Delivering Experimental Medicine Research in Critical Care
Supporting the capacity and capability of Critical Care to develop and deliver Experimental Medicine studies, in partnership with industry, patients and clinical researchers.
Foreword
The NIHR Critical Care Specialty Experimental Medicine subgroup supports investigators - academic and industry - undertaking early phase clinical research in the NHS. Experimental medicine studies tend to be more complex and of higher intensity, though smaller in size, than later phase clinical effectiveness trials. Specialist facilities and skills are often required to ensure successful study delivery. We work in collaboration with all the sectors of the Life Sciences industry, including Clinical Research Organisations (CROs) to facilitate experimental medicine research in Critical Care.
Our network of investigators includes leading clinical academics who are experienced in conducting experimental medicine studies within the NHS. Our centres have the expertise and facilities to tackle the challenges of complex experimental medicine studies within a critical care environment.
We provide advice on all aspects of trial design, including which centres are able to undertake different experimental designs. We can advise on centre facilities, such as the availability of laboratories for sample analysis, and provide details on how many patients with a specific condition are treated within each centre. Once a study is up and running we help tackle any obstacles that might arise; from study set-up right through to study completion.
Due to the complex nature of experimental studies we welcome early engagement with interested collaborators to ensure the trial protocol can be delivered. This leaflet provides an overview of the 12 centres that comprise the NIHR Critical Care Specialty Experimental Medicine sub group. If you would like to discuss centre capabilities or other aspects of how the group can help your research please contact us.
Our Centres
We have high performing research centres situated across UK with experience of conducting research on a global level. These centres are equipped with quality facilities and a skilled, world-class, interdisciplinary research workforce. Centres host some of the UK’s leading clinical academics, from top ranked universities, working in collaboration on Critical Care research. Our NHS clinicians have a wide range of research interests and capabilities alongside a proven track record of delivering experimental medicine studies.
To facilitate experimental medicine research and to increase our understanding of critical illness we have established connections with other NIHR infrastructure. For example, we work in partnership with the Critical Care Health Informatics Collaborative (CCHIC). The CCHIC is a source of detailed clinical data for research purposes.
The lists below provide an outline of some of the key sample processing and analytical techniques available at centres. Critical Care is a complex and fast changing environment so the development of new skills and techniques is of high importance – we therefore welcome opportunities to explore and evaluate new areas and technologies as they arise. The group can be contacted via the NIHR Critical Care Specialty Experimental Medicine subgroup.
Sample/Processing/Analysis
- Cell separation
- Flow cytometry
- Broncho-alveolar lavage (BAL)
- Metabolic profiling
- Bronchoalveolar lavage cell separation
- Lipidomics
- Pharmacogenetic analysis
- Genomic profiling
Techniques
- Molecular diagnostics
- Cell therapy facilities
- Cell sorting
- PiCCO
- LidCO
- SPECT-CT
- PET-MRI
- Radio-pharmacy/radio-labelling
- Echocardiography
- Manufacturing pharmacy
Barts Health London
Our ICUs have over 3000 admissions annually and provide specialist services for trauma, cardiothoracic and oncology patients.
We have collaborated with industry partners developing novel treatments using human in-vitro and ex vivo models of lung, injury and repair for example, testing novel antibody fragments targeting individual TNF receptors.
We have an interest in developing precision medicine techniques including genomic, transcriptomic and metabonomic profiling.
Collaborating Institutions:
- Barts Health NHS Trust
Belfast
The major focus of the experimental medicine research programme in Belfast is to investigate novel treatments for ARDS using clinically relevant models of ARDS and in early phase clinical trials underpinned by mechanistic studies.
There is a broader multi-professional research programme investigating sepsis, delirium and recovery from critical illness.
Our group have experience in cell therapy and trials of pharmacological therapies in ARDS.
Advanced imaging techniques, a manufacturing pharmacy and GMP cell therapy facility are all available locally.
Collaborating Institutions:
- Queen’s University Belfast;
- Belfast Health & Social Care Trust
Birmingham
In Birmingham we have the largest single critical care facility in Europe with 100 beds (75 at level 3) and 40 consultant intensivists.
There is a 24/7 research nurse support team to undertake acute interventional studies.
With state of the art facilities we are able to undertake complex studies which require capabilities such as RT-PCR and metabolic profiling.
We have a history of working with industry partners to develop novel treatments.
Collaborating Institutions:
- University of Birmingham;
- University Hospitals Birmingham NHS Foundation Trust
Cambridge
Our hospitals offer the full range of clinical services alongside dedicated facilities for conducting complex clinical research.
The team at Cambridge have a substantial track record of ICU-related research across a number of domains including lung injury, infection and brain injury/trauma.
We have successfully delivered projects across the translational medicine spectrum, from preclinical patient phenotyping, through to multicentre randomised controlled trials.
We have extensive experience of translating basic science into commercially viable drug development ventures, with Cambridge investigators securing >£15 million in VC funding for critical care-related spin-out companies since 2016.
Collaborating Institutions:
- University of Cambridge;
- Cambridge University Hospitals NHS Foundation Trust;
- Royal Papworth Hospital NHS Foundation Trust
Edinburgh
At Edinburgh we have led multiple clinical trials, including national and international pragmatic trials.
We have undertaken collaborative research programmes with technology companies, especially in relation to novel technologies and biomarker discovery and evaluation.
Advanced imaging techniques, isotope cell labelling and stem cell therapy facilities are available at Edinburgh, making it the ideal place to conduct complex research in critically ill patients.
Novel imaging facilities that will enable studies in mechanically ventilated cases are currently being developed.
