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Professor Pippa Tyrrell (MD, FRCP) - research

Research interests

I am Clinical Lead for an internationally leading programme of Translational Research with colleagues in Faculty of Life Sciences (Professor Dame Nancy Rothwell, Professor  Stuart Allan) and the Institute of CV Sciences where I lead the Vascular and Stroke Centre.  Working with colleagues in stroke (Dr Craig Smith), neurosurgery (Professor Andrew King, Mr Hiren Patel) and inflammation (Dr Stephen Hopkins) we are studying the inflammatory response to stroke and subarachnoid haemorrhage, and its modulation by the naturally occurring cytokine antagonist, IL-1Ra. Our studies have demonstrated the variability of the immune response to stroke and its association with clinical outcome, the relationship between inflammation and delayed cerebral ischaemic following subarachnoid haemorrhage; the association of the inflammatory response with outcome following TIA; the penetration of IL-1Ra administered intravenously into central CSF, the pharmacokinetics of CSF penetration; the effect of iv IL-1Ra on CSF biomarkers of inflammation and the impairment of the immune response following stroke and its reversal with IL-1Ra. We have recently completed a MRC funded study to evaluate whether subarachnoid haemorrhage is a valid model for stroke, working to ensure that animal and clinical experimental models of stroke and SAH are as closely linked as possible. We have also demonstrated MR evidence of microvascular angiopathy in patients at risk of stroke, together with elevated PK11195 (PET) binding in these patients. This has led to a "reverse translation" study where co-morbid animals have undergone PET studies showing similar  distribution of microglial activation. Current studies include a MRC DCS/DPFS study of IL-1Ra in subarachnoid haemorrhage and a Stroke Association study of IL-1Ra in acute ischaemic stroke. I supervise two NIHR Clinical Lecturers, Adrian Parry-Jones (developing studies in intracerebral haemorrhage) and James Galea (studies in subarachnoid haemorrhage).

I am Clinical Lead for the Stroke Implementation theme of the Greater Manchester CLARHC. We developed a 6 month post stroke assessment tool, the GM-SAT, which is is now in use across the country, and woking on implementation of home monitoring of blood pressure in practices across N Manchester.  I am lead nationally for the Stroke Audit (SSNAP) which is an important source of research data.

I work with colleagues in psychology (particularly Dr Audrey Bowen, Reader) and rehabilitation (Professor Sarah Tyson), together with Professor Shaheen Hamdy.

Collaborators and affiliated staff

Faculty of Life Sciences:

Professor Dame Nancy Rothwell

Professor Stuart Allan

Dr Herve Boutin

FMHS Vascular and Stroke Centre:

Dr Stephen Hopkins

Professor  Andrew King

Dr Audrey Bowen

Professor Sarah Tyson

Mr Andy Vail (Biostatistics)

Mr Hiren Patel

Dr Craig Smith

Dr Adrian Parry-Jones

Mr James Galea

Brain Behaviour and Mental Health:

Professor Anthony Jones

Professor  Shaheen Hamdy

Salford Royal Foundation Trust:

Dr Steve Hopkins

Mr Andy Vail

Mr Hiren Patel

Mr James Galea

Mrs Sharon Hulme

GM CLARHC

Professor Bonnie Sibbald

Professor Ruth Boaden (MBS)

Ms Joanne Thomas

Ms Katy Rothwell

Imaging Science:

Professor Alan Jackson

Psychiatry:

Professor Alistair Burns

University of London

Professor Anthony Rudd

Professor Charles Wolfe

Professor Naomi Fulop

Methodological knowledge

As lead for a translational programme of stroke research I have expertise in the design and conduct of difficult clinical trials in vulnerable groups, together with observational studies of inflammatory markers in plasma and CSF. I am aware of many of the pitfalls and difficulties of biomarker studies particularly inflammatory biomarkers. I have expertise in the design of imaging (MR and PET) studies in cerebrovascular disease, and in the basic science underlying the translational aspects of my work.

My role as Clinical Lead for the NW Stroke LRN means that I have experience in the adoption, design and conduct of a wide variety of RCTs and other well designed studies in stroke and subarachnoid haemorrhage. I am able to assess the feasibility of studies in a variety of service providers (Trusts) and understand the relationships between the Comprehensive Local Research Networks and the Topic Specific networks nationally. I have expertise in patient and public involvement through the clinical and research networks, and am frequently asked to talk to public groups about both research and clinical practice.

I have extensive clinical expertise in acute stroke and stroke rehabilitation, with a very active clinical practice including 24/7 cover for acute interventions, and I am nationally recognised as an expert in stroke care. I wrote the NICE Acute Stroke and TIA guideline in 2008, and I am lead for SSNAP, the national stroke audit. I have expertise in stroke rehabilitation studies, particularly dysphagia studies, as well as a specific interest in post stroke pain. I have expertise in implementation research and I am familiar with the role of qulaitative research in rehabilitation studies. I have been involved in the development of functional electrical stimulation studies with Dr laurence Kenney.

I have supervised a PhD student in inflammation and mild cognitive impirment and have expertise in some aspects of degenerative dementias.