Projects

Projects in the NIHR Centre for Precision Approaches to Combatting Antimicrobial Resistance are funded by the NIHR, MRC and INNOVATE UK.

Current projects

Pulse-CF

Pulse‑CF is a UK-wide research programme led by Professor Alex Horsley at The University of Manchester and funded by the Cystic Fibrosis Trust and LifeArc. The study aims to understand what triggers lung exacerbations in people with cystic fibrosis and why individuals respond differently to treatment. Working with collaborators and clinical teams across the UK, Pulse‑CF collects samples and detailed data to uncover the biological and environmental factors that influence flare-ups. Through its innovative CF‑Tracker and UNIFIED‑CF studies, the programme examines inflammation, infection, and treatment responses to identify patterns that can guide care. The findings will help improve how exacerbations are predicted, prevented, and managed, paving the way for more personalised therapies and better long-term lung health for people with CF. More information about the project can be found on the Pulse-CF Innovation Hub and the Pulse-CF website.

BAC2BAC

BAC2BAC is an experimental medicine study of a novel technology designed to improve our ability to diagnose ventilator-associated pneumonia in patients receiving mechanical ventilation in Intensive Care Units. The study is funded by the Wellcome Trust and will recruit patients in Edinburgh before moving to include Manchester and other UK sites. The study will use bronchoscopy to test a novel technology known as ‘molecular alveoscopy’ which involves passing small fibres coupled with locally delivered molecular imaging agents (referred to as ‘SmartProbes’) into the distal lung to collect optical signatures of pathobiology. The study will assess the performance and safety of the technology, as well as enable the collection of ‘alveolar lavage’ samples for further exploratory analysis via the range of established techniques within C-PACA. Our group’s lead contributor is Dr Richard O’Sullivan.

RADicA

Rapid Access Diagnostics for Asthma (RADicA) is a study involving adults and children with symptoms consistent with asthma, not currently receiving regular treatment. Currently, there is no “gold standard” test to diagnose asthma. The condition is primarily identified through clinical evaluation based on typical symptoms and signs. As a result, asthma is often both overdiagnosed and underdiagnosed. Therefore, there is a pressing need for the development of highly sensitive and specific tests that could serve as a reliable standard for diagnosing asthma. The goal of RADicA study is to determine the optimum series of investigations to diagnose asthma. One of the promising novel investigation tests for detection of asthma is the analysis of volatile organic compounds (VOCs). In the AMR lab we identify the profile of biomarkers in VOCs, which could best predict asthma diagnosis by using thermal desorption – gas chromatography – mass spectrometry.

SIPRES

The Subphenotyping Immune Profiles in Respiratory Sepsis (SIPRES) Study is an NIHR-funded doctoral fellowship study (NIHR 304654), sponsored by the University of Manchester. SIPRES aims to explore the interaction between transcriptomic signatures in sepsis and low levels of antibiotics in blood. This prospective observational study, with an embedded population pharmacokinetic substudy, will recruit 119 critically ill adults with pneumonia from two Manchester intensive care units. Participants will be classified into two signature categories (Davenport & Sinha), and the study will assess the risk of not achieving antimicrobial target levels in blood. The study is set to launch in November 2025, with Dr Jan Hansel as the principal investigator.

AcCReDiT

AcCReDiT is a study of novel approaches in the diagnosis and management of patients with acute respiratory infections and acute exacerbations of chronic respiratory diseases. This study is funded by the NIHR Manchester Biomedical Research Centre. Traditional diagnostic labels, such as pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), or asthma exacerbations, group together diverse presentations that may require disparate treatments. This study takes a disease label agnostic approach when assessing the clinical and immunological characteristics of acute respiratory conditions, to identify common treatable traits. The study developed a strategy to recruit patients upon presentation to the hospital and prior to receiving treatment. The study uses multi-omics, immune profiling and infection diagnostics to rigorously characterise acute infections and exacerbations and explores the clinical benefits this novel, label agnostic approach could yield.

DEMAND

Defining mechanisms underpinning antibiotic mediated disruption of pulmonary immune responses (DEMAND) is an RCT designed study to explore the impact of antibiotic administration on systemic and pulmonary immune responses through disruption of the commensal microbiota – in both asthmatics and healthy participants. Existing data indicates a link between altered commensal microbiota and regulation of immune responses including in the airways in asthma – including potential switching to a maladaptive Th2 immune endotype. DEMAND will characterise any causal link through deliberate disruption of the microbiome with amoxicillin (or placebo) in both healthy volunteers and asthmatics, with subsequent assessment of microbial metabolites and immune cell characterisation in both blood and broncho-alveolar fluid. DEMAND is a collaborative project with Dr Elizabeth Mann’s group based at the Lydia Becker Institute. Our group’s lead contributor and trial PI is Dr James Orr.