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About us

 

Our mission is to deliver world-class research and education focusing on the immune system and how it functions during health and disease.  

Our multidisciplinary research has applications in many areas of medicine, particularly in the fields of organ transplantation, oncology, diabetes, rheumatology, virology, immunology, hepatology, vaccines and many more.  

From leading large European consortiums into the effect of the microbiome on chronic liver disease to facilitating local Public, Patient Involvement groups and conducting a national survey on the state of rheumatoid arthritis care, we work across disciplines and have many partners in the United Kingdom and globally.  

We educate the next generation of scientists, researchers and clinicians. Our academic programmes of research-inspired teaching and clinical practice are embedded across our three departments.

Our Community

As a student and member of our School, you’ll develop lifelong networks and friendships. Whether it’s a being part of our postdoctoral researcher's network, chairing our regular weekly presentations or networking with invited world-class speakers you will make connections that will assist your future.

Our School Postdoc Network aims to create a community within which postdocs can access and share information concerning all aspects of postdoc life.

We are linked to the MRC Doctoral training programme and contribute to their integrated and multi-disciplinary approach to medical research.

Our history

Dr Peter Gorer's (1907-1961) work transformed immunology. Gorer identified several determinants of tumour cells to which the immune systems of inoculated mice would react. Because he had the rare foresight to realise the importance of raising and using genetically identical mice for his studies, he deduced that the second determinant, H-2, was not a tumour-specific response, but a response of one strain of mouse to the cells of another.

Gorer had been appointed Reader in Experimental Pathology at Guy’s in 1947. Without teaching responsibility, and hence with almost total freedom to carry out research, Gorer sustained a powerful collaboration he had begun with George Snell at the Jackson Laboratory in Bar Harbor, Maine. Snell had initiated his own studies of the genetics of histo-compatibility, which began to mesh extraordinarily with work on the blood-typing of mice with tumours resistant to the immune response that Gorer undertook during a year’s stay at Bar Harbor.

Together they demonstrated that the histo-compatibility locus responsible for Snell’s observations was one and the same as H-2 described by Gorer a decade earlier. A decade later, and the human equivalent of H-2, known as HLA, was characterised by Dausset, following which it was shown that the natural function of H-2/HLA is to bind to small fragments of microbes and present them for recognition to thymus-derived T-cells that compose the core of the cellular adaptive response.

Peter Gorer’s discovery of murine H-2 lies at the heart of cellular immunology and provides a basis for understanding the immune response to infections, tumours, and transplanted organs, as well as autoimmune disease.

His legacy continues in the School of Immunology & Microbial Sciences which conducts research over a wide range of interests. This research is being translated into understanding and treating many different conditions ranging from Type 1 diabetes, transplantation, rheumatoid arthritis and multiple sclerosis to HIV infection.

A succession of Guy’s physicians made contributions to study of renal diseases, notably Frederic Akbar Mahomed (1849-1884) in disease and hypertension and Sir William Gull (1816-1890) who developed crucial ideas in vascular pathology and hypertension.

At King’s College Hospital, Sir George Johnson (1818-1896) wrote prolifically on renal disease and hypertension, and Sir Nestor Tirard (1853-1928) was one of the earliest experts on renal disease in childhood. In the early years of the twentieth century, Ernest Starling (1866-1927) developed his ideas of capillary filtration and exchange, so important in renal function and oedema formation.

As the techniques of renal biopsy and dialysis developed and the need to treat chronic renal failure became apparent, renal units were formed at Guy’s in the 1960s by Stewart Cameron (b 1934), at King’s College Hospital by Victor Parsons (1929-1995) and at St Thomas’ by Norman Jones (b 1931). A unique opportunity arose at Guy’s as a children’s renal unit had been set up by Richard White (b 1930). This allowed Cameron, and Cyril Chantler (b 1939), White’s successor in 1973, and their colleagues to work at the interface of adult and paediatric nephrology, as well as in their own fields. Cameron’s leadership and scholarship forged a renal unit with an international reputation for linking bedside observations with laboratory work and practice, and for its studies on the immunology, immunopathology and natural history of glomerulonephritis and the development of transplantation. The paediatric renal unit became the largest centre in the UK for children with renal failure and made contributions to preventing growth failure and long-term renal bone disease.

