Contents
Cover
Title Page
Copyright
Dedication
Contributors
Preface
Foreword
Acknowledgements
Chapter 1: Population Health
Introduction
Shoe-Leather Epidemiology
Smoking and Cancer: Association and Causality
The Inverse Care Law
Framingham and the Heart
The Evidence-Based Revolution
The Black Report
The Prevention Paradox
The Principles of Screening
Determining Causation
On the State of Public Health
Conclusion
Key Outstanding Questions
Key Research Centres
References
Chapter 2: Patient Safety
Introduction
Florence Nightingale on Running a Hospital
Codman and the End Results System
Understanding the Prevalence of Medical Error
Models for Understanding Error
The Story of Wayne Jowett
Setting the Agenda and Building Learning Organisations
Technology and Patient Safety
Hand Hygiene
Standardising Care
Using Checklists
Conclusions
Key Outstanding Questions
Key Research Centres
References
Chapter 3: Heart Failure
Introduction
The Landmark Trial of Renin-Angiotensin Inhibition
The Multidisciplinary Heart Failure Team
An About-Turn in Medical Thinking: Beta-Blockers Are Good for Heart Failure
B-Type Natriuretic Peptide in Helping to Identify Heart Failure
The Digoxin Trial in Heart Failure Study
The Randomized Aldactone Evaluation (RALES) Study
Flogging a Dying Horse: The Sad Tale of Intravenous Inotropes
A Paradigm Shift: The Development of Cardiac Resynchronisation Therapy: CARE HF
Preventing Sudden Death by an Implantable Cardioverter Defibrillator
Telemonitoring: An Important Technological Advance in Monitoring Heart Failure
Key Outstanding Questions
Key Laboratories and Clinics
References
Additional References
Chapter 4: Acute Coronary Syndrome (NSTEMI)
Introduction
Troponin: The Basis of Diagnosis
Aspirin: The Cornerstone of MI Management
The Additive Effect of Clopidogrel: A Case for Dual Anti-Platelet Therapy
The New Kid on the Block: Fondaparinux
Percutaneous Coronary Intervention: Who Should Get It?
The Role of GPIIb/IIIa Inhibitors
Use of ACE Inhibitors Post Myocardial Infarction: Dawn of a New HOPE
Beta-Blockers: When to Give Them?
Should All Post-MI Patients Get Statins?
Aldosterone Antagonists
Conclusion
Key Outstanding Questions
Key Research Centres
References
Chapter 5: Lipids, Dyslipidaemia and Cardiovascular Disease
Introduction
The Beginnings of Clinical Lipidology: Fredrickson's Classification of Lipoprotein Phenotypes
Dietary Saturated Fat and Cardiovascular Disease: The Seven Countries Study
Risk Factors for Coronary Heart Disease: The Framingham Study
Discovery of the LDL Receptor and the Cause of Familial Hypercholesterolaemia
Recognition of the Protective Role of HDL against Cardiovascular Disease
The Discovery of Compactin: The First Statin
ApoE Polymorphism and Type III Hyperlipoproteinaemia
Role of the Scavenger Receptor in Atherosclerosis
Atheromatous Plaque Fissuring and Fatal Coronary Events
4S: The Trial That Proved the Lipid Hypothesis
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Chapter 6: Atrial Fibrillation
Introduction
Basic Mechanisms: The Multiple-Wavelet Hypothesis
Basic Mechanisms: Wavelength
Basic Mechanisms: Pulmonary Veins
Basic Mechanisms: Mother Rotor
Atrial Remodelling: Atrial Tachycardia-Induced Remodelling
Atrial Remodelling: Congestive Heart Failure-Related Atrial Remodelling
Drug Therapy: Anticoagulation Therapy
Drug Therapy: Rhythm Control versus Rate Control
