Shankar-Hari Group

Manu Shankar-Hari leads this translational research group.

Shankar-Hari group’s research explores ways to improve outcomes in adult critically ill patients with sepsis and with ARDS, by linking the illness immunobiology with novel interventional trial designs.

Our lab has the following focussed research themes

Immunobiology: Explore adaptive immune system changes during sepsis, during ARDS and longer-term in patients who survive sepsis. We integrate orthogonal multilevel data with repeated measurements of cellular phenotype, functional assessments, alongside corresponding transcriptomes and epigenetic landscapes.
Epidemiology and Stratified medicine: We use early-phase randomised controlled trials, cohort studies, systematic reviews and large clinical trial datasets to (a) explore treatment effect heterogeneity; (b) identify treatable traits based on dominant biological mechanisms, and (c) modifiable proximate determinants of sepsis and ARDS.

Current PhD students

Rohit Saha
Matthew Fish

Members

Michael Carter

NIHR Academic Clinical Lecturer in Paediatrics

Yasmeen Ghnewa

Post Doctoral Researcher

Aislinn Jennings

Research Assistant

Rohit Saha

Consultant in Intensive Care Medicine

Manu Shankar-Hari

NIHR Clinician Scientist, Reader and Consultant in Intensive Care Medicine

Pneumococcal VACcination to accelerate Immune Recovery in Sepsis Survivors: randomized placebo-controlled trial: VACIRISS trial

Sepsis survivors are at much higher risk of infection-related rehospitalisation and death. The aim of VACIRiSS trial is to evaluate the immunogenicity of single-dose 13-valent conjugate pneumococcal vaccine in preventing infection-related rehospitalisation or death in sepsis survivors and to collect outcome event data with the necessary precision to inform future definitive trial design.

VACIRISS trial

Cellular and molecular mechanisms of IMMunE dysfunction and Recovery from SEpsis related critical illness: an observational cohort study (IMMERSE)

IMMERSE study aims to integrate orthogonal multi-omics datasets of longitudinal (repeated) measurements of key lymphocyte phenotype, immune response signalling proteins, transcriptome and epigenome to describe the main patterns of immune trajectory. The ultimate goal is to inform future immunomodulation trials and aims to use T cell exhaustion as an example.

Defining ARDS and sepsis sub-phenotypes: a re-analysis of two trials to inform stratified medicine approach with future trials

Acute Respiratory Distress Syndrome (ARDS) and sepsis are the two most common illnesses in the critically ill, with increasing incidence and high mortality and many statistically negative trials. This research programme aims to identify homogenous groups (sub-phenotypes) such as patients with clinical or biological features or treatment response characteristics to inform future trial design by enriching patient populations likely to benefit the most from interventions.

Relationship between eligibility criteria in randomised controlled trials and ARDS clinical criteria on outcomes

Using systematic review, meta-analysis, cohort studies and risk modelling approaches, Rohit’s PhD aims to explain the impact of trial eligibility criteria on variability in outcomes between ARDS trials, variability in treatment effect between trials, sample size estimations, and evaluated design biases. The ultimate goal is to identify parsimonious variables that will improve future ARDS trial design.

Demographic Shifts, Case Mix, Activity, and Outcome for Elderly Patients Admitted to Adult General ICUs in England, Wales, and Northern Ireland
Jones, A., Toft-Petersen, A. P., Shankar-Hari, M., Harrison, D. A. & Rowan, K. M., 1 Apr 2020, In : Critical Care Medicine. 48, 4, p. 466-474 9 p. Research output: Contribution to journal - Article. DOIs: https://doi.org/10.1097/CCM.0000000000004211
Rate and risk factors for rehospitalisation in sepsis survivors: systematic review and meta-analysis
Shankar-Hari, M., Saha, R., Wilson, J., Prescott, H. C., Harrison, D., Rowan, K., Rubenfeld, G. D. & Adhikari, N. K. J., 1 Apr 2020, In : Intensive Care Medicine. 46, 4, p. 619-636 18 p. Research output: Contribution to journal - Review article. DOIs: https://doi.org/10.1007/s00134-019-05908-3
Lack of Clinical Benefit of Interferon Î²-1a Among Patients With Severe Acute Respiratory Distress Syndrome: Time to Overhaul Drug Trials in ARDS?
Shankar-Hari, M. & Calfee, C. S., 25 Feb 2020, In : JAMA. 323, 8, p. 713-715 3 p. Research output: Contribution to journal - Editorial. DOIs: https://doi.org/10.1001/jama.2019.22524
Could stress ulcer prophylaxis increase mortality in high-acuity patients?
Harhay, M. O., Young, P. J. & Shankar-Hari, M., 19 Feb 2020, In : Intensive Care Medicine. 46, 4, p. 793-795 3 p. Research output: Contribution to journal - Editorial. DOIs: https://doi.org/10.1007/s00134-020-05959-x
Is T Cell Exhaustion a Treatable Trait in Sepsis?
Fish, M., Swanson, C. M. & Shankar-Hari, M., 12 Feb 2020, Annual Update in Intensive Care and Emergency Medicine 2020. Vincent, J-L. (ed.). Cham: Springer International Publishing, p. 271-279 9 p. Research output: Chapter in Book/Report/Conference proceeding - Chapter. DOIs: https://doi.org/10.1007/978-3-030-37323-8_22
Maternal Risk Modeling in Critical Care-Development of a Multivariable Risk Prediction Model for Death and Prolonged Intensive Care
Simpson, N. B., Shankar-Hari, M., Rowan, K. M., Cecconi, M., von Dadelszen, P., Huning, E. Y-S., Magee, L. A., Payne, B. A., Quinn, A. C. & Harrison, D. A., 9 Jan 2020, In : Critical Care Medicine. p. 663-672 10 p. Research output: Contribution to journal - Article. DOIs: https://doi.org/10.1097/CCM.0000000000004223
Should we consider blocking the inhibitory immune checkpoint molecules for treating T cell exhaustion in sepsis?
Shankar-Hari, M., Fish, M. & Azoulay, E., 1 Jan 2020, In : Intensive Care Medicine. 46, 1, p. 119-121 3 p. Research output: Contribution to journal - Editorial. DOIs: https://doi.org/10.1007/s00134-019-05814-8
Trials on oxygen supplementation in sepsis: better late than never
Perner, A., De Jong, A. & Shankar-Hari, M., 1 Jan 2020, In : Intensive Care Medicine. 46, 1, p. 116-118 3 p. Research output: Contribution to journal - Editorial. DOIs: https://doi.org/10.1007/s00134-019-05874-w
Current gaps in sepsis immunology: new opportunities for translational research
Rubio, I., Osuchowski, M. F., Shankar-Hari, M., Skirecki, T., Winkler, M. S., Lachmann, G., La Rosée, P., Monneret, G., Venet, F., Bauer, M., Brunkhorst, F. M., Kox, M., Cavaillon, J-M., Uhle, F., Weigand, M. A., Flohé, S. B., Wiersinga, W. J., Martin-Fernandez, M., Almansa, R., Martin-Loeches, I. & 10 others, Torres, A., Giamarellos-Bourboulis, E. J., Girardis, M., Cossarizza, A., Netea, M. G., van der Poll, T., Scherag, A., Meisel, C., Schefold, J. C. & Bermejo-Martín, J. F., 1 Dec 2019, In : Lancet Infectious Diseases. 19, 12, p. e422-e436 Research output: Contribution to journal - Review article. DOIs: https://doi.org/10.1016/S1473-3099(19)30567-5
Sepsis hysteria: excess hype and unrealistic expectations
Singer, M., Inada-Kim, M. & Shankar-Hari, M., 26 Oct 2019, In : Lancet. 394, 10208, p. 1513-1514 2 p. Research output: Contribution to journal - Letter. DOIs: https://doi.org/10.1016/S0140-6736(19)32483-3

