient demographics, quality of life, lung function, CT scans (AIR2 participants only), severe exacerbations, and health-care use during the previous year were collected at the BT10+ 10-year outcomes study visit. The primary effectiveness endpoint was durability of the thermoplasty treatment effect, determined by comparing the proportion of participants who had severe exacerbations during the first and fifth years after bronchial thermoplasty treatment with the proportion of participants who had severe exacerbations during the 12-month period before the BT10+ visit. The primary safety endpoint was the absence of clinically significant post-treatment respiratory image changes after bronchial thermoplasty, defined as bronchiectasis or bronchial stenosis as confirmed by pulmonary volumetric high-resolution CT scan at the BT10+ visit (AIR2 participants only). All analyses were done on an intention-to-treat basis. The trial is registered with ClinicalTrials.gov, NCT03243292. The last patient was enrolled on Dec 11, 2018. The last patient completed follow-up on Jan 10, 2019. FINDINGS: The BT10+ study enrolled 192 (45%) of the 429 participants who were enrolled in the AIR, RISA, and AIR2 trials. The BT10+ participants comprised 136 who received bronchial thermoplasty (52% of the 260 participants who received bronchi

Journal article

Hartman JE, Garner JL, Shah PL, Slebos D-Jet al., 2021, New bronchoscopic treatment modalities for patients with chronic bronchitis, EUROPEAN RESPIRATORY REVIEW, Vol: 30, ISSN: 0905-9180

Journal article

Shah PL, 2021, Springs that don't spring out: Fiducials for stereotactic radiotherapy, RESPIROLOGY, Vol: 26, Pages: 409-410, ISSN: 1323-7799

Journal article

Hartman JE, Klooster K, Augustijn SWS, van Geffen WH, Garner JL, Shah PL, Ten Hacken NHT, Slebos D-Jet al., 2021, Identifying Responders and Exploring Mechanisms of Action of the Endobronchial Coil Treatment for Emphysema, RESPIRATION, Vol: 100, Pages: 443-451, ISSN: 0025-7931

Journal article

Pison C, Shah PL, Slebos D-J, Ninane V, Janssens W, Perez T, Kessler R, Deslee G, Garner JL, Hartman JE, Degano B, Mayr A, Mayse M, Peterson AD, Valipour Aet al., 2021, Safety of denervation following targeted lung denervation therapy for COPD: AIRFLOW-1 3-year outcomes (vol 22, pg 62, 2021), RESPIRATORY RESEARCH, Vol: 22

Journal article

Hartman JE, Criner GJ, Moore WH, van Rikxoort EM, Sciurba FC, Shah PL, Vliegenthart R, Welling JBA, Slebos D-Jet al., 2021, HRCT characteristics of severe emphysema patients: Interobserver variability among expert readers and comparison with quantitative software, EUROPEAN JOURNAL OF RADIOLOGY, Vol: 136, ISSN: 0720-048X

Journal article

Gregson FKA, Watson NA, Orton CM, Haddrell AE, McCarthy LP, Finnie TJR, Gent N, Donaldson GC, Shah PL, Calder JD, Bzdek BR, Costello D, Reid JPet al., 2021, Comparing aerosol concentrations and particle size distributions generated by singing, speaking and breathing, Aerosol Science and Technology, Vol: 55, Pages: 681-691, ISSN: 0278-6826

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in an unprecedented shutdown in social and economic activity, with the cultural sector particularly severely affected. Restrictions on musical performances have arisen from a perception that there is a significantly higher risk of aerosol production from singing than speaking, based upon high-profile examples of clusters of COVID-19 following choral rehearsals. However, comparing aerosol generation from different types of vocalization, including singing, across a range of volumes is a rapidly evolving area of research. Here, we measured aerosols from singing, speaking and breathing from a large cohort of 25 professional singers in a range of musical genres in a zero-background environment, allowing unequivocal attribution of aerosol production to specific vocalizations. We do not assess the relative volumes at which people speak and sing. However, both showed steep increases in mass concentration with increase in loudness (spanning a factor of 20–30 across the dynamic range measured, p < 0.001). At the quietest volume (50 to 60 dBA), neither singing (p = 0.19) nor speaking (p = 0.20) were significantly different to breathing. At the loudest volume (90 to 100 dBA), a statistically significant difference (p < 0.001) was observed between singing and speaking, but with singing only generating a factor of between 1.5 and 3.4 more aerosol mass. Guidelines for musical performances should be based on the loudness and duration of the vocalization, the number of participants and the environment in which the activity occurs, rather than the type of vocalization. Mitigations such as the use of amplification and increased attention to ventilation should be employed where practicable.

