With over 1,500 studies either recruiting or in follow-up at present and many more in set up within  Guy’s and St Thomas’, it is impossible to provide a highlight that would cover all of our work. Instead we are delighted to provide a few highlights that will give you a flavour of the breadth of the research happening within the organisation’.

Over the eighteen months our focus has been predominantly on COVID-19 research with our teams leading on research into diagnostics, treatments and vaccines for COVID-19.

Our non COVID-19 world leading clinical research delivered by teams across our Research and Development Department and its NIHR Biomedical Research Centre spans a broad spectrum of disease areas. Our research highlights in this article cover our research into immune therapies for cancer, our women’s health, paediatric allergy, diabetes, imaging, and critical care research as well as research looking into expanding the understanding of COVID-19.

To find out about our other research work please head over to

www.gstt.nhs.uk/research

www.guysandstthomasbrc.nihr.ac.uk/news-events

–  www.evelinalondon.nhs.uk/research/studies-and-trials.aspx

Immune therapies for treatment of solid tumours

Immune therapies are now making an increasing impact on cancer treatment. We expect that cancer will have caused the death of more people in the UK over the past 12 months than COVID-19. This estimate is based on published numbers of deaths due to COVID-19 coupled with trends in UK mortality attributed to cancer in recent years. Dr John Maher focuses on the development of cellular immunotherapies for patients with refractory solid tumours. This involves genetic programming of patient white blood cells so that they make a new protein called a CAR (main image). His current clinical trial is testing CAR- T cell immunotherapy, in patients with otherwise untreatable head and neck cancer. The therapy has been .produced in-house using the Advanced Therapies Manufacturing GMP Unit and other infrastructure in our NIHR Guy’s and St Thomas’ BRC, You can read more about this this research here.

A recent study supported by NIHR Guy’s and St Thomas’ BRC led by Professor Sophia Karagiannis and Dr Sophie Papa found that immune-activating antibody and genetically modified cell therapies targeting the cancer antigen SLC3A2 can safely target tumours without affecting healthy cells. You can read more about this research here.

Critical care research

A long term research study led by Dr Marlies Ostermann, Consultant in Nephrology and Intensive Care at Guy’s and St Thomas’ found that survivors of critical illness should have their kidney health monitored in the early months after discharge from intensive care.  During critical illness, acute kidney injury (AKI), also known as acute kidney failure, is common. In most cases, kidney function initially recovers when patients get better. This long-term study showed that patients continue to have increased risk of poor health and mortality after they leave hospital, which is thought to be caused by the progression of chronic disease and other risk factors. You can read more about the recommendation of this study for clinical practice here.

 Women’s health

Recent research led by our womens’ health research teams has improved clinical practice for the management of pre-eclampsia, through a blood test developed by Professor Andrew Shennan which has been recommended by NICE clinical guidance, for use when caring for women with suspected pre-eclampsia.  Watch a short film about this work and history of obstetric research at Guy’s and St Thomas’ here.

Professor Andrew Shennan also leads specialist pre-term surveillance clinic at St Thomas’ Hospital. He and the team have been studying interventions to prevent premature birth including research into a pioneering procedure called Transabdominal Cerclage (TAC) – also known as an abdominal stitch. Women who suffer from repeated pregnancy losses can have successful pregnancies with an abdominal stitch. The procedure is different to the traditional vaginal stitch as it’s placed higher up the cervix and provides a stronger physical barrier to keep a baby inside the uterus and prevent women from going into early labour. Our research shows that women receiving the procedure were more likely to have a baby that survived and less likely to give birth before 32 weeks of pregnancy compared to the vaginal stitch. Read how one mother who suffered a loss of five pregnancies named her daughter after Professor Shennan and find out more about the work of the team here.

ICP is a potentially serious liver disorder that can develop in pregnancy. In ICP, the bile acids do not flow properly from the liver to the gut to help digest food and build up in the body instead. It is known to increase rates of pregnancy complications including premature birth (both spontaneous and clinician-initiated), neonatal unit admission and, for women with the most severe disease, stillbirth. Research led by Professor Catherine Williamson showed that ursodeoxycholic acid (UDCA) reduces the risk of spontaneous premature birth (birth before 37 weeks of pregnancy) for women with intrahepatic cholestasis of pregnancy (ICP) by more than 40%.  You can read more about the teams work here .

Paediatric Allergy

Research led by our team at Guy’s and St Thomas’ and the Evelina London Children’s Hospital  led to changes in infant feeding guidelines in 2015. Our teams are currently working on the BAT 2 study which is looking to determine if the Basophil Activation Test (BAT) which is used to detect peanut allergy, can predict whether a participant is allergic or tolerant to other allergen of interest (milk/egg/cashew/sesame). The BAT test is considered the ‘gold standard’ diagnostic test and is currently the most accurate and safest way to diagnose food allergies. The  team are comparing the diagnostic accuracy of the BAT test with that of the food challenge test, to see which is better for diagnosing food allergies to cow’s milk, egg, sesame and cashew nuts.  You can read more about this here.

Imaging research

Research supported by our NIHR Guy’s and St Thomas’ BRC and Clinical Research Facility has developed a new method for helping to detect congenital heart disease in babies in utero using MRI. For the first time, in a paper recently published in Nature Communications, researchers have been able to look at the fetal heart in four dimensions – the images are still 3D but change through time as the heart beats.Rather than just getting a snapshot of the heart, a series of images is taken allowing cardiologists to see the heart contracting and beating. While this is standard for adult imaging, until now it has not been possible for the fetal heart because of the spontaneous movement of the baby and the rapid speed of its beating heart, which is twice as fast as an adult’s. You can read more about this here.

Research funded by the NIHR Guy’s and St Thomas’ BRC found that a 40 minute test for angina could help patients avoid an overnight stay in hospital. The MR-INFORM trial looked at whether magnetic resonance imaging (MRI) could be used to guide treatment decisions for angina patients, rather than performing a more invasive procedure. You can read more about this here.

Diabetes

Our diabetes research teams have been working to find out whether a drug currently used to treat rheumatoid arthritis might help people who have recently been diagnosed with type through the COMBAT Type-1 trial. The trial is a small trial involving 13 patients, to see if the drug Abatacept, which is currently used to treat rheumatoid arthritis, could help people with type 1 diabetes extend the period when their body is still producing some insulin. The drug works by blocking the immune cells that attack the pancreas. . You can find out more about this work here.

Understanding COVID-19

With COVID-19 affecting us all our research teams have been working tirelessly to increase our understanding of the disease. One particular study published in Nature Medicine showed that the COVID-19 linked childhood syndrome PIMS-TS is a new disease with its own immune profile. This was the first evidence of the role of the immune system in the disease in children.  It provides vital evidence for future research and will indicate what treatments may help patients with the condition. Our teams have also found a common ‘immune signature’ in many of the sickest COVID-19 patients which could help guide treatment. You can read more about this here.