Malcolm Marquette

Project: Asthma and cardiovascular disease association: the effect of leukotriene status on cardiovascular dysfunction

Research has shown that if you have asthma, you are at a higher risk of getting heart disease. We don’t know why but uncontrolled inflammation is likely to play a role. One of the body’s chemicals that causes inflammation is called leukotrienes. Leukotrienes have been shown to have an impact on heart disease and cause airway inflammation in asthma. Therefore, this chemical might be the link between asthma and heart disease.

One type of asthma is associated with high leukotrienes, it’s called “Non-steroidal anti-inflammatory drug–exacerbated respiratory disease” or “N-ERD”. When people with N-ERD take drugs such as aspirin or ibuprofen, their asthma symptoms get worse which leads to higher leukotriene levels. Therefore, by studying people with N-ERD we will be able to look closer at leukotrienes and how they impact heart disease.

There are 4 stages to our study:

1. We will measure the risk of heart disease with an ultrasound test called flow-mediated dilatation. This test involves measuring the size of blood vessels with an ultrasound probe after a blood pressure cuff is inflated.
2. We will use another ultrasound test called Pulse-Wave Velocity to measure how stiff the blood vessels are.
3. To study the effects leukotrienes have on developing heart disease, we will measure the amount of leukotrienes in urine samples. Participants will then be treated with a drug that stops leukotrienes from being made.
4. Finally, we will repeat all three tests

By looking at the change in leukotriene levels and the change in blood vessel size (through flow-mediated dilatation (FMD)) it will allow us to see if leukotrienes impact the risk of heart disease.

This research aims to improve our understanding of heart disease in people with asthma, thereby improving the management of people with asthma.

About me

I completed my undergraduate medical degree at the University of Malta (Doctor of Medicine and Surgery – M.D.) and recently completed my speciality training in Respiratory and General internal Medicine in the East of England Deanery. During my clinical training, I was awarded a Senior Clinical Fellowship in Airways Disease and Inflammation at Cambridge University Hospitals Severe Asthma Centre under the supervision of Dr M Knolle and Dr R Gore. My research interests are Asthma phenotypes and endotypes, epidemiology and mechanisms of disease.

Publications

• Marquette, M., Tailor, B.V., Calder, P.C. et al. Urinary Leukotriene E4 as a Biomarker in NSAID-Exacerbated Respiratory Disease (N-ERD): a Systematic Review and Meta-analysis. Curr Allergy Asthma Rep 22, 209–229 (2022). doi:10.1007/s11882-022-01049-8
• Yung H, Sharma K, Flowers W, Marquette M, Starace L, Sander C, Burnstein R, Herre J. Food for Thought: Dietary Intervention in a Rare Cause of Severe Ventilatory Failure Eur J Case Rep Intern Med. 2020 Mar 26;7(5):001523. doi: 10.12890/2020_001523.
• Brij, S. O., Chatterji, S., & Marquette, M. (2016). Chronic Obstructive Pulmonary Disease (COPD). In D. S. Suresh , Clinical Pathways in Emergency Medicine (pp. 245-257). Springer. (Chapter in a book)
• Marquette M, Haworth CS. Bone health and disease in cystic fibrosis. Paediatr Respir Rev. 2016 Aug;20 Suppl:2-5. doi: 10.1016/j.prrv.2016.06.003. Epub 2016 Jun 21. PMID: 27461283.
• Malcolm Marquette, Sanjay Budhdeo, Vivek Rajagopal, Mirela Marinescu. Cardiac device-associated lead infection: a diagnosis not to be missed Oxford Medical Case Reports, Volume 2015, Issue 3, March 2015, Pages 222–225. doi: 10.1093/omcr/omv014 
• Budhdeo S, Marquette M, Singh D, Rajagopal V. Normoammonemic encephalopathy: solely valproate induced or multiple mechanisms? BMJ Case Rep. 2014 Mar 10;2014:bcr2013201928. doi: 10.1136/bcr-2013-201928.

Research Activity

Poster presentations

• Mater dei audit of the appropriateness of red cell transfusion 

  • Malcolm Marquette, Alessandro Gerada,  Matthew Mercieca Balbi, Darlene Muscat,  Maria Elena Pawley, Stefan Laspina.
  • Malta Medical Journal Volume 21 Supplement November 2009, P171
• Anterior mini pyeloplasty for adult PUJ obstruction: A better alternative than laparoscopic pyeloplasty in selected cases?
  • Oliver Fuge, Malcolm Marquette, Rajiv Pillai, John Mcloughlin.
  • International Journal of Surgery Vol. 10, Issue 8, Page S102
• Bronchial artery embolization (BAE) in adults with cystic fibrosis: a single-centre case series.
  • Marquette M, Shauda N, Cousins A, Winterbottom C, Johnson C, Shafi N, et al.
  • Journal of Cystic Fibrosis. 2014 June; 135(2): p. S88.
• A Single UK Centre Descriptive Study of the Aetiology of Eosinophilic Pleural Effusions Investigated by Medical Thoracoscopy
  • M. Marquette, P. Sivasothy, S. Chatterji, T. Pulimood, J. Herre, E. Reid
  • Addenbrooke's Hospital Cambridge University NHS Foundation Trust - Cambridge/UK (ATS 2015)
• A Retrospective Review of Medical Thoracoscopy (MT) Outcomes for Benign Pleural Effusions (BPE) at the Cambridge Pleural Unit UK
  • M. Marquette, S. Chatterji, J. Herre, T. Pulimood, P. Sivasothy, E. Reid
  • Addenbrooke's Hospital Cambridge University NHS Foundation Trust - Cambridge/UK (ATS 2015)
• Nebulised Temocillin for Prophylaxis Against B. vietnamiensis in an Adult with Cystic Fibrosis.
  • M. Marquette, H.C. Barker, N.S. Shafi, C.J. Johnson, C.S. Haworth
  • (ECFS 2015 Brussels)
• Tracheobronchomalacia in Severe Asthma.
  • Malcolm Marquette, Chelliah Paramasivan, Caroline Owen, Jurgen Herre, Robin B Gore, Martin D Knolle
  • (BTS Winter Meeting 2019)

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