Professor Brian J Lipworth

Professor of Allergy and Pulmonology (Clinical)

Airway allergy and COPD

Address:

Scottish Centre for Respiratory Research
Molecular & Clinical Medicine
School of Medicine
University of Dundee
Ninewells Hospital
Dundee
DD1 9SY

Phone Number:

+(44) 01382 383902

Email Address:

b.j.lipworth@dundee.ac.uk

Biography

Over 30 years experience in clinical allergy and pulmonology allied to extensive research activity with an H index of 74 and 580 peer reviewed articles.

Head of the Scottish Centre of Respiratory Research and Clinical Professor of Allergy and Pulmonology at Ninewells Hospital and Medical School, Dundee.

Clinical and research expertise includes asthma, allergic rhinosinusitis and COPD.

Previously visiting Professor at Harvard University Medical School and University of Florida, as well as Honorary Clinical Professor at University of St Andrews Medical School. Currently Honorary Clinical Professor of Medicine at University of Central Lancashire.

Honoured for research excellence by the British Pharmacological Society, Scottish Thoracic Society, American College of Allergy, Asthma and Immunology (FACAAI) and European Respiratory Society (FERS).

 

Research

Current research interests are beta-adrenoceptor regulation and associated pharmacogenetics in asthma and COPD, airway inflammation in asthma, therapeutics of allergic rhinosinusitis.

Current H index = 64. Member of MRC peer review college and NIHR college of Experts.

Teaching

Dundee Curriculum

Has played a major role in the implementation and development of the new medical curriculum in Dundee.  Previous system convener for respiratory teaching (1991 – 2014), and was responsible for the complete restructuring of the teaching delivered in this area, which included a significant hands on component.  New innovations include the drawing up of an electronic study guide and web based teaching aids.

Postgraduate Teaching

Previously involvement in teaching and examining for the MRCP PACES, Glasgow postgraduate respiratory medicine course; respiratory education for the Royal College of Physicians of Edinburgh.  Regularly delivers postgraduate educational lectures to primary and secondary care doctors, both in the UK and abroad.

PhD Supervision

  • Dr S Jabbal (Ongoing, University of Dundee, MD): The Role of Bronchodilator therapy in obstructive airway disease
  • Dr J Weir-McCall (Ongoing, University of Dundee, MD)
  • Dr P Liu Shiu Cheong (Ongoing, University of Dundee, MD)
  • Dr A Manoharan (Ongoing, University of Dundee, MD): Perspectives of Small Airway Dysfunction in Obstructive Airway Disease
  • Dr W Anderson (2016, University of Dundee, MD): Personalising inhaled corticosteroid dose response in persistent asthma
  • Dr P Short (2013, University of Dundee, MD): Evaluation of beta-blockers for the treatment of asthma and COPD
  • Mr S Vaidyanathan (2013, University of Dundee, MD): Optimising therapeutic strategies of allergic rhinosinusitis
  • Dr Daniel Morales (2014, University of Dundee, PhD): Quantifying the risk of beta-blockers and non-steroidal anti-inflammatory drugs in asthma
  • Dr A Nair (2011, University of Dundee, MD): Pharmacotherapy of asthma: Effect of spacer devices on lung dose bioavailability of inhaled fluticasone
  • Dr Kaninika Basu (2010, University of Dundee, MD): The effects of genetic variation on asthma severity and treatment in childhood
  • Mr M Barnes (2008, University of Dundee, MD): Therapeutic Interventions and their Assessment in Allergic Rhinitis
  • Dr D Menzies (2008, University of Dundee, MD): Novel anti-inflammatory strategies in the treatment of asthma
  • Dr K Haggart (2006, University of Dundee, MSc): Effects of pharmacotherapy on asthma and allergic rhinitis
  • Dr D Lee (2004, University of Dundee, MD): Pharmacological modulation of allergic airways disease
  • Dr C Jackson (2004, University of Dundee, MD): Airway Hyperresponsiveness and allergic airways disease
  • Dr G Currie (2003, University of Dundee, MD): Effects of pharmacotherapy on bronchial hyperresponsiveness and surrogate inflammatory markers in asthmatic patients
  • Dr I Aziz (2002, University of Dundee, MD): Studies to investigate the facilitatory effects of corticosteroids on b2-adrenoceptor desensitization induced by long-acting b2-agonists
  • Dr O Dempsey (2002, University of Aberdeen, MD): An evaluation of the role of leukotriene receptor antagonist therapy in asthma
  • Dr S Fowler (2002, University of Manchester, MD): Clinical application of bronchial challenge: its relation to markers of asthma severity and dose response during treatment with inhaled corticosteroids
  • Dr R I Cargill (2000, University of Dundee, MD): The role of vasoactive peptides in modulation of the human pulmonary vascular bed
  • Dr D Kiely (2000, University of Edinburgh, MD): Cardiopulmonary interactions of hypoxia and hypercapnia and the role of vasoactive mediators in the pulmonary circulation in man
  • Dr A Wilson (2000, University of Edinburgh, MD): Anti-inflammatory therapy in allergic airways disease
  • Dr K S Tan (1999, University of Glasgow, MD): Regulation of b2-adrenoceptors by steroid hormones in asthma
  • Dr A Grove (1998, University of Cambridge, MD): Modulation of b2-adrenoceptor mediated responses
  • Dr D M Newham (1995, University of Aberdeen, MD): Airways and systemic responses to b2-agonists in man
  • Dr N M Wheeldon (1993, University of Manchester, MD): Studies on the b2-adrenoceptor subtypes responsible for mediating cardiovascular and metabolic responses in man

