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Fungal Resistance Evolution and Acquisition in chronic Lung infection

  • Research type

    Research Study

  • Full title

    Understanding susceptibility to fungal infection and evolution of antimicrobial resistance in chronic respiratory disease

  • IRAS ID

    244685

  • Contact name

    Anand Shah

  • Contact email

    s.anand@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    2 years, 11 months, 31 days

  • Research summary

    Fungal disease is a complication of chronic lung disease and is associated with poor clinical outcomes. Several factors determine the outcome of these infections, including the host immune state and drug susceptibility. Oral triazole antifungal drugs are effective against the most common mould pathogen, Aspergillus fumigatus, and are the front-line therapy in management of Aspergillus–related infection and allergy in chronic respiratory disease. However, we and others have shown a rapid and global emergence of multiple triazole resistance (MTR) phenotypes in A. fumigatus over the past decade.

    Given the increase in antimicrobial resistance, there is an additional heightened need to consider alterative therapeutic approaches. Immunotherapies are currently revolutionizing clinical medicine, leading to dramatic improvements in mortality and outcome across a range of malignant diseases and auto-inflammatory conditions. Within respiratory medicine, novel immunotherapies are now available that target airway inflammation. There are hence now unprecedented opportunities to better define the utility of these immunotherapies in pulmonary fungal disease.

    Through this study we aim to understand the evolutionary dynamics of antifungal drug resistance development using whole genome sequencing in individuals with chronic respiratory disease, and develop rapid low-cost point-of-care technology to aid detection given the global implications for disease management. In parralel, we will collect prospective samples to better understand the host immune response in chronic respiratory patients with pulmonary fungal disease.

  • REC name

    London - Brent Research Ethics Committee

  • REC reference

    19/LO/1663

  • Date of REC Opinion

    29 Nov 2019

  • REC opinion

    Further Information Favourable Opinion