Joseph Lister (1827-1912) developed his practice of antiseptic surgery which changed the outlook for the future of surgery.

In 1853, following medical training at University College London, Lister went to Edinburgh to take up a surgical post at the Royal Infirmary. In 1860 he was appointed Professor of Surgery at Glasgow Infirmary. It was during this time that Lister began to investigate the implications of Pasteur’s germ theory. Convinced that putrefaction was caused by airborne bacteria, he used carbolic acid-soaked bandages on wounds to create a barrier against infection. In 1867 he reported in The Lancet that of 11 cases of compound fracture so treated, nine had recovered – an excellent result for the time.

Lister was appointed Professor of Surgery at King’s College London in 1877 and continued to develop antisepsis at King’s College Hospital. On accepting the professorship he made it a condition that he should bring with him his house surgeon, William Watson Cheyne, a senior assistant, John Stewart, and two dressers, W M Dobie and James Altham, in order that his antiseptic methods could be carried out to his specification. He made surgeons wash their hands and instruments in carbolic acid before and after operations, wear clean gloves, swab incisions with carbolic and introduced carbolic sprays into the operating theatre. There was great resistance to these changes from a profession which had worn blood-soaked frock-coats as a mark of honour, as well as objections to the harsh effects of the carbolic acid which left surgeons with cracked skin.

Cheyne was an active supporter of Lister’s theories and contributed to them being recognised by the profession. In 1882 he wrote Antiseptic Surgery: Its Principles, Practice, History and Results which was described by The Lancet as ‘a starting point for the more general adoption of Mr Lister’s treatment’. Lister’s theory and practices gradually gained support from surgeons and by the mid-1880s there was a rapid increase in the use of his antiseptic techniques. This made possible more advanced lifesaving surgery, including brain and abdominal surgery (Lister was the second man in England to operate on a brain tumour). The technical knowledge already existed but the practice had been defeated up to this point because of post-operative sepsis.

By 1910 postoperative mortality for major operations reduced from 40 per cent to less than three per cent and Lister’s principle – that bacteria must never gain entry to an operation wound – remains a basic principle of surgery to this day. Such was his contribution to the profession that surgery is often described as ‘before Lister and after Lister’.

Frederick Heaf (1894-1973) qualified at St Thomas' and worked at a specialist tuberculosis sanatoria before being appointed as a medical officer in charge of the anti-tuberculosis service for London. While Professor of Tuberculosis at the University of Wales, Heaf devised and validated the standard multiple puncture 'Heaf Test' which gives a quantitative assessment of tuberculin sensitivity from a single skin test. This test was used in the UK until 2005.

The history of liver disease begins at King’s with the work of George Budd (1808-1882). In 1840, Budd was appointed Professor of Medicine at King’s College London and made a special study of liver diseases producing one of the earliest books on the topic. His name is perpetuated in the Budd-Chiari syndrome, a disease of progressive liver failure caused by obstruction to the hepatic vein which he described in 1845.

In 1966, Roger Williams (b 1931) established the Liver Unit at King’s College Hospital and Medical School. Two years later the MRC set up within it a ‘Group for Studies into the Metabolism and Haemodynamics of Liver Disease’ and in the same year, a collaboration began with Professor Sir Roy Calne in Cambridge to perform the first liver transplants in the UK.

In the early 1970s, the first specialist liver intensive care ward for adults in the world was opened at King’s. Over the ensuing twenty-four years and consequent on the strong laboratory base that was set up by Williams (in what became recognised by King’s College London as the Institute of Liver Studies), and with an increasing referral practice, many original contributions were published on the management and outcome of liver failure and liver transplantation as well as on the pathogenesis and treatment of autoimmune liver disease, viral hepatitis and the causes of chronic liver disease.