Drug Therapy: Upstream Therapy
Genetics
Conclusions
References
Chapter 7: Asthma
Introduction
The Pathophysiology of Asthma
Treatment of Asthma
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Chapter 8: Cystic Fibrosis
Introduction
An Electrifying Finding: Abnormal Mucosal Potential Differences
On the Shoulders of Giants: Chloride Permeability and CF
Big Is Beautiful, and More Is Better
A False Dawn? Finding the CF Gene
Treatment of Respiratory Infection: The Early Bird Catches the Worm
Many a Slip! The First Animal Model of CF
No Such Thing as a Free Lunch: New Infections, New Problems
Catch Them Early, Treat Them Quickly: A Randomised Controlled Trial of Screening for CF
Pathophysiology of CF: The Low-Volume Hypothesis
A True Dawn? The Modern Era of Mutation Specific Therapies
Summary and Conclusions
Key Outstanding Questions
Key Useful Websites
References
Chapter 9: Chronic Obstructive Pulmonary Disease
Introduction
The Dutch Hypothesis
Quantifying Lung Resistance in Small Airways Disease
Assessing Decline in FEV1
Exercise Training in COPD
Supplementary O2 Therapy in COPD
Synchronised Smoking Cessation: Effect on Decline in FEV1
Breathlessness and Dynamic Hyperinflation
Effect of an Inhaled Steroid on FEV1 Decline in Smokers with Mild COPD
The Nature of Persistent Airway Inflammation in Ex-Smokers with COPD
Small Airways Inflammation in COPD
Exacerbations in COPD
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Chapter 10: Pneumonia
Introduction
Prevention of Pneumonia – Vaccination against Streptococcus pneumoniae
Recognising the Patient with Pneumonia
Determining Where to Treat the Patient Diagnosed with Pneumonia
Surviving Sepsis: Reducing the Mortality of Patients with Severe Pneumonia
Optimal Duration of Antibiotic Therapy
Sequelae of Pneumonia: Pleural Space Infection
Microbiology of Pneumonia
Novel Approaches to Diagnosing an Aetiological Cause of Pneumonia
Clustering of Pneumocystis jirovecii The First Presentation of the Acquired Immunodeficiency Syndrome (AIDS)
Legionnaires' Disease: an Epidemiological and Laboratory Mystery
Summary and Conclusions
Key Outstanding Questions
References
Chapter 11: Stroke
Introduction
Classifying Stroke by Aetiological Subtype
The Brain Must Be Imaged Immediately after Arrival at Hospital
Stroke Units Save Lives
The First Definitive Drug Treatment for Acute Ischaemic Stroke
Hemicraniectomy Saves Lives in Malignant Cerebral Infarction without Increasing the Numbers of Severely Disabled Survivors
Secondary Prevention Should Start Early after Ischaemic Stroke
Preventing Recurrent Stroke in Those with Atrial Fibrillation
Preventing Recurrent Stroke in Those with Severe Carotid Artery Stenosis
Lowering Blood Pressure to Reduce the Risk of Recurrence after Stroke
Lowering Blood Lipids to Reduce the Risk of Recurrence after Stroke
Key Outstanding Questions
Key Research Centres
References
Chapter 12: Parkinson's Disease
Introduction
Describing the Condition
Drug Treatments in Parkinson's Disease
Assessing Disease Severity
Developing Animal Models
Parkinson's Disease Surgery
Establishing the Diagnosis
Motor Complications
Redefining the Pathology
Understanding the Genetics
Summary
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 13: Epilepsy
Introduction and Historical Perspective
The Birth of Anti-Epileptic Medication
When to Begin Anti-Epileptic Medication?
