“I’m here to find better ways of caring for acutely ill children; I can’t do that just by staying in the lab”. Vikki Goss typifies Southampton’s approach to clinical research, and is one of a new generation working at the join between laboratory and clinic.
Improving critical respiratory care
Vikki aims to help develop better support for critically ill children with failing lungs and breathing difficulties, working with Southampton’s paediatric intensive care unit (PICU).
A key issue for these children is a loss or change in their lung surfactant, a fluid lining that helps the lung expand properly, avoid collapse and absorb oxygen efficiently.
Need for targeted treatment
“Giving extra surfactant (exogenous surfactant therapy, or EST) is potentially a good way of improving lung function. Unfortunately, despite some individuals responding well, it hasn’t proven to be effective as a standard treatment for all,” explained Dr Michael Marsh, medical director at our hospital trust and founder of Southampton’s PICU.
“And that’s the key to Vikki’s work. She is studying surfactant in these children, to see if it is possible to identify those individuals who respond well to EST, enabling our clinical teams to target it to those it would help most.”
A new test
Vikki’s results so far have shown significant differences in the surfactant of individual patients, and that these differences don’t relate to the clinical measures used to decide on EST use.
“On the one hand we have shown that the traditional clinical measures can’t be relied on to identify underlying causes of poor lung function and, on the other, we’ve generated a test that does differentiate patients based on their surfactant biochemistry,” she said.
“The next phase is to analyse the surfactant of children receiving EST, to identify which of those biochemical differences are associated with positive responses to EST. It is a test any hospital laboratory can do and, if successful, could rapidly be developed for use throughout the NHS.”
Vital: Southampton’s research culture and NIHR Respiratory Biomedical Research Unit
Vikki is clear that the NIHR Southampton Respiratory Biomedical Research Unit is the key to enabling this work, providing access to powerful research resources and expertise in immediate contact with the clinical front line.
“It can be all too easy as a scientist to lose sight of what the end goal is; here I’m lucky that, alongside my laboratory work, I am able to spend time with the PICU team– I have had to work hard to understand the medical context, but I think now I am seen by the clinical teams as someone who can help answer problems they encounter,” said Vikki.
Dr Marsh added: “This is how it needs to be. The support from NIHR is critical, providing the facilities and resources that enable careers and research like Vikki’s - but so is the culture. I see that as my role, opening doors and ensuring clinicians and scientists have the space to collaborate on work that makes a real difference to patients’ lives.
Posted on Saturday 19 March 2016