Professor Ian Adcock awarded Gold Medal by the European Respiratory Society

Professor Ian Adcock, of the National Heart and Lung Institute (NHLI), has received the 2019 Gold Medal in COPD from the ERS.

Ian Adcock is Professor of Respiratory Cell and Molecular Biology with NHLI, and received the gold medal for his outstanding contribution in the field of chronic obstructive pulmonary disease (COPD). He also holds an honorary research position at the Royal Brompton Hospital enabling him to translate basic research activities into the clinical environment, and was recently elected as a Fellow of the British Pharmacological Society.

"Teaching goes hand in hand with research, at NHLI you’re teaching right at the cutting edge" Professor Ian Adcock

Professor Adcock has served the Airways Disease Assembly at the ERS for 14 successive years at both Group and Assembly level, and now chairs its Long-Range Planning Committee.

I sat down with Professor Adcock to find out more about his research and the award itself.

How did you feel on hearing about the award? 

I was really pleased and happy, but more so for all the amazing people I’ve worked with over the years, as it is really a summary of their work and not mine. It was really for them as we’ve worked together as a team. 

How have you effected change within the ERS?

One of the major things I did, following on from the initial work of Professor Peter Barnes, was ensure that every type of session, at the annual meeting and other meetings, combine science with the clinical impact. I expanded on Peter’s initial work on symposia sessions to extend this approach to postgraduate and other sessions and worked closely with other Assemblies to create sessions between groups who’d never worked together such as molecular biologists, paediatricians and computer scientists – we designed sessions to have all these people working together to obtain greater disease understanding. The assembly set up has now changed at ERS so the defining factor for a session is the disease, and people across all areas come together to discuss it and feed in their insights.

What are you currently researching?

What I am doing right now is trying to use novel models of disease such as lung organoids to try and get a better test system for drugs. Because we don’t have anti-inflammatory drugs for COPD and we need to have better models to test possible new therapies.  Better predictive models will provide new drugs for patients. We create the lung organoid by taking basal epithelial cells and growing them in a matrix so they self-organise into a ball that has cilia and mucus secreting cells on the inside. You can co-culture this with smooth muscle and fibreblasts and they form a tube that can contract, simulating an airway.

I am also collaborating with groups in Groningen (Netherlands) and Sydney (Australia) using single cell sequencing of patients with COPD who respond to steroids. We want to see what pathways are associated with a positive response to the drug and compare these with pathways activated in patients for whom the steroids provide no help.

How important is collaboration within research?

I think it is critically important, gone are the days when you can sit in the lab by yourself and come up with the next greatest discovery, now it’s all about collaboration. There are brilliant people globally who are world leading experts in their field, working together with them leads to better results for everyone.

I collaborate with lots of people across NHLI, the College and further afield. As well as the world-leading researchers in my section I am working with Dr Michela Noseda on the Human Cell Atlas, and people in Physics, Engineering, and Materials Science at Imperial. I have long-term collaborations with many researchers including Gaetano Caramori, who is a former PhD student, who is about to become Head of the Faculty of Medicine at Messina, Italy. I also work very closely with Phil Hansbro who has just become Head of the Inflammation Centre at the Centenary Institute in Sydney, and we co-supervise PhD students. 

Why did you become a scientist?

My major interest in science has always been in nuclear hormone receptors, this originally stemmed from looking at the effects of an insect hormone (ecdysone) on chromosomes, it makes them puff out as the whole structure of the chromosome is changed. You can watch this is real-time and it made me think – wow that’s amazing, how does it do that? That was when I was at secondary school and everything I’ve done since then has really been related to inflammation and steroids.

How does teaching interact with the demands of research? 

Teaching goes hand in hand with research, at NHLI you’re teaching right at the cutting edge. It is extremely important that you can convey the fun you’ve had doing your research to the next generation of students – it’s all about inspiring the next generation.

Seeing what students go on and achieve is exciting and I am in touch with many my former students, in fact I have just been to visit a former PhD student in China: this is another great way to form and maintain collaborations. 

Do you have a research highlight to date?

I pushed the role of epigenetics in chronic inflammation and steroid responsiveness particularly in airways disease, started working on that in 1998. Many papers and grants have come out of that work and we are still working on drugs that might be useful in disease from this research, the drugs are in clinic now for other diseases and hopefully trials in COPD will be forthcoming.  I hope that this work will have a significant impact for patients. 

What is on the research horizon for you?

The really exciting stuff is what we are doing with Groningen and Sydney as part of the Human Cell Atlas with Martin Nawajn, Michela Noseda (NHLI) and Sarah Tiechmann (Sanger) - which is to do with single cell sequencing and steroid responsiveness in severe asthma. My main interest in this research is in the responsiveness to the steroids. We will of course have to go across to COPD and do single cell work on that - I think it is the way forward. We need to know the mechanisms and single cell sequencing is the way to find out.

This analysis is really a follow on from the U-BIOPRED project. This has the goal of personalised medicine where we can get down to what is actually driving an individual patient’s disease. In the long term, blockbuster drugs won’t treat a single therapeutic area or disease, they will be across therapeutic areas - because the same underlying mechanisms will be present in sub-sets of patients with different diseases. 

This research has got to be based on patients with disease, as models are never as good as in man. I have to thank all the patients that have contributed time and samples to my research, we do a lot of work with Asthma UK, British Lung Foundation, and the European Lung Foundation through the ERS, who facilitate links with patient organisations across Europe.  Without the patient engagement in our work we are lost. 

What do you foresee as the upcoming challenges in the next 10 years? 

This comes down to personalised medicine again and how we utilise the ever-expanding amount of data we have. There are two aspects – firstly data sharing – sharing is the most important thing, you cannot work on your own and we need to work in consortia. We need to work with people who understand data - data scientists, bioinformaticians or mathematicians. I have a collaboration with mathematicians in CERN looking at how we can apply principles used in Physics to biological issues. And I also got to go inside the large Hadron Collider so that was an unexpected perk!

The second part is that it doesn’t matter if we can pick out a key pathway in a disease if we can’t diagnose the disease and spot it in patients easily. U-BIOPRED is looking at using e-NOSEs to better detect what a patient is suffering from. It will be a non-invasive test that takes about 20sec, all you will have to do is breathe into a tube and you will have the answer whilst still at the doctors. That is the goal for me, what we need to aim for. A bit like Star Trek’s tricorder! 

Overall, we need to be utilising all that big data with a way of getting a readymade biomarker for disease that is readily available and monitorable.