Which Anti-Epileptic Drugs to Start? The SANAD study
Early Identification of Refractory Epilepsy
Anti-Epileptic Drug Withdrawal
Genetics and Epilepsy
Impact of Epilepsy
Anti-Epileptic Drugs and the Foetus
Summary and Conclusions
Key Outstanding Questions
References
Additional References
Chapter 14: Motor Neuron Disease
Introduction
The Recognition of ALS as a Disease of Two Compartments
Identification of the Pathological Hallmarks of MND
The First Gene in Familial MND
An Animal Model
The First Disease-Modifying Treatment
Identification of Clinical Prognostic Factors
Standardised Measurement of Disease Progression and the Evolution of Clinical Trials
The Discovery of TDP-43
Understanding Focality and Spread of Pathology
Summary and Conclusion
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 15: Migraine
Introduction
Migraine and Ergotamine
Introduction of the Serotonin Antagonists
Headache Classification
An Account of Auras
The Development of Triptans
The Trigeminovascular System and Migraine
Migraine Genetics
Key Outstanding Questions
Key Research Groups
References
Additional References
Chapter 16: Multiple Sclerosis
Introduction
1916: The Pathological Anatomy of the Lesion in Multiple Sclerosis
1960: Evidence for an Immune Response within the Central Nervous System
1970: An Exemplary Trial of Steroid Treatment of the Acute Relapse
1972: The First Clinical Demonstration of Demyelination
1972: Identifying the Primary Genetic Association for Multiple Sclerosis
1973: Remyelination Is Possible in the CNS
1977: Plotting the Epidemiology of MS
1981: The First Evidence Showing That MS Is Treatable: The End of the Beginning?
1983: A Step towards Increased Diagnostic Accuracy
1988: Surrogate Markers in Life for Disease Activity in MS
Conclusion
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 17: The Autoimmune Basis for Guillain-Barré Syndrome
Introduction
What Is Guillain-Barré Syndrome?
Describing the Syndrome
Defining the Pathology
Assessing Treatment
Clinical Variants and Neuroimmunology
The Mechanism of Antiganglioside Antibody-mediated Nerve Injury
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 18: Helicobacter pylori, Peptic Ulcers and Gastric Cancer
Introduction
An Infectious Theory
The Human Guinea Pig and Koch's Postulates
How Does an Infection in the Antrum Cause Ulcers in the Duodenum? The Gastrin Link
What Is the Effect of Helicobacter pylori on Gastric Physiology?
A Simple Treatment That Cures Ulcers?
The Power of the NIH Consensus Statements
The H. pylori Genome
H. pylori and Gastric Cancer
H. pylori and the Gastric Cancer versus Duodenal Ulcer Phenotype
The Role of Host Genetics in Outcome of H. pylori Infection
Summary and Conclusion
Key Outstanding Questions
Key Research Centres
References
Chapter 19: Acute Liver Failure
Introduction
Definitions of Acute Liver Failure
Prognostication in Acute Liver Failure
Pathophysiology of ALF: Multiple Organ Failure and Covert Tissue Hypoxia
N-Acetyl Cysteine in ALF: From Clinical Observation to Randomised Controlled Trials
Ammonia: The Key Player in Hepatic Encephalopathy and Cerebral Oedema
Conclusion
Key Outstanding Questions
Key Research Centres
References
Chapter 20: Haemostasis and Thrombosis
Introduction
The Discovery of Heparin
The Discovery of Warfarin
The Treatment of Pulmonary Embolism
Prevention of Venous Thrombosis
Warfarin and Heparin in the Initial Treatment of Thromboembolic Disease
Activated Protein C Resistance and the Discovery of the Factor V Leiden Mutation
The Introduction of Low Molecular Weight Heparin
Mechanical Methods of Preventing Pulmonary Emboli
Predicting Venous Thrombosis
Conclusion
Key Outstanding Questions
Key Research Centres
References
Chapter 21: The Inherited Disorders of Haemoglobin
Introduction
Molecular and Cellular Pathology
Improvements in the Prevention and Treatment of the Thalassaemias and Sickle Cell Disease
Why Are the Inherited Haemoglobin Disorders So Common?
