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Professor Aubrey Cunnington's Inaugural Lecture: An Extraordinary Journey into Malaria Research


THE RECORDING OF THE EVENT IS AVAILABLE ON YOUTUBE



Professor Aubrey Cunnington delivered his Inaugural Lecture on Wednesday 29th November 2023 at the Imperial College South Kensington Campus, in a Lecture Theatre brimming with colleagues and collaborators from Imperial College and other Institutions and organizations, as well as friends and family.

 

Introductions were made by Professor Wendy Barclay, Head of the Department of Infectious Disease at Imperial College London, thrilled and honoured to preside over Professor Cunnington’s Inaugural Lecture.


BIOGRAPHY

Professor Aubrey Cunnington graduated from the University of Oxford in Medicine in 2000. He pursued a Diploma in Tropical Medicine and Health in 2005 and was awarded a PhD 2012 from the the London School of Hygiene and Tropical Medicine. For his PhD, he was bestowed with the prestigious Garnham Prize for the Best Doctoral Thesis, a recognition that “does not surprise any of us” Professor Barclay remarked, eliciting a spread assent from the audience. The subject of the PhD thesis was the “Malaria and Susceptibility to Other Infections". In the same year (2012) he completed his Certificate of Completion of Specialist Training.

 

Following these accomplishments and a short period at the Great Ormond Street Hospital, "we were lucky enough to recruit Aubrey to Imperial College in 2013, from where he has risen through the ranks from a Clinical Research Fellow to Senior Lecturer, then Reader, and now Professor in Paediatric Infectious Diseases", remarked Prof Barclay. Professor Aubrey Cunnington also assumes the role of Head of Section of Paediatric Infectious Disease in the Department of Infectious Disease at Imperial College. He is a Fellow of the Royal College of Paediatrics and Child Health and serves as the Chair of the Committee for Scientific Affairs and Awards for the European Society for Paediatric Infectious Disease, contributing significantly to the community in various capacities.

 

Professor Cunnington not only leads and conducts excellent and innovative science but also mentors and guides young investigators, strongly exemplifying Imperial College values; "Aubrey, we are so proud of you for reaching the giddy heights of being a Professor here," expressed Professor Wendy Barclay before handing the stage to Professor Cunnington for his talk entitled Malaria: from toxic gas to “bad air”.

 

EARLY CAREER AND RESEARCH

After warmly expressing gratitude to the numerous colleagues, friends, and family present at the event, Professor Cunnington guided the audience through his research journey, commenced with his life experiences, highlighting a garden accident that resulted in sepsis, a pivotal moment that directed him towards the path of medicine. During his hospitalization, he found himself captivated by the clinical team and each member seamlessly playing their roles, an experience that sparked his aspiration to become a doctor. This incident also ignited his interest in infectious diseases, as he grappled with the perplexity of how an infection in the foot could have such a strong and severe impact throughout the rest of the body. This curiosity deepened over time and became a focal point in the subsequent research endeavors he pursued.

 

From his formative years, Professor Cunnington held a steadfast belief that his aspiration was "to have a positive impact on people's lives, engage in work that interested and excited me, and collaborate with people whom I liked and who inspired me." These ambitions found fruition through his multifaceted roles as a Doctor, Scientist, Leader, Educator, and Manager, for which he expressed profound gratitude to Imperial College London, feeling honoured and privileged to work with so many brilliants and amazing colleagues, teams, and students, and to do what he considers "one of the best job in the world" (Fig. 1-3).

Fig. 1

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 Fig. 3


Professor Cunnington took the audience on a journey through his research, commencing with a question inspired by a clinical case occurred while he was teaching at John Radcliffe Hospital – could the diagnosis of malaria be made through the measurement of exhaled carbon monoxide? To respond to this question, he secured funding through a small grant and obtained breath analyzers from a manufacturing company, which then transported to Kenya for conducting research in the field. However, the research faced setbacks due to challenging environmental conditions characterized by high humidity and temperature in the field, leading to persistent malfunctions in the devices. But "That's science, right?", he remarked with his special and highly appreciated positive attitude. As the use of breath analyzers didn't unfold as expected, he resourcefully turned to a blood gas analyzer available at the local facilities to measure carbon monoxide in blood. Gathering the data offered an alternative approach to addressing the same research question. The unexpected findings (Fig. 4), in line with Isaac Asimov's notion that "the most exciting phrase to hear in science is not 'Eureka!' but 'That's funny..." added a layer of curiosity and potential for new discoveries to the project.

