NIHR Barts Biomedical Research Centre & Precision Musculoskeletal Care theme
NIHR Barts Musculoskeletal Biomedical Research Centre
The NIHR Barts musculoskeletal BRC combines the second largest NHS Trust, serving ~7.5 million people from 97 nations, with the strengths of Queen Mary University of London partnered with St George’s University of London and St George’s University Hospitals NHS Foundation Trust.
Our vision is to:
- Detect disease early, carefully sub-divide patients into groups and provide effective individualised treatments. We will use real-world data to identify different patient groups that will enable us to better understand disease so we can develop more precise treatments.
- Build on our world-leading track record of translational digital precision healthcare from the 100,000 Genomes Project.
- Integrate real time multi-modal digital health data (clinical, digital pathology, imaging, deeper phenotyping), precision multi-omics, functional characterisation and advanced analytics to maximise new diagnoses, early disease detection, and tailored therapeutic innovation.
- Create the NHS of the future in cardiovascular disease (CVD), musculoskeletal disease (MSK) and cancer, accelerating translational research from patient to gene variant to function to phenotype into stratified healthcare that transforms lives.
Our goals are to transform outcomes in arthritis by:
- Improved risk assessment through the development and testing of new genetic risk scores for arthritis prevention.
- Optimising treatments using information from tissue samples to select tailored treatments for arthritis.
- Placing patient-shaped digital precision healthcare research, with full engagement and equality, diversity, and inclusion at the heart of this BRC.
- Harnessing our population scale to engage niche diverse groups with a disproportionate burden of musculoskeletal conditions in research that transforms outcomes in our diverse community.
Background – Precision Musculoskeletal Care theme
Musculoskeletal (MSK) conditions affect over 14.9m people nationally, represent 20% of GP consultations and are the second biggest cause of sickness absence, costing the UK economy £7bn per year and £5bn per year directly to the NHS.
While biologic therapies have revolutionised management of rheumatoid arthritis, huge clinical challenges remain with 40% of patients reporting a poor therapeutic response, 10-20% remain refractory to all current medications leading to delayed disease control and disability. No biologics are currently available for Sjorgrens syndrome, while in osteoarthritis absence of disease-modifying therapy leads to >250,000 NHS joint replacements per year.
Our multidisciplinary research team will apply multi-modality data integration to high burden, common MSK diseases to address major areas of unmet need.
Summary
Precision Musculoskeletal Care pioneered the selection of biologics tailored to patients’ synovial pathotype (Lancet 2021). We will combine deeper phenotyping and remote patient disease activity monitoring (see Precision Digital Health, Cardiovascular Devices and Trials), with pan-BRC digital pathology (with Cardiovascular and Cancer) and single cell multi-omic profiling, including a novel method of immune repertoire sequencing across a suite of funded trials with Manchester (joint MRC funding), Oxford (joint Versus Arthritis Osteoarthritis Centre), Bristol & Nottingham (Perioperative Care TRC).
Aims & Objectives – Precision Musculoskeletal Care
Through deep clinical, biomechanical, molecular and imaging phenotyping we will drive AI analyses generating novel predictive algorithms to answer the research questions of:
- Who will rapidly progress and when? (precision detection/surveillance).
- Which cellular, molecular, bio-mechanical mechanisms/pathways underpin disease progression/treatment resistance for novel target identification? (precision pathogenesis/discovery).
- Who will respond/non-respond to current/novel medications? (precision stratification/therapy).
funded by
National Institute for Health and Care Research
Our Team – Precision Musculoskeletal Care
Co-Theme Leads
Professor Costantino Pitzalis
Professor Xavier Griffin
Personalised healthcare, multi-omics & Clinical Trials
Professor Michele Bombardieri
Professor Jack Cuzik
Professor Rhian Gabe
Professor Xavier Griffin
Dr Myles Lewis
Professor Dylan Morrissey
Professor Costantino Pitzalis
Dr William Marsh
Novel Therapeutics & Target Discovery
Professor Francesco Dell’Accio
Dr Karin Hing
Professor Mauro Perretti
Professor Gleb Sukhorukov
In-vitro Testing/Organ-chip Models/Tissue-Engineering/Biomechanical-Imaging-Pain phenotyping
Professor Michael Barnes
Professor Shaogang Gong
Professor Himadri Gupta
Professor Martin Knight
Professor David Lee
Professor Hazel Screen
Dr Shafaq Sikandar
Professor Greg Slabaugh