Summary
Key Outstanding Questions
Acknowledgements
References
Additional References
Chapter 22: Diabetes Therapy and the Prevention of Vascular Damage
Introduction
Urinary Glucose Control and Microvascular Complications in Clinical Practice
Subcutaneous Pumped Insulin: Better Glucose Control in Type 1 Diabetes
A Feasibility Study of Glucose Control and Complications
The Ultimate Type 1 Diabetes Study
Persistent Effects of Glucose Control on Arteriosclerotic Outcomes
Type 2 Diabetes: A Study That Took 20 Years
The Glucose Legacy Effect Wins Again
The Power of Multifactorial Intervention in Type 2 Diabetes
Intensive Glucose Control or Over-Intensive Glucose Control?
Meta-Analysis to the Rescue
Concluding Comment
References
Additional References
Chapter 23: Rheumatoid Arthritis
Introduction
What Is the Tissue Pathology?
What Mediates the Systemic Process?
How Might Rheumatoid Factors Be Pathogenic?
What Is the Basis of Genetic Susceptibility to RA?
What Is the Crucial Inflammatory Mediator in RA?
Does Smoking Contribute to the Causation of RA?
Why Do RA Patients Have Antibodies to Keratin?
What New Insights Can Immunohistochemistry Provide?
When Does the Immunopathology Begin?
Is RA Due to Self-Perpetuating Autoreactive B Cells?
Conclusions and Key Outstanding Questions
References
Additional References
Chapter 24: Osteoarthritis
Introduction
Risk Factors for Osteoarthritis
Focus on Pain
Linking Radiological OA and Clinical Symptoms
Surgical Treatment of Osteoarthritis
Autologous Chondrocyte Implantation: The Future of OA Therapuetics?
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 25: Systemic Vasculitis
Introduction
Describing the Disease
Classification of Vasculitis
Aetiology and Pathogenesis
Treatment
Summary
Key Outstanding Questions
Key Research Groups
References
Additional References
Chapter 26: Polycystic Kidney Disease
Introduction
Autosomal Dominant Polycystic Kidney Disease
Describing the Syndrome and Diagnosis of ADPKD
Identifying the Genes and Proteins: ADPKD1 Gene and Polycystin-1
Identifying the Genes and Proteins: ADPKD2 gene and Polycystin-2
Defining the Pathogenesis
Prospective Treatments
Autosomal Recessive Polycystic Kidney Disease
Identifying the Gene and Protein
Defining the Pathogenesis
Prospective Treatment
Summary and Conclusions
Note
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 27: Glomerular Disease and the Nephrotic Syndrome
Introduction
The Beginnings of Clinical Nephrology: Bright's Disease
Classification of Bright's Disease
The Nephrotic Syndrome
Structure, Function and Pathology of the Glomerular Filtration Barrier
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 28: Acquired Immunodeficiency Syndrome
Introduction
The Discovery of AIDS and HIV
The Origin and Evolution of HIV-1
Identification of Cellular Entry Receptors and Co-Receptors Required for HIV-1 Infection
The Course of HIV-1 Infection: From Transmission to the Development of AIDS
Host Immune Mechanisms Controlling HIV-1 Infection
Treatment of HIV-1 Infection by Antiretroviral Drugs
HIV-1 Vaccines: Preventative versus Therapeutic
Conclusion
Key Outstanding Questions
Key Research Centres
References
Additional References
Chapter 29: Transplantation
Introduction
Identification of Chromosomal Loci Encoding Major Histocompatibility Antigens in Mice and Humans
Tolerance to Transplanted Tissue Can Be Induced Post-natally (skin grafts are rejected by ‘cell mediated immunity’)
Clinical Transplantation of Kidneys Is Feasible
Clinical Transplantation of Bone Marrow Creates Chimerism
The Thymus Controls the Ability to Reject Grafts and Humoral Responses
Mutation Involving Thymus Affecting Ability to Reject Grafts
Regulation of Immunity by T Cells
T Cell Responses are MHC Restricted – a Central Tenet for All T Cell Responses
Repertoire Selection of T Cells in the Thymus Depends on Structural Components of the T Cell Receptor and Self MHC Molecules
Key Outstanding Questions
Key Research Centres
Acknowledgements
References
Additional References
Chapter 30: Autoimmunity
Introduction
Is ‘Horror Autotoxicus’ Possible?