Conferences

  • Visiting Professorship, Harvard Medical School, Brigham and Womens Hospital, Boston, USA (2008) - Beta-2 adrenoceptor responses in man: more questions than answers
  • Johns Hopkins Asthma & Allergy Centre, Baltimore: Grand Rounds (2008) - Emerging research  in the role of anti-leukotrienes in asthma
  • European Respiratory Society Vienna (2009) - Can beta-blockers be useful to treat asthma?
  • Mount Sinai School of Medicine, New York, USA (2009): Grand Rounds - Role of the distal lung in asthma
  • Western Society of Allergy, Asthma and Immunology, Lanai, Hawaii (2010)-Invited international plenary speaker sessions (a) Unlocking the small airways compartment for asthma, (b) Beta- agonists and their antagonists in asthma
  • The Sylvia and Thomas Bodamer Lecture in Allergy and Immunology. Scripps Clinic, Carmel Valley, California (2010) - Beta-adrenoceptor regulation in asthma
  • Los Angeles Allergy Society. Plenary lecture (2010) - Treating inflammation in the large and small airways
  • Johns Hopkins Asthma & Allergy Centre, Baltimore, USA. Grand Rounds (2011) - Strategies for improving anti-inflammatory therapy in asthma
  • University of Florida, Gainesville, USA (2013) – Combined pediatric/adult pulmonary division seminar series.  Importance of the small airways in asthma
  • American Academy of Allergy Asthma and Immunology, San Diego CA (2014) –The case for anti-cholinergics in persistent asthma
  • Nemacolin Asthma Conference, PA, USA (2014) (a) Beta-blockers for asthma and COPD. (b) Pro-con debate –The Arg-16-Gly beta2 receptor genotype increases the risk if inhaled long acting beta-agonist use in asthma
  • European Respiratory Society, Munich (2014) – From phenotypes to endotypes in asthma
  • San Diego Allergy Society (2016) – Unlocking the quiet zone in asthma
  • UCLA Allergy ground rounds (2016) – The silent zone in asthma management
  • Utah Society of Allergy and Asthma (2016) – Assessment and treatment of small airways in asthma
  • Palm Beach Allergy Society (2016) – New perspectives of optimising inhaled steroid therapy in asthma

 

Impact

Significance of Research for NHS

  • Research studies using health informatics data linkage has identified a defined small airway asthma phenotype which is associated with impaired control (Manoharan et al Eur Respir J 2014; 44: 1353–1355; Lipworth et al Lancet RM 2014;2: 497–506;Jabbal et al J Allergy Clin Immunol 2016;138:601-603).
  • A genotyped database showed a adverse interaction between beta-2 receptor Arg16Gly genotype and use of long-acting beta-2 agonists (Lee et al. Br J Clin Pharmacol 2004:57:68-75, Palmer et al. Thorax 2006;61:940-44, Basu et al. J Allergy Clin Immunol 2009;124:1188-94; Turner et al J Allergy Clin Immunol 2016;138:107-113).  This led to the first RCT showing a personalised genotyped based approach to prescribing (Lipworth et al Clin Sci 2013;124:521-528).
  • A meta-analysis evaluated potential adverse reactions to NSAIDs and COX2 inhibitors in patients with asthma (Morales et al J Allergy Clin Immunol 2014;134:40-45; Morales et al Allergy 2015;70:828-8).
  • Health informatics demonstrated the potential for adverse effects of beta-blockers in asthma and concomitant cardiovascular disease (Morales et al BMC Medicine 2017;doi:10.1186/s12916-017-0781-0; Morales et al Br J Clin Pharmacol 2016;82:814-822; Morales et al Chest 2014;145:779-786).
  • Using a national database, I also showed underuse of beta-blockers in patients with heart failure and COPD, indicating a clinically relevant unmet need in such patients (Lipworth et al Heart 2016;102:1909-1914).This in turn led to an NIHR funded randomized  controlled trial  to evaluate the effects of bisoprolol on exacerbations in COPD on which I am co-chief applicant.
  • A screening programme involving bronchial challenge testing was employed to identify potential overtreatment of patients with adult asthma in the community (Manoharan et al Clin Exp Allergy 2014;44:1240-1245).
  • We showed the impact of the smoking ban on health in bar workers, and received international media coverage (Menzies et al JAMA 2006;296:1742-1748) with an accompanying editorial emphasizing its importance.
  • I have also shown that a novel osmotic bronchial challenge test with mannitol is well tolerated in primary care, to assess airway inflammation, resulting in better long term asthma control (Lipworth et al Chest 2010;141:607-15). A screening programme involving bronchial challenge testing was employed to identify potential overtreatment of patients with adult asthma in the community (Manoharan et al Clin Exp Allergy 2014;44:1240-1245).
  • Research into the role of the unified allergic airway (Barnes et al. Allergy 2007:62:73-80) has driven setting up of a unique one stop combined medical/surgical rhinology service.