Following the College’s excellent REF 2021 results, we take a look at some of the Faculty of Medicine’s work.

Last month Imperial College London was ranked top in a UK-wide assessment of university research. The Research Excellence Framework (REF) 2021 found that Imperial had a greater proportion of 4* “world-leading” research than any other UK university.

Our work is vital to improving the lives of people and populations around the world. I take great pride in what we do; in all of our researchers and clinicians, and they should be equally proud of themselves and one another Professor Jonathan Weber Dean of the Faculty of Medicine

Within the Faculty of Medicine, researchers and collaborators helped to secure the College’s rating as top in the UK overall for world-leading research in the ‘Public Health, Health Services and Primary Care’ and ‘Psychology, Psychiatry and Neuroscience’ units of assessment, with other units including ‘Clinical Medicine’ also ranking highly.

Commenting on the success, Professor Jonathan Weber, Dean of the Faculty of Medicine, said: “This is a superb outcome – the best ever for our Faculty of Medicine – and is testament to our staff’s unwavering commitment to their work, even through the most trying of times.

“Our work is vital to improving the lives of people and populations around the world. I take great pride in what we do; in all of our researchers and clinicians, and they should be equally proud of themselves and one another.”

Here we shine a spotlight on just a few of Imperial’s impressive medical research projects from the last REF assessment period.

Transforming cystic fibrosis treatment

Outcomes for people with cystic fibrosis (CF) have greatly improved thanks to the development of new drugs, called CFTR modulators. Before these were introduced we could only treat the symptoms of cystic fibrosis, but now we can target the genetic causes.

The new treatments reduce people’s need for lung transplants, restore lung function, and reduce lung infections and the amount of time people with cystic fibrosis spend in hospital.

Imperial researchers played a key role in the introduction of CFTR modulators, with Professor Jane Davies from the National Heart & Lung Institute leading a clinical trial programme evaluating potential treatments to target the genetic causes of cystic fibrosis. The work included the UK arms of trials for ivacaftor, which found the drug to be highly effective for patients with particular genetic mutations.

Professor Davies has since been involved in trials of the newer drugs, which are suitable for the majority of people with cystic fibrosis. Once proven to be safe and effective in adults, she also helped design the trials of these treatments in children.

Supporting the global response to COVID-19

In early 2020, Imperial’s COVID-19 response team rapidly analysed data and developed epidemiological models to help inform the global response to the emergence of a rapidly spreading respiratory virus.

Their work modelling the severity and spread of SARS-CoV-2 helped alert the world to the pandemic threat posed by the new virus, informing governments of the need for public health measures to suppress transmission to avoid healthcare systems becoming overwhelmed.

Led by Professors Neil Ferguson and Azra Ghani and involving an extensive network of colleagues across the College and beyond, the team continued its work throughout the pandemic by providing estimates of the evolving epidemic across the globe, analysing the impact of public health measures and studying new variants as they emerged.

By the end of 2020, they had produced 42 open-access reports with summaries translated into seven languages, developed open-access dashboards and modelling tools and undertaken media appearances across 49 countries.

Proving new stroke treatments are cost effective

Making any new treatment widely available to patients is a constant balancing act – showing it works for the patient is one thing, but proving it can be cost-effective for the health system is another.

One such treatment is a technique to mechanically break up and remove clots in the blood vessels of the brain following a stroke. The approach, called mechanical thrombectomy (MT), had a limited roll out due to a lack of evidence it was a cost-effective treatment for the NHS.

A team led by Professor Kyriakos Lobotesis in the Department of Brain Sciences established that the technique is a highly cost-effective treatment for acute ischaemic stroke. The evidence underpins the UK’s National Institute for Health and Care Excellence (NICE) policy recommendations, supporting MT as a treatment for patients, leading to a significant impact on outcomes for patients with severe stroke.

Between April 2019 and March 2020, 1,607 patients were treated with mechanical thrombectomy in England, Wales and Northern Ireland, with 70% having an improved prognosis as a result.

Understanding how noise pollution affects health

Many Imperial researchers are exploring the long-term impact of the environment on people’s health.

A team including Professors Marta Blangiardo, Mireille Toledano, Paul Elliott, Anna Hansell (now at University of Leicester) and Dr Daniela Fecht, focused on the long-term health effects linked to noise pollution, and identified a link between noise from aircraft and road traffic and cardiovascular disease and deaths.

The team’s results have informed policies and public health guidance on how to reduce health risk from noise exposure in the UK and beyond, including the 2018 WHO Environmental Noise Guidelines for the European Region and the debate around expansion plans at Heathrow Airport.

Treatments for critically ill COVID-19 patients

Imperial’s researchers have been central to efforts to evaluate treatments for critically ill patients with COVID-19.

Professor Anthony Gordon, from the Department of Surgery & Cancer, is UK Chief Investigator for the international REMAP-CAP trial. One of the key findings to emerge from this study was that treating COVID-19 patients in intensive care with hydrocortisone reduced their risk of death and the length of time they received organ support.

These findings were rapidly incorporated into treatment recommendations for COVID-19 by the World Health Organisation (WHO) and the National Institute for Health and Care Excellence (NICE).

Corticosteroids have become the standard of care for patients around the world, improving survival in the sickest patients and saving hundreds of thousands of lives. REMAP-CAP has continued to find other treatments that have been crucial to tackling severe COVID-19.

Sight saving research

Early findings from College researchers looking at hereditary sight loss are now being translated into treatments. Choroideremia is a genetic eye condition which leads to a gradual loss of sight as the light sensitive cells of the retina die.

The condition, which almost entirely affects males (due to the location of the mutation), is characterised initially by ‘night blindness’ and a gradual worsening of vision over time.

While there is no cure, incremental advances have led to trials of therapies targeting the faulty genetic element underpinning the condition. Key to this progress was work led by Professor Miguel Seabra, formerly of Imperial’s National Heart & Lung Institute, which uncovered the faulty protein (and its gene) responsible for choroideremia.

Working with colleagues at Oxford University and other collaborators, the team developed a gene therapy (NSR-REP1) for the condition. In clinical trials, the therapy showed evidence for stopping and even reversing the progressive sight loss caused by disease in some patients. The work has also led to a successful spin-out company, Nightstar Therapeutics, which is developing the therapy further.

Read more about Imperial’s REF 2021 results.

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