Is Collagen Vascular Disease a Systemic Reaction to Dying Self?
Might Auto-antibodies Cause Organ-Specific Disease?
Can Instability of B Cell Tolerance Be Modeled in Animals?
Are B Cell Dynamics as Important as Reactivity?
How Can Autoreactive B Cells Get T Cell Help?
Does B Cell/T Cell Antigen Discordance Occur In Vivo?
What Roles Do Innate Thresholds Play?
Are There Genetic Effects on T Cell Tolerance?
What Does Therapeutic Depletion of B or T Cells Tell Us?
Conclusions
Key Outstanding Questions
References
Additional References
Chapter 31: The Biochemistry of Depression
Introduction
A Laboratory Test for Depression?
Hypersecretion of Cortisol as a State-Independent Marker of Depression
Noradrenaline Dysfunction in Depressed Patients
Role for Noradrenaline in Depressive Relapse
Serotonin and Depression: A Possible Link with Suicide
Low Serotonin Function in Depression Detected by Neuroendocrine Challenge
PET Imaging of the 5-HT1A Receptor in Depression
Tryptophan Depletion Provokes Relapse in Recovered Depressed Patients
An Interaction between a Serotonin Genetic Mechanism and Environmental Stress
Beyond Monoamines: A Role for GABA and Glutamate in Depression
Conclusion
Key Questions Remaining
References
Additional References
Chapter 32: Schizophrenia and the Dopamine Hypothesis
Introduction
What Is the Dopamine Hypothesis?
Amphetamine-Induced Psychosis
Experimental Studies of Amphetamine
Discovery of Antipsychotic Drugs
Dopamine and Parkinson's Disease
Dopamine Blockade and the Efficacy of Antipsychotic Drugs
Determination of the Different Classes of Dopamine Receptors
Atypical Antipsychotics
A Revised Dopamine Theory of Schizophrenia
Imaging Dopamine Receptors
Summary and Conclusions
Key Outstanding Questions
Key Research Centres
References
Chapter 33: Alzheimer's Disease
Introduction
Alzheimer's Original Description of the Disease
Loss of Subcortical Neurones from the Basal Nucleus of Meynert
The Relationship between the Pathology of Alzheimer's Disease and the Clinical Syndrome
Standardising Diagnostic Criteria for Research Studies
Revising the NINCDS–ADRDA Criteria
The Symptoms of Alzheimer's Disease
Cholinesterase Inhibitors as Treatment for AD
The Possible Central Role of ‘Amyloid’
Risk Factor Genes for Alzheimer's Disease: APOE 4
Time to Reconsider the Amyloid Cascade Hypothesis? Amyloid Removal from the Brain Does Not Benefit AD Sufferers
Key Outstanding Questions
Key Research Centres
References
Additional References
Index
Contributors
Raza Alikhan
Consultant Haematologist
Haemophilia and Thrombosis Centre
University Hospital of Wales
Cardiff, UK
Nigel Arden
Professor of Rheumatology
Botnar Research Centre
Institute of Musculoskeletal Sciences
University of Oxford
Oxford, UK
Peter J. Barnes
Professor and Head of Respiratory Medicine
Airway Disease Section
National Heart and Lung Institute
Imperial College London
London, UK
Philip M.W. Bath
Professor of Stroke MedicineStroke Association
Division of Stroke
School of Clinical Sciences
University of Nottingham
Nottingham, UK
Colin Berry
Professor and Honorary Consultant Physician and Cardiologist
BHF Glasgow Cardiovascular Research Centre
University of Glasgow
Glasgow, UK
Alistair Burns
Professor of Old Age Psychiatry
Department of Old Age Psychiatry
School of Medicine
University of Manchester
Manchester, UK
Andrew K. Burroughs
Consultant Physician and Professor of Hepatology
Royal Free Sheila Sherlock Liver Centre
Royal Free Hospital
London, UK
Andrew Bush
Professor of Paediatric Respirology
