Professor Mona Bafadhel studies the pathophysiology of COPD (chronic obstructive pulmonary disease). There are broadly two inflammatory phenotypes of COPD that are clinically indistinguishable but have different treatment responses. Dr Bafadhel is working on the development of novel therapeutic strategies for COPD, particularly to treat the regular periods of worsened symptoms that patients experience.
Asthma and COPD (chronic obstructive pulmonary disease) are very common conditions that affect the lives of many people. A better understanding of the inflammation, genetic makeup and disease pattern, as well as response to various treatments, will ultimately allow doctors to offer personalised treatments to patients.
Ultimately, medical research must translate into improved treatments for patients. At the Nuffield Department of Medicine, our researchers collaborate to develop better health care, improved quality of life, and enhanced preventative measures for all patients. Our findings in the laboratory are translated into changes in clinical practice, from bench to bedside.
Mona Bafadhel: I mainly research airways disease, which comprises of asthma and chronic obstructive pulmonary disease - or COPD, as it is otherwise known. It is a very common condition and affect lots of people. I am trying to understand how we can improve on our understanding of what causes these two different diseases, the similarities between patients and how they respond to different treatments. We know that the patients' genetic makeup is different. We know that the inflammation is different. We know that their responses to treatment are different. What I would like to do is investigate these differences a little more to understand these diseases better.
Q: Can you give us an example?
MB: For example, in COPD, part of the disease process is exacerbations or lung attacks. They impact on patients quite a lot in association with other significant symptoms. When we give treatments, such as antibiotics and steroids, not everyone responds to treatment.
I have found that if through a simple blood test, we can identify who will respond to steroids and who won’t. Hopefully this will streamline the way we treat our patients, by giving patients the right treatment at the right time.
We also try and understand why this particular group, based on the blood test, have a difference in their responses and in their inflammation. So we are narrowing down the disease process, hopefully, by looking at it a bit more closely.
Q: How has your research actually changed the treatment and the understanding of these diseases?
MB: It has changed our understanding by saying that COPD is not the same disease in everyone. A ‘one size fits all’ approach does not work. It has tried to hone in on individual patterns of information and responses.
What is really exciting is that other groups, nationally and internationally, have found the same type of information parameters. The work is being validated by different groups and the community is understanding the disease a little more. We are at the forefront, because we have understood it a bit better a bit earlier on.
Q: What are the most important lines of research which have emerged in this area over the last 5 to 10 years?
MB: For airways disease (asthma and COPD for example), we have been giving bronchodilators (in the form of of inhalers), to treat our patients.
But more recently, we have managed to get monoclonal antibodies (biological treatment for asthma), as studies are now being performed in COPD. Only last week, a certain monoclonal antibody was approved and hopefully will be a new treatment for asthma. This is really an exciting process to be a part of.
Q: Why is your line of research important and why should we fund it?
MB: I think COPD is really important. It affects probably up to 10% of the UK adult population, so it is very common. Asthma affects 5 million people of all age ranges. COPD costs the NHS one billion pounds per year and each time people have exacerbations they feel worse and they have worsened symptoms.
So it is common, and it affects a lot of people in lots of different ways and if we can even impact on that, I think that will help. That is why we should definitely fund COPD!
Q: How does your work fit more largely within translational medicine in the department?
MB: The work that I do is really trying to look at how the patient is, understanding what is happening to our patients, improving the treatment on our patients. So we apply research, and then go back into the laboratory and understand why the disease patterns exist, and what the disease mechanisms and cellular responses are.
I think this fits the line of translationa research here within NDM. It is also a unique opportunity to be able to engage with other scientists and researchers who are active in understanding cellular, immune and microbial responses. So I think we are in a really exciting time.