Journal article

RECOVERY Collaborative Group, Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi E, Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie JK, Haynes R, Landray MJet al., 2021, Dexamethasone in hospitalized patients with Covid-19., New England Journal of Medicine, Vol: 384, Pages: 693-704, ISSN: 0028-4793

BACKGROUND: Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. METHODS: In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the final results of this assessment. RESULTS: A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P<0.001). The proportional and absolute between-group differences in mortality varied considerably according to the level of respiratory support that the patients were receiving at the time of randomization. In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.92 to 1.55). CONCLUSIONS: In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support. (Funded by the Medical Research Council and National Institute for Health Research and others; RECOVERY Clin

Journal article

Garner J, Biddiscombe MF, Meah S, Lewis A, Buttery SC, Hopkinson NS, Kemp SV, Usmani OS, Shah PL, Verbanck Set al., 2021, Endobronchial valve lung volume reduction and small airways function., American Journal of Respiratory and Critical Care Medicine, Vol: 203, Pages: 1576-1579, ISSN: 1073-449X

Journal article

Horby PW, Roddick A, Spata E, Staplin N, Emberson J, Pessoa-Amorim G, Brightling C, Prudon B, Chadwick D, Ustianowski A, Ashish A, Todd S, Yates B, Buttery R, Scott S, Maseda D, Baillie JK, Buch M, Chappell L, Day J, Faust SN, Jaki T, Jeffery K, Juszczak E, Lim WS, Montgomery A, Mumford A, Rowan K, Thwaites G, Mafham M, Haynes R, Landray MJ, Horby PW, Landray MJ, Baillie JK, Buch M, Chappell L, Day J, Faust SN, Haynes R, Jaki T, Jeffery K, Juszczak E, Lim WS, Mafham M, Montgomery A, Mumford A, Rowan K, Thwaites G, Sandercock P, Darbyshire J, DeMets D, Fowler R, Lalloo D, Roberts I, Wittes J, Horby P, Landray MJ, Haynes R, Fletcher L, Barton J, Basoglu A, Brown R, Brudlo W, Denis E, Howard S, McChlery G, Taylor K, Cui G, Goodenough B, King A, Lay M, Murray D, Stevens W, Wallendszus K, Welsh R, Crichton C, Davies J, Goldacre R, Harper C, Knight F, Latham-Mollart J, Mafham M, Nunn M, Salih H, Welch J, Campbell M, Pessoa-Amorim G, Peto L, Roddick A, Knott C, Wiles J, Bell JL, Emberson J, Juszczak E, Linsell L, Spata E, Staplin N, Bagley G, Cameron S, Chamberlain S, Farrell B, Freeman H, Kennedy A, Whitehouse A, Wilkinson S, Wood C, Reith C, Davies K, Halls H, Holland L, Wilson K, Howie L, Lunn M, Rodgers P, Barnard A, Beety J, Birch C, Brend M, Chambers E, Chappell L, Crawshaw S, Drake C, Duckles-Leech H, Graham J, Harman T, Harper H, Lock S, Lomme K, McMillan N, Nickson I, Ohia U, OKell E, Poustie V, Sam S, Sharratt P, Sheffield J, Slade H, Hoff WV, Walker S, Williamson J, De Soyza A, Dimitri P, Faust SN, Lemoine N, Minton J, Gilmour K, Pearson K, Armah C, Campbell D, Cate H, Priest A, Thomas E, Usher R, Johnson G, Logan M, Pratt S, Price A, Shirley K, Walton E, Williams P, Yelnoorkar F, Hanson J, Membrey H, Gill L, Oliver A, Das S, Murphy S, Sutu M, Collins J, Monaghan H, Unsworth A, Beddows S, Williams KB, Dowling S, Gibbons K, Pine K, Asghar A, Aubrey P, Jewell DB, Donaldson K, Skinner T, Luo J, Mguni N, Muzengi N, Pleass R, Wayman E, Coe A, Hicks J, Hough M, Levettet al., 2021, Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial, The Lancet, Vol: 397, Pages: 605-612, ISSN: 0140-6736

BackgroundAzithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.MethodsIn this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.FindingsBetween April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No

Journal article

Ravi A, Goorsenberg AWM, Dijkhuis A, Dierdorp BS, Dekker T, van Weeghel M, Sabogal Piñeros YS, Shah PL, Ten Hacken NHT, Annema JT, Sterk PJ, Vaz FM, Bonta PI, Lutter Ret al., 2021, Metabolic differences between bronchial epithelium from healthy individuals and patients with asthma and the effect of bronchial thermoplasty., J Allergy Clin Immunol