Today the Instititue of Hepatology includes the adult and paediatric liver services and has the largest liver transplant programme in Europe with 2,500 transplants performed since 1990. Several new surgical techniques have been pioneered, such as reduced liver, split-liver and living-related transplantation which effectively increase the supply of donated organs. As an example, one donor liver can provide three grafts – right lobe for an adult, left lateral segment for a child and the remaining tissue for harvesting cells for transplantation. The last is a different approach to transplantation which is being explored at King’s. Using isolated human liver cells (hepatocytes) has several advantages: it reduces reliance on donor organ availability, it can buy time to allow the damaged organ to recover or until a donor organ is available, and it avoids major surgery.

The first requirements for hepatocyte transplantation are for effective isolation of hepatocytes from a donor or fetal liver and then preservation. Research has resulted in high yields and viability of 90 per cent being achieved. The second requirement is that the hepatocytes, when infused into the liver, should remain and repopulate the liver, ie successful engraftment. Methods being investigated to promote this includes the application of growth factors and ex vivo gene therapy to induce growth factor production in the hepatocytes themselves.

The first successful human liver transplants in the world using cryopreserved hepatocytes have been performed at King’s College Hospital. The patients were children with various metabolic disorders: the bleeding disorder congenital Factor VII deficiency; ornithine transcarbamylase deficiency, diagnosed antenatally, and usually fatal within weeks; progressive familial intrahepatic cholestasis, which causes severe jaundice. These initial results pave the way for an alternative treatment to transplanting part or whole of the liver. If it becomes widely available it will solve two major problems for patients needing an urgent liver transplant, which are the lack of a hepatic equivalent to dialysis in renal failure and the difficulty with donor organ availability.

Hugh De Wardener is described as the single most influential nephrologist in the UK in the second half of the last century, Hugh De Wardener (b 1916) is internationally known for his work on salt and its relation to blood pressure, and natriuretic hormones. He qualified from St Thomas’ in 1939 and, after distinguished service in the Royal Army Medical Corps in World War 2, returned there to a lecturer’s post when his research work on sodium began. It was during this time that he wrote his famous monograph The Kidney which over its several editions influenced many young physicians towards nephrology.

The case of Baby Billy shows how liver cell (hepatocyte) can be life-saving and buy time until a whole-organ transplant can be made. Billy was born with a severe deficiency of the enzyme ornithine transcarbamylase. This is a rare disease in which toxic levels of ammonia accumulate, as protein is not normally metabolized. Death usually occurs in two weeks. During the first two weeks of life, Billy was given a total of 1.8 billion hepatocytes in several infusions via the umbilical vein, the first frozen hepatocyte transplant in the world. A further 200 million cells were infused directly into the liver at five months. He was able to eat a normal protein diet and maintain normal blood ammonia levels. An auxiliary whole organ transplant was performed at seven months and at 18 months (pictured) progress was satisfactory and he continues to be well.

For centuries, diseases with a high mortality such as plague, smallpox, syphilis and tuberculosis were made more terrifying by the mystery of how they were transmitted. The scientific approach adopted by St Thomas’ physician Richard Mead (1673-1754) stands out from a history of quack remedies, astrological theories and charms against infection. His Short Discourse Concerning Pestilential Contagion and Methods to be Used to Prevent it was commissioned by the government in 1720 in response to a further threat of plague. At its peak, the plague in 1665 killed 6,000 people a week.

The statement helped to alleviate general panic and made a number of practical and theoretical innovations, such as the advice to separate the sick from the healthy (rather than quarantining a whole households) and the observation that fabrics could transmit plague (although the role of fleas was not yet known) leading to an early theory of contagion.

Mead turned his attention to smallpox in the following year, when he conducted trials of smallpox inoculations among condemned prisoners at Newgate Prison. His report on these trials (1747) helped to establish the practice of inoculation in England.

In the following century, Samuel Wilks (1824-1911), a physician at Guy’s Hospital, was the first to observe that tertiary syphilis affected not only the internal organs such as liver, stomach and lungs but also the skin.

Our Departments

What's happening in our School

Mark-howard-sims-5-min-with

17 April 2019

5 minutes with Mark Howard

Dr Mark Howard is a research associate in the Peter Gorer Department of Immunobiology and is working…

26 Apr

Iron sulfur meeting

26 April 2019

A meeting to discuss iron-sulfur cluster biogenesis and other related metal mediated pathways.