Genomic and Environmental Medicine

What we do

We investigate the burden, cause, management and prognosis of respiratory health within the general population and within the workforce (including the military), in the UK, Europe, and in low and middle income countries. Our researchers look at the genetic basis of disease, from human genomics to bacterial (i.e. microbiome), and the genomic cause of disease in the workplace. This helps explain why some workers may be more likely to develop certain conditions, whilst others go unaffected. We also examine the world’s most severe respiratory infections such as influenza, Respiratory Syncytial Virus (RSV) and tuberculosis (TB) and the application of genetic, genomic and metabolomic technologies to the study of diseases of human epithelial surfaces.

Our researchers investigate diseases to try and identify their cause, with the aim of these findings being used as a basis for future disease prevention. We undertakine cutting-edge translational research into the immunological, metabolic and genetic components of these diseases in patients, and their contacts at risk of infection, to develop new tools for improved screening, diagnosis and prevention of respiratory diseases. 

Why it is important

Poor respiratory health and respiratory disease are a major cause of morbidity in children and adults worldwide, and a major predictor of mortality in adults. Some of the lifestyle and environmental factors that lead to poor respiratory health and respiratory disease are preventable, and effective treatment may reduce the impact of disease on patients’ lives.  Common lung diseases with an infective component such as pneumonia, asthma and COPD affect hundreds of millions of people worldwide. Pneumonia and COPD are amongst the leading cause of death in every country and the treatment of lung infections with antibiotics is a primary driver of antibiotic resistance in human populations. 

Exposures encountered at work are an important cause of almost every type of respiratory disease. We lead the UK in research into identifying these exposures and devising means for preventing them, both in this country and in poorer parts of the world.

Lung cancer and malignant pleural mesothelioma are devastating illnesses with few effective treatments and poor outcomes. Our section leads collaborative research with The Royal Brompton Hospital and The Royal Marsden Hospital that is improving the diagnosis and identifying new targets for treating lung and pleural cancers.

One in three people on the planet are infected with Mycobacterium tuberculosis (MTB), with eight to ten million new cases each year of which 2-3 million are fatal. Within the UK, TB incidence in the UK has increased over the last 15 years and there is an urgent need for improved diagnosis and screening for TB infection both in the NHS and throughout the world. 

Influenza results in about three to five million cases of severe illness and about 250,000 to 500,000 deaths worldwide every year. Larger outbreaks known as pandemics are less frequent. Flu vaccine is the best protection we have against this unpredictable virus which is of particular risk to, older people, pregnant women and those with a health condition. Flu vaccines need to change every year to overcome rapid viral mutation. Further research is needed to identify how our immune system responds to infection with influenza and to understand how viral infections are controlled, so that we can design new therapies and possibly create better vaccines against flu.

Research Impact

We carry out investigations which enhance interactions between basic laboratory research and patients with severe lung diseases treated at the Royal Brompton Hospital. Highlights include the landmark genome-wide association studies (GWAS) for asthma, the first analysis of the psoriasis transcriptome, development of target genomic capture (leading to exome sequencing), identification of the first metastatic cancer gene, the application of genomics to regenerative epithelia, and leading studies of the airway microbiome. 

Our research on asthma and COPD were central for the Global Burden of Disease (GBD) estimates 2010, and we continue to lead and contribute to major national and international efforts to improve knowledge and management of respiratory disease through state-of-the-art epidemiological research. This includes expertise in the use of electronic health record data, including Dr Jennifer Quint's role as the Deputy Director of the HDR UK Data Research Hub BREATHE that is investigating respiratory conditions. 

We contribute to prevention strategies for protecting the health of the workforce and are home to the largest national referral service for occupationally related respiratory disease. Our Lungs at Work clinic helps patients with lung conditions caused by workplace exposures, and breathing difficulties related to the wider environment outside work.

We are currently undertaking research on:

• common causes of occupational asthma in the UK
• the role of occupational and other environmental exposures in the development of fibrotic lung diseases
• the effects of ‘tunnel dust’ on the health of workers on the London tube
• firefighters from the Grenfell fire
• farmers in Thailand and textile workers in Pakistan
• British servicemen who were seriously injured in the Afghan war.

The most significant practical output to date from our tuberculosis research programme has been the development and clinical validation of the first T cell-based diagnostic test in medicine. The ELISpot assay for diagnosis of TB infection is recognised as the new gold standard for diagnosing latent TB infection and has mostly replaced the 100 year old tuberculin skin test. The regulatory-approved version of the assay is approved by NICE and several European guidelines and is entering clinical practice in the UK and Europe. Our ongoing translational research into fundamental immunology has great potential to generate further advances in screening, diagnosis and monitoring of TB, sarcoidosis and Influenza. We focus on systematic translation of cutting-edge scientific biomedical advances.

Find out more about our current research or view a selection of publications from the section.

Our researchers