BACKGROUND: Asthma is a heterogeneous disease with differences in onset, severity, and inflammation. Bronchial epithelial cells (BECs) contribute to asthma pathophysiology. OBJECTIVE: We determined whether transcriptomes of BECs reflect heterogeneity in inflammation and severity in asthma, and whether this was affected in BECs from patients with severe asthma after their regeneration by bronchial thermoplasty. METHODS: RNA sequencing was performed on BECs obtained by bronchoscopy from healthy controls (n = 16), patients with mild asthma (n = 17), patients with moderate asthma (n = 5), and patients with severe asthma (n = 17), as well as on BECs from treated and untreated airways of the latter (also 6 months after bronchial thermoplasty) (n = 23). Lipidome and metabolome analyses were performed on cultured BECs from healthy controls (n = 7); patients with severe asthma (n = 9); and, for comparison, patients with chronic obstructive pulmonary disease (n = 7). RESULTS: Transcriptome analysis of BECs from patients showed a reduced expression of oxidative phosphorylation (OXPHOS) genes, most profoundly in patients with severe asthma but less profoundly and more heterogeneously in patients with mild asthma. Genes related to fatty acid metabolism were significantly upregulated in asthma. Lipidomics revealed enhanced levels of lipid species (phosphatidylcholines, lysophosphatidylcholines. and bis(monoacylglycerol)phosphate), whereas levels of OXPHOS metabolites were reduced in BECs from patients with severe asthma. BECs from patients with mild asthma characterized by hyperresponsive production of mediators implicated in neutrophilic inflammation had decreased expression of OXPHOS genes compared with that in BECs from patients with mild asthma with normoresponsive production. BECs obtained after thermoplasty had significantly increased expression of OXPHOS genes and decreased expression of fatty acid metabolism genes compared with BECs

Journal article

Goorsenberg AWM, D'Hooghe JNS, Srikanthan K, Ten Hacken NHT, Weersink EJM, Roelofs JJTH, Kemp S, Bel EH, Shah PL, Annema JT, Bonta Pet al., 2021, Bronchial Thermoplasty Induced Airway Smooth Muscle Reduction and Clinical Response in Severe Asthma The TASMA Randomized Trial, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 203, Pages: 175-184, ISSN: 1073-449X

Journal article

Singh S, Shah PL, 2021, Safe and efficient practice of bronchoscopic sampling from mechanically ventilated patients: a structured evaluation of the ambu bronchosampler-ascope 4 integrated system, Respiration: international journal of thoracic medicine, Vol: 100, Pages: 27-33, ISSN: 0025-7931

BACKGROUND: Bronchoscopic sampling of bronchoalveolar fluid (BAL) should be safe and effective. Current sampling practice risks loss of sample to the attached negative flow, aerosolisation, or spillage, due to repeated circuit breaks, when replacing sample containers. Such concerns were highlighted during the recent coronavirus pandemic. OBJECTIVES: Evaluation of an alternative integrated sampling solution, with the Ambu Bronchosampler with aScope 4, by an experienced bronchoscopist in ICU. METHODS: An observational study of 20 sequential bronchoscopic diagnostic sampling procedures was performed on mechanically ventilated patients with suspected ventilator-associated pneumonia. Mixed methods assessment was done. The predefined outcome measures were (1) ease of set up, (2) ease of specimen collection, (3) ease of protecting specimen from loss or spillage, and (4) overall workflow. The duration of the procedure and the % volume of sample retrieved were recorded. RESULTS: The mean (±standard deviation [SD]) time for collecting 1 sample was 2.5 ± 0.8 min. The mean (±SD) specimen yield for instilled miniBAL was 54.2 ± 17.9%. Compared with standard sampling, the set-up was much easier in 18 (90%), or easier in 2 (10%) of procedures, reducing the connection steps. It was much more intuitive to use in 14 (70%), more intuitive in 4 (20%), and no more intuitive to use in 2 (10%). The overall set-up and workflow was much easier in 69% of the 13 intraprocedural connections and easier or as easy in the remaining 31% procedures. All procedures where pre connection was established were much easier (7, 100%). The Ambu Bronchosampler remained upright in all procedures with no loss or spillage of sample. Obtaining a sample was much easier in 60%, easier in 10%, no different in 20%, and worse in 10%. The ability to protect a sample from start to finish compared to standard procedures was much easier in 80%, easier in 15%, and no different in 5% of procedur