Collaborating Institutions:
- University of Edinburgh;
- NHS Lothian
Heartlands
As a centre for Thoracic Surgery, Cystic Fibrosis, Infectious Diseases along with a Trauma Unit, Upper/Lower and Vascular Surgery Units, Bone Marrow Transplant Unit plus all medical specialities we ideally placed to support research into complex critical care studies.
A strong partnership with the University supports areas such as detailed sample processing and analysis for immunological investigations.
Our experience extends beyond leading on academic studies - we have supported a range of Pharma led trials and collaborate with many companies.
Collaborating Institutions:
- Heart of England NHS Foundation Trust;
- University of Warwick
Imperial College London
At Imperial we have superb facilities across 3 NHS sites with over 2000 admissions per year.
We have expertise in the design and management of CTIMPs in critical care.
We have a particular interest in developing Precision Medicine techniques including genomic, transcriptomic and metabonomic profiling.
We have collaborated with industry partners developing novel treatments using in-vivo models, for example testing novel antibodies targeting individual TNF receptors.
Collaborating Institutions:
- Chelsea and Westminster Hospital NHS Foundation Trust;
- Imperial College London;
- Imperial College Healthcare NHS Trust;
- Royal Brompton & Harefield NHS Foundation Trust
Liverpool
Liverpool is an established centre and equipped to undertake complex Critical Care research.
Our research focuses on endothelial and cardiovascular physiology, infection, immunology and muscle biology.
Special expertise is available in pharmacogenomics (Wolfson Centre of Personalised Medicine), the MRC Centre for Drug Safety and the NHS Clinical Research Unit with Phase I accreditation.
We have previously worked with multiple companies and SMEs and have a proven track record in delivering experimental and clinical research.
Collaborating Institutions:
- Royal Liverpool and Broadgreen University Hospitals NHS Trust;
- University of Liverpool
Manchester
Through the University of Manchester, Health Innovation Manchester and NIHR’s Manchester Biomedical Research Centre, we work across an ecosystem of NHS hospitals to lead and deliver large academic studies, commercial multicentre trials, CTIMPs and biomarker validation projects.
We collaborate on trial design, integration of clinical and biomarker datasets, pharmacokinetics and pharmacodynamics. Our experience includes working with products in development - phase I and II plus licensed drugs.
Collaborating Institutions:
- University of Manchester;
- Salford Royal NHS Foundation Trust;
- Manchester University NHS Foundation Trust
Newcastle
Our Newcastle team have existing NIHR links facilitating the development of methodologies for the evaluation of in vitro diagnostic tests - assisting industry partners in the evaluation of their products in critically ill patients.
Translational models: administration of inhaled and intravenous LPS to healthy human volunteers allows study of acute inflammatory responses, as well as their therapeutic manipulation.
Collaborating Institutions:
- Newcastle University;
- Newcastle upon Tyne Hospitals NHS Foundation Trust;
- City Hospitals Sunderland NHS Foundation Trust;
- South Tees Hospitals NHS Foundation Trust;
- Northumbria Healthcare NHS Foundation Trust;
- Gateshead Health NHS Foundation Trust
Southampton
Southampton is the regional centre for specialist services including neuro and cardiac surgery and is the regional Trauma Centre.
We have a substantial track record in delivering a full range of ICU-related research from nationally funded drug and complex intervention studies to industry sponsored device and drug trials and investigator led projects.
We have successfully partnered with pharma, big device manufacturers and SMEs.
Collaborating Institutions:
- University of Southampton;
- University Hospital Southampton NHS Foundation Trust;
- Southampton NIHR Biomedical Research Centre (Respiratory and Critical Care Theme)
University College London
We have led multiple CTIMPs in ICU and successfully collaborated with pharma on both academically led clinical trials and industry-led trials including ‘first in man’ in Europe for stem cells in ARDS.
Research interests include sepsis - particularly animal models and human phase I – III trials, mitochondrial and cellular studies and associated inflammatory cell biology and intracellular signalling pathway work including monocyte/macrophage cell biology.
Collaborating Institutions:
- University College London;
- University College Hospitals London NHS Foundation Trust
Critical Care HIC
Critical Care HIC (CCHIC) is an NIHR funded IT capability designed to securely collect, collate and analyse routine clinical data to improve research and clinical outcomes in critical illness. To achieve this CCHIC has the created the legal, governance and technical structures to allow routine electronic health care data to be collected from all critical care patients in participating NHS Trusts. The vision is to become a unique, highly flexible database where the fidelity and quality of data will enable a broad range of researchers to answer questions pertinent to Critical Care.
The aim will be to increase the data collection to an expanding cohort of hospitals that is increasingly representative of UK Critical Care. The depth of data is also set to expand, especially in terms of therapies and microbiology. Increasing the frequency of data collection aiming to be as near real time as possible.
The data should be available to researchers across the field of biomedical research that may include students, academics, charitable organisations and the pharmaceutical and medical device industries. The ability to link data should not be restricted and linkage should be made to other databases that reflect outcomes (cancer, heart disease, dialysis registries, ONS Mortality etc). The research should be for public benefit.
Collaborating Institutions:
- University College London Hospitals NHS Foundation Trust;
- University College London; University of Cambridge;
- Cambridge University NHS Foundation Trust;
- Imperial College Healthcare NHS Trust;
- Imperial College London; Guy’s and St. Thomas’ NHS Foundation Trust;
- King’s College London; University of Oxford;
- Oxford University Hospital NHS Foundation Trust
Contact us
Get in touch with the NIHR Critical Care Specialty Experimental Medicine subgroup.