Anaesthesia, Critical Care and Pain Medicine

Stress and Immunity

Critical illness is by definition a severe insult which inflicts an enormous stress on a patient's physiology.

DNA molecule with xray of persons brain

Molecular mechanisms of stress

Despite a major research effort there remains uncertainty about how, in the acute setting, ICU care may best approach supporting or augmenting the patient's own response. There is also incomplete understanding of how these profound stimuli, which are known to cause persistent morbidity in ICU survivors, may be enacting their long term consequences at the molecular level.


Our DNA was first observed in its condensed form as chromosomes at the end of the 19th centruy and the classical double helix structure has been known for over 50 years, but the significance of the many states in between have been much slower to become apparent. It is now clear however that how the fine strands of DNA wind and unwind interacting with proteins - a combination known as chromatin - has a profound influence on how our cells behave and that this process is subject to change in response to external stimuli.

Dr Alasdair Jubb

The focus of Alasdair Jubb's work is studying the mechanism of action of glucocorticoids, classical systemic stress hormones, on higher order chromatin structure in macrophages (essential and ubiquitous cells of the innate immune system) to help unravel some of this complexity.