Nik Hirani's group are interested in the mechanisms that regulate inflammation in the lung and how these can be modified so that inflammation resolves without scarring or damaging the lung.
Interstitial lung diseases (ILD) are a group of conditions that cause varying degrees for inflammation and fibrosis in the lung. Examples include Idiopathic Pulmonary Fibrosis (IPF), asbestosis, sarcoidosis, bird-fanciers lung and rheumatoid-arthritis associated lung fibrosis. Most are associated with significant morbidity and some with shortened life expectancy. IPF in particular is a progressive disease with a median survival from diagnosis of 3-4 years and there are 15-20000 patients with IPF currently in the UK. Recently there have been approved drugs for treating IPF, but the proportion and patients who respond to these drugs is not known and the drugs are associated with significant side-effects.
Our aim is to better characterise the interstitial lung diseases by establishing a detailed 'molecular' signature (endotype) for individuals with lung fibrosis. This precision medicine approach will be used to discover new targets for drug therapy and to better predict response to treatment and prognosis.
Since 2002 we have established a specialist clinic for interstitial and fibrotic disease of the lung. The clinic is supported by expert clinicians, radiologists and pathologists and is integral to the basic science we conduct at the Centre for Inflammation Research. Almost every patient who attends the clinic is informed of the types of research projects we perform. Since 2007 more than 1000 patients have agreed to take part in clinical studies, such as consenting to blood and lung-wash samples which we are using to discover new mediators and genes that may be linked to lung scarring. This single centre longitudinal inception cohort is the largest such study of interstitial lung disease globally.
Our research goals are based on four steps; 1) describing the natural history of lung fibrotic diseases, 2) identifying the molecular signatures of subgroups of patients with lung fibrosis, 3) defining the tractability of these molecular pathways in models of fibrosis, and 4) perform early phase proof of principle clinical trials in patients with lung fibrosis.
Ongoing projects in the lab are:
We are actively recruiting to the following studies:
Nik Hirani qualified from Nottingham University and, following Wellcome and GSK clinician scientist training fellowships, is currently a senior lecturer and PI in the MRC Centre for Inflammation Research in Edinburgh and honorary consultant at the Royal Infirmary Edinburgh. He is Clinical Director for Respiratory Medicine in Lothian and leads the Edinburgh Lung Fibrosis service. His research interests include macrophage biology in lung fibrosis and the natural history of interstitial lung diseases. He is past chair of the British Thoracic ILD guideline committee, the National Institute for Clinical Excellence working group for idiopathic pulmonary fibrosis and is a member of several academic and industry advisory boards.
Clinical Director for Respiratory Medicine
US Department of Defence