Journal article

Soni S, Garner J, O'Dea K, Kohn M, Finney L, Tirlapur N, Srikanthan K, aboelhassan A, Singh S, Wilson M, Wedzicha J, Kemp S, Usmani O, Shah P, Takata Met al., 2021, Intra-alveolar neutrophil-derived microvesicles are associated with disease severity in COPD, American Journal of Physiology: Lung Cellular and Molecular Physiology, Vol: 320, Pages: L73-L83, ISSN: 1040-0605

Despite advances in the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD), there is a distinct lack of biochemical markers to aid clinical management. Microvesicles (MVs) have been implicated in the pathophysiology of inflammatory diseases including COPD but their association to COPD disease severity remains unknown. We analysed different MV populations in plasma and bronchoalveolar lavage fluid (BALF) taken from sixty-two patients with mild to very severe COPD (51% male; mean age: 65.9 years). These patients underwent comprehensive clinical evaluation (symptom scores, lung function, exercise testing) and the capacity of MVs to be clinical markers of disease severity was assessed. We successfully identified various MV subtype populations within BALF (leukocyte, PMN (polymorphonuclear leukocyte i.e. neutrophil), monocyte, epithelial and platelet MVs) and plasma (leukocyte, PMN, monocyte and endothelial MVs), and compared each MV population to disease severity. BALF neutrophil MVs were the only population to significantly correlate with the clinical evaluation scores including FEV1, mMRC dyspnoea score, 6-minute walk test, hyperinflation and gas transfer. BALF neutrophil MVs, but not neutrophil cell numbers, also strongly correlated with BODE index. We have undertaken, for the first time, a comprehensive evaluation of MV profiles within BALF/plasma of COPD patients. We demonstrate that BALF levels of neutrophil-derived MVs are unique in correlating with a number of key functional and clinically-relevant disease severity indices. Our results show the potential of BALF neutrophil MVs for a COPD biomarker that tightly links a key pathophysiological mechanism of COPD (intra-alveolar neutrophil activation) with clinical severity/outcome.

Journal article

Barnett J, Pulzato I, Javed M, Lee YJ, Choraria A, Kemp S, Rice A, Jordan S, Shah PL, Nicholson AG, Padley S, Devaraj Aet al., 2021, Radiological-pathological correlation of negative CT biopsy results enables high negative predictive value for thoracic malignancy, CLINICAL RADIOLOGY, Vol: 76, ISSN: 0009-9260

Journal article

Garner JL, Shah PL, 2020, Lung Volume Reduction in Pulmonary Emphysema, SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 41, Pages: 874-885, ISSN: 1069-3424

Journal article

Garner JL, Shaipanich T, Hartman JE, Orton CM, Caneja C, Klooster K, Thornton J, Sin DD, Slebos D-J, Shah PLet al., 2020, A prospective safety and feasibility study of metered cryospray for patients with chronic bronchitis in COPD, EUROPEAN RESPIRATORY JOURNAL, Vol: 56, ISSN: 0903-1936

Journal article

Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR, Wiselka M, Ustianowski A, Elmahi E, Prudon B, Whitehouse T, Felton T, Williams J, Faccenda J, Underwood J, Baillie JK, Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, Tarning J, Watson JA, White NJ, Juszczak E, Haynes R, Landray MJet al., 2020, Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 383, Pages: 2030-2040, ISSN: 0028-4793

Journal article

Horby PW, Landray MJ, Mafham M, Bell JL, Linsell L, Staplin N, Emberson JR, Palfreeman A, Raw J, Elmahi E, Prudon B, Green C, Carley S, Chadwick D, Davies M, Wise MP, Baillie JK, Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, Juszczak E, Haynes Ret al., 2020, Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial, LANCET, Vol: 396, Pages: 1345-1352, ISSN: 0140-6736

Journal article

Bartlett EC, Kemp S, Ridge CA, Desai SR, Mirsadraee S, Morjaria JB, Shah PL, Popat S, Nicholson AG, Rice AJ, Jordan S, Begum S, Mani A, Derbyshire J, Morris K, Chen M, Peacock C, Addis J, Martins M, Kaye SB, Padley SPG, Devaraj A, McDonald F, Robertus JL, Lim E, Barnett J, Finch J, Dalal P, Yousaf N, Jamali A, Ivashniova N, Phillips C, Newsom-Davies T, Lee R, Vaghani P, Whiteside S, Vaughan-Smith Set al., 2020, Baseline Results of the West London lung cancer screening pilot study - Impact of mobile scanners and dual risk model utilisation, LUNG CANCER, Vol: 148, Pages: 12-19, ISSN: 0169-5002

Journal article

Shah PL, Orton C, 2020, Epithelial Resurfacing: The Bronchial Skin Peel, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 202, Pages: 641-642, ISSN: 1073-449X

Journal article

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