Fig. 4


This research held significant importance as it laid the foundation for subsequent investigations into heme oxygenase during his Ph.D. studies at the London School of Hygiene. His outstanding work was awarded with the prestigious award for Best Doctoral Thesis. The research revealed a pivotal mechanism of malaria, but not amenable to be an easy target for clinical treatment. During this period, he conducted research and worked clinically at MRC Unit the Gambia, collaborating with brilliant and reserchers and dedicated clinicians who also had a major impact in the research ahead (Fig 5).

Fig. 5


IMPERIAL COLLEGE LONDON

Soon realizing that heme oxygenase presented challenges as a viable treatment target, but driven by a strong commitment to advancing malaria research, in 2013 Professor Cunnington joined Imperial College, becoming part of Professor Michael Levin's team, that was pioneering many methods to test various hypothesis at once through gene expression (Fig. 6). The idea was to use these methods to treat severe malaria, which subsequently led Professor Cunnington to use what was at the time a novel technique (the RNA sequencing), persuaded by his colleague Dr Dave Conway (Fig. 5) and with the collaboration of a PhD student and other colleagues (Fig.7).

Fig. 6

Fig.7


The results obtained (Fig. 7) opened the way to an extended programme of research, focused on the signatures and mechanism of neuthrophils in malaria, led by Dr Athina Georgiadou (Fig. 8).

Fig. 8


But once again neutrophils resulted not suitable as target for treatment, leading Professor Cunnington to turn his research to diagnostics and the huge gap in access to diagnostics technolgies for nearly half of the global population (Fig. 9).

Fig. 9


One of the amazing thing about working at Imperial is being able to make connections with people looking in different disciplines. Jake Baum and I through setting up the malaria network we made connections with an engineering group team led by professor Georgiou, who had produced a machine that could be held in the palm of your hand, and carry out a PCR-like reaction, so it can detect very sensitively, it can detect mutations that are associated with resistance to antimalaria drugs, and thought this could be used for malaria (Fig. 10).

Fig. 10


Fig. 11


This embarked Prof Cunnington on a series of work focused on diagnostics, starting with the Digital Diagnostics for Africa Network (Fig. 11), funded in 2020 in the middle of the pandemic by an UKRI Global Challenge Fund scheme. Built around the innovative digital molecular diagnostics device developed by Professor Pantelis Georgiou and Professor Jesus Rodriguez Manzano teams at Imperial College, the Network brings together a large group of experts from Africa and other countries to develop a strategy for this innovative digital diagnostics technology to address health needs specific to the different regions of the African continent.


Another important project Professor Cunnington has joined in his career is DIAMONDS, a huge consortium of 29 institutions around the globe aimed at developing a molecular test for the rapid diagnosis of serious infectious and inflammatory diseases using personalised gene signatures (Fig. 12), which was also applied to malaria (Fig. 13).


Fig. 12

Fig. 13

This research on gene expression for malaria, and other research workstream targeting different malaria species using the digital diagnostics device developed at Imperial College has led to the foundation in August 2022 of the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems, a huge consortium led by Professor Cunnington and Professor Halidou Tinto, Director of the Research Unit of Nanoro at the Institut de la Recherche en Sciences de la Santé in Burkian Faso, and one of the leader of the R21 Malaria Vaccine developed at University of Oxford.

Fig. 14


Prof Cunnington's Inaugural ends with the research liying ahead and and an enthusiastic smile (Fig. 15), a widely recognized signature of an extraordinary leader and research journey.


Fig. 15



After a brief session of Q&A, vote of thanks were given by Professor Michael Levin (Imperial College London), highlighting Prof Cunnington's meticolus attention to details, dedication to duties and a contagious enthusiastic smile that brings together and inspire colleagues and students everyday.


On behalf the the NIHR Global Health Research Group on Digital Diagnostics for African Health Systems and the Digital Diagnostics for Africa Network, warmest congratulate to Professor Cunnington on these great achievements and Inagural Lecture.













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