Imperial College London and Royal Brompton Hospital
London, UK
Geraldine Cambridge
Principal Research Fellow and Honorary Senior Lecturer in Rheumatology
Centre for Rheumatology
Division of Medicine
University College London
London, UK
Alasdair Coles
University Lecturer in Neuroimmunology
Department of Clinical Neurosciences
University of Cambridge
Cambridge, UK
Alastair Compston
Professor of Neurology
Department of Clinical Neurosciences
University of Cambridge
Cambridge, UK
Philip J. Cowen
Professor of Psychopharmacology
Department of Psychiatry
University of Oxford
Oxford, UK
Martin R. Cowie
Professor of Cardiology
National Heart and Lung Institute
Imperial College London
London, UK
Robert J.O. Davies
Professor of Respiratory Medicine
Respiratory Medicine Group
Experimental Medicine Division
University of Oxford
Oxford, UK
Sir Liam Donaldson
Chief Medical Officer for England and UK Government Chief Medical Adviser 1998–2010
Department of Health
London, UK
Anahita Dua
Department of General Surgery
Medical College of Wisconsin
Milwaukee, Wisconsin, USA
Jonathan C.W. Edwards
Professor in Connective Tissue Medicine
Centre for Rheumatology
Division of Medicine
University College London
London, UK
Emad M. El-Omar
Professor of Gastroenterology
Gastrointestinal Group
Institute of Medical Sciences School of Medicine & Dentistry Aberdeen University
Aberdeen, UK
Paul A. Ford
Senior Clinical Research Fellow
Airway Disease Section
National Heart and Lung Institute
Imperial College London
London, UK
John A. Goodfellow
Honorary Clinical Academic Fellow
Neuroimmunology Group
Division of Clinical Neuroscience
University of Glasgow
Glasgow, UK
Kaushik Guha
Clinical Research Fellow
National Heart and Lung Institute
Imperial College London
London, UK
Felix Greaves
Public Health Registrar and Clinical Research Fellow
Department of Primary Care and Public Health
Imperial College London
London, UK
Donald G. Grosset
Consultant Neurologist and Honorary Senior Lecturer in Neurology
Greater Glasgow Movement Disorder Clinic
Institute of Neurological Sciences
Southern General Hospital
Glasgow, UK
Philip Home
Chair of Diabetes Medicine
Institute of Cellular Medicine
University of Newcastle upon Tyne
Newcastle, UK
Eve C. Johnstone
Professor and Head of Division of Psychiatry
Centre for Clinical Brain Sciences
University Department of Psychiatry
University of Edinburgh
Edinburgh, UK
Mandy Johnstone
Clinical Lecturer in Psychiatry
Centre for Clinical Brain Sciences
University Department of Psychiatry
University of Edinburgh
Edinburgh, UK
Maria J. Leandro
Honorary Senior Lecturer
Centre for Rheumatology
Division of Medicine
University College London
London, UK
Tak H. Lee
Asthma UK Professor of Allergy and Respiratory Medicine
Division of Asthma, Allergy and Lung Biology
Kings College London
London, UK
Wei Yao Lim
Academic Foundation Trainee
BHF Glasgow Cardiovascular Research Centre
University of Glasgow
Glasgow, UK
Raashid Luqmani
Senior Lecturer in Rheumatology
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
University of Oxford
Oxford, UK
Eleanor K. Mishra
Research Fellow
Oxford Centre for Respiratory Medicine
University of Oxford
Oxford, UK
Stanley Nattel
Associate Professor
Department of Medicine
Montreal Heart Institute
Université de Montreal
Canada
Edward J. Newman
Clinical Lecturer in Neurology
Greater Glasgow Movement Disorder Clinic
Institute of Neurological Sciences
Southern General Hospital
Glasgow, UK
Alexander S. Nicholls
Botnar Research Centre