View all publications

2017 2022 NIHR Clinician Scientist Award, National Institute for Health Research

UK2018 2019 Lowry Fink Fellowship, International Sepsis Forum

2017 Global Rising Star in Intensive Care, Australia and New Zealand Intensive Care Society

Health Technology Assessment programme (2019 – 2025)

Efficacy and Mechanism Evaluation Programme (2019-2021)

Efficacy and Mechanism Evaluation Programme (2017-2019)

National Institute for Health Research Clinician Scientist Award (2017-2022)

BJA/RCoA PhD studentship (2019-2022 )

Kings Commercialisation Institute Challenge Fund (2015-2016)

Our partners

National Institute for Health Research

Medical Research Council

National Institute of Academic Anaesthesia

Contact us

manu.shankar-hari@kcl.ac.uk

Shankar-Hari Group

Members

Michael Carter

Yasmeen Ghnewa

Aislinn Jennings

Rohit Saha

Manu Shankar-Hari

Pneumococcal VACcination to accelerate Immune Recovery in Sepsis Survivors: randomized placebo-controlled trial: VACIRISS trial

Cellular and molecular mechanisms of IMMunE dysfunction and Recovery from SEpsis related critical illness: an observational cohort study (IMMERSE)

Defining ARDS and sepsis sub-phenotypes: a re-analysis of two trials to inform stratified medicine approach with future trials

Relationship between eligibility criteria in randomised controlled trials and ARDS clinical criteria on outcomes

Demographic Shifts, Case Mix, Activity, and Outcome for Elderly Patients Admitted to Adult General ICUs in England, Wales, and Northern Ireland

Rate and risk factors for rehospitalisation in sepsis survivors: systematic review and meta-analysis

Lack of Clinical Benefit of Interferon Î²-1a Among Patients With Severe Acute Respiratory Distress Syndrome: Time to Overhaul Drug Trials in ARDS?

Could stress ulcer prophylaxis increase mortality in high-acuity patients?

Is T Cell Exhaustion a Treatable Trait in Sepsis?

Maternal Risk Modeling in Critical Care-Development of a Multivariable Risk Prediction Model for Death and Prolonged Intensive Care

Should we consider blocking the inhibitory immune checkpoint molecules for treating T cell exhaustion in sepsis?

Trials on oxygen supplementation in sepsis: better late than never

Current gaps in sepsis immunology: new opportunities for translational research

Sepsis hysteria: excess hype and unrealistic expectations

European Society of Intensive Care Medicine

UK Intensive Care Society

News coverage of research

JAMA Sepsis Webpage highlighting 2016 definitions

Our partners

Contact us

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Shankar-Hari Group

Members

Pneumococcal VACcination to accelerate Immune Recovery in Sepsis Survivors: randomized placebo-controlled trial: VACIRISS trial

Cellular and molecular mechanisms of IMMunE dysfunction and Recovery from SEpsis related critical illness: an observational cohort study (IMMERSE)

Defining ARDS and sepsis sub-phenotypes: a re-analysis of two trials to inform stratified medicine approach with future trials

Relationship between eligibility criteria in randomised controlled trials and ARDS clinical criteria on outcomes

European Society of Intensive Care Medicine

UK Intensive Care Society

News coverage of research

JAMA Sepsis Webpage highlighting 2016 definitions

Our partners

Contact us

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