Cardiovascular and respiratory disease
Key areas of focus
- Identify new and tractable targets for prevention and treatment of cardiovascular disease from large-scale genetic and epidemiology studies
- Develop new approaches to predict risk of atherosclerotic plaque rupture to prevent heart attacks
- Undertake clinical trials of potential new medicines for atherosclerosis, acute lung injury and bronchiectasis
Cardiovascular and respiratory diseases are the leading causes of premature death worldwide, killing 26 million people a year. In the UK alone, 1 in 4 of us will die from heart disease, and 1 in
5 from lung disease. Half of all deaths from heart disease are sudden and unexpected. Many patients live with chronic heart and lung diseases but are severely limited by their condition. The financial burden of these diseases on healthcare systems is potentially overwhelming and unsustainable.
The theme will address the unmet need in heart and lung disease through a series of grand challenges. Ultimately the aim is to improve prediction, prevention and treatment of cardiovascular and respiratory disease through an interdisciplinary approach. For example, despite the widespread use of aspirin, statins and blood pressure lowering agents, the rates of cardiovascular morbidity and mortality remain unacceptable. There remains an urgent need to develop panels of genetic and soluble biomarkers to predict individual risk, inform mechanism, and identify new pathways for therapeutic intervention.
Platelets are important risk factors for cardiovascular disease. However, existing anti-platelet agents are sometimes ineffective, can lead to severe bleeding, and are not targeted to a specific process (e.g. heart attack versus stroke). Considerable refinement of anti-platelet approaches is needed based on a more detailed understanding of mechanisms.
Atrial fibrillation is a major cause of cardiovascular disease and stroke and yet our approach to treatment remains rudimentary and carries significant risks of anticoagulation. Early detection and prevention of atrial fibrillation would make a major impact in this field.
Despite advances in management of the vulnerable atherosclerotic plaque (the commonest cause of a heart attack), there remains a need to develop imaging modalities that can prospectively identify high-risk atherosclerotic plaques before they rupture, and to develop new drugs to target the unmet needs in atherosclerosis, for example, inflammation.
In respiratory disease, our focus is on chronic obstructive pulmonary disease (COPD), lung fibrosis, acute lung injury, and bronchiectasis. The progressive clinical course of these conditions is not adequately addressed by existing treatments. In addition, earlier detection of lung cancer would have the single largest impact on lung cancer survival. The theme also addresses rare but important cardiovascular and respiratory conditions in which there is world-leading expertise locally, with significant likelihood of transformative new treatments exemplified by severe pulmonary arterial hypertension.