Institute of Musculoskeletal Sciences
University of Oxford
Oxford, UK
Kunihiro Nishida
Assistant Professor
The Second Department of Internal Medicine
University of Toyama
Toyama, Japan
Douglas Noble
Public Health Registrar and Honorary Clinical Lecturer
Centre for Health Sciences
Barts and the London School of Medicine and Dentistry
London, UK
James O'Beirne
Consultant Hepatologist
Royal Free Sheila Sherlock Liver Centre
Royal Free Hospital
London, UK
Jenny Papakrivopoulou
NIHR Clinical Lecturer in Nephrology
UCL Centre for Nephrology
Royal Free Hospital
London, UK
Charles Percy
Specialty Registrar in Haematology
Haemophilia and Thrombosis Centre
University Hospital of Wales
Cardiff, UK
Tica Pichulik
MRC Human Immunology Unit
Weatherall Institute of Molecular Medicine
University of Oxford
Oxford, UK
Qi Qian
Lecturer in Internal Medicine and Nephrology
Division of Nephrology and Hypertension
Department of Internal Medicine
Mayo Clinic
Rochester, Minnesota, USA
Joanna Robson
Rheumatology Registrar
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
University of Oxford
Oxford, UK
Fergus J. Rugg-Gunn
Consultant Neurologist
Department of Clinical and Experimental Epilepsy
National Hospital for Neurology and Neurosurgery
Queen Square
London, UK
Leonard Siew
Clinical Research Fellow
Department of Asthma, Allergy and Respiratory Science
Kings College London
London, UK
Alison Simmons
Senior Clinical Lecturer
MRC Human Immunology Unit
Weatherall Institute of Molecular Medicine
University of Oxford
Oxford, UK
Elizabeth Simpson
Emeritus Professor of Transplantation Biology
Division of Immunology and Inflammation
Imperial College London
London, UK
Anushka Soni
Botnar Research Centre
Institute of Musculoskeletal Sciences
University of Oxford
Oxford, UK
Nikola Sprigg
Clinical Associate Professor
Division of Stroke
School of Clinical Sciences
University of Nottingham
Nottingham, UK
Ravi Suppiah
Rheumatology Clinical Fellow
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
University of Oxford
Oxford, UK
Kevin Talbot
Professor of Motor Neuron Biology and Honorary Consultant Neurologist
Oxford Motor Neuron Disease Centre and Department of Clinical Neurology
University of Oxford
Oxford, UK
Gilbert R. Thompson
Emeritus Professor of Clinical Lipidology
Department of Medicine
Imperial College London
London, UK
Martin R. Turner
Lady Edith Wolfson Clinician Scientist and Honorary Consultant Neurologist
Oxford Motor Neuron Disease Centre and Department of Clinical Neurology
University of Oxford
Oxford, UK
Robert Unwin
Professor of Nephrology and Physiology
UCL Centre for Nephrology
Royal Free Hospital
London, UK
Sir David Weatherall
Regius Professor of Medicine Emeritus
Weatherall Institute of Molecular Medicine
University of Oxford
Oxford, UK
Chancellor
Keele University
Keele, UK
Mark W. Weatherall
Consultant Neurologist
Princess Margaret Migraine Clinic
Department of Clinical Neurology
Charing Cross Hospital
London, UK
Kirsten White
Botnar Research Centre
Institute of Musculoskeletal Sciences
University of Oxford
Oxford, UK
Gordon Wilcock
Professor of Clinical Geratology
Dementia Clinical Research Group
Experimental Medicine Division
University of Oxford
Oxford, UK
Hugh J. Willison
Professor of Neurology
Neuroimmunology Group
Division of Clinical Neuroscience
University of Glasgow
Glasgow, UK
John M. Wrightson
Clinical Research Fellow and Respiratory Specialist Registrar
Oxford Centre for Respiratory Medicine
University of Oxford
Oxford, UK
