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Abstract
The input of pathologists is essential for the conduct of many forms of research, including clinical trials. As the custodians of patient samples, pathology departments have a duty to ensure compliance with the relevant regulations, standards and guidelines to ensure the ethical and effective use for their intended investigational analysis. This includes where patients are participating in a research study. The results of research studies have impacts beyond the research study itself as they may inform changes in policy and practice or support the licensing of medicines and devices. Compliance with regulations and standards provides public assurance that the rights, safety and wellbeing of research participants are protected, that the data have been collected and processed to ensure their integrity and that the research will achieve its purpose. The requirements of the regulatory environment should not be seen as a barrier to research and should not significantly impact on the work of the laboratory once established and integrated into practice. This paper highlights important regulations, policy, standards and available guidance documents that apply to research involving NHS pathology departments and academic laboratories that are contributing to research involving human subjects.
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Affiliation(s)
- Owen John Driskell
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent,, Staffordshire, UK
- Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK
- National Institute for Health Research Clinical Research Network West Midlands, NIHR CRN, Albrighton, Shropshire, UK
| | - Jessica L. Lee
- Strategy and Initiatives, National Cancer Research Institute, London, UK
| | - Karin A. Oien
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Clare Verrill
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - CM-Path QA Panel
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent,, Staffordshire, UK
- Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK
- National Institute for Health Research Clinical Research Network West Midlands, NIHR CRN, Albrighton, Shropshire, UK
- Strategy and Initiatives, National Cancer Research Institute, London, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Newcastle University, Newcastle, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Abstract
The input of pathologists is essential for the conduct of many forms of research, including clinical trials. As the custodians of patient samples, pathology departments have a duty to ensure compliance with the relevant regulations, standards and guidelines to ensure the ethical and effective use for their intended investigational analysis, including when patients are participating in a research study. The results of research studies have impacts beyond the research study itself as they may inform changes in policy and practice or support the licensing of medicines and devices. Compliance with regulations and standards provides public assurance that the rights, safety and wellbeing of research participants are protected, that the data have been collected and processed to ensure their integrity and that the research will achieve its purpose. The requirements of the regulatory environment should not be seen as a barrier to research and should not significantly impact on the work of the laboratory once established and integrated into practice. This paper highlights important regulations, policy, standards and available guidance documents that apply to research involving NHS pathology departments and academic laboratories that are contributing to research involving human subjects.
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Affiliation(s)
- Owen John Driskell
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent,, Staffordshire, UK
- Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK
- National Institute for Health Research Clinical Research Network West Midlands, NIHR CRN, Albrighton, Shropshire, UK
| | - Jessica L. Lee
- Strategy and Initiatives, National Cancer Research Institute, London, UK
| | - Karin A. Oien
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Clare Verrill
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - CM-Path QA Panel
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent,, Staffordshire, UK
- Institute for Applied Clinical Sciences, University of Keele, Stoke-on-Trent, Staffordshire, UK
- National Institute for Health Research Clinical Research Network West Midlands, NIHR CRN, Albrighton, Shropshire, UK
- Strategy and Initiatives, National Cancer Research Institute, London, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Newcastle University, Newcastle, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Steveling EH, Lao-Araya M, Koulias C, Scadding G, Eifan A, James LK, Dumitru A, Penagos M, Calderón M, Andersen PS, Shamji M, Durham SR. Protocol for a randomised, double-blind, placebo-controlled study of grass allergen immunotherapy tablet for seasonal allergic rhinitis: time course of nasal, cutaneous and immunological outcomes. Clin Transl Allergy 2015; 5:43. [PMID: 26682038 PMCID: PMC4682243 DOI: 10.1186/s13601-015-0087-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/29/2015] [Indexed: 12/21/2022] Open
Abstract
Background Seasonal Allergic Rhinitis is characterised by inflammation of the nasal mucosa upon exposure to common aeroallergens, affecting up to 20–25 % of the population. For those patients whose symptoms are not controlled by standard medical treatment, allergen specific immunotherapy is a therapeutic alternative. Although several studies have shown changes in immunologic responses as well as long term tolerance following treatment with a sublingual allergy immunotherapy tablet, a detailed time course of the early mechanistic changes of local and systemic T and B cell responses and the effects on B cell repertoire in the nasal mucosa have not been fully examined. Methods/design This is a randomized, double-blind, single-centre, placebo controlled, two arm time course study based in the United Kingdom comparing sublingual allergy immunotherapy tablet (GRAZAX®, ALK-Abello Horsholm, Denmark) plus standard treatment with placebo plus standard treatment. Up to 50 moderate to severe grass pollen allergic participants will be enrolled to ensure randomisation of at least 44. Further, we shall enrol 20 non-atopic volunteers. Screening will be completed before eligible atopic participants are randomised to one of the two treatment arms in a 1 to 1 ratio. The primary endpoint will be the total nasal symptom score assessed over 60 min following grass pollen nasal allergen challenge after 12 months of treatment. Clinical assessments and/or mechanistic analyses on blood, nasal fluid, brushing and biopsies will be performed at baseline at 1, 2, 3, 4 (coinciding with the peak pollen season), 6 and 12 months of treatment. After 12 months of treatment, unblinding will take place. Those atopic participants receiving active treatment will continue therapy for another 12 months followed by a post treatment phase of 12 months. Assessments and collection of biologic samples from these participants will take place again at 24 and at 36 months from the start of treatment. The 20 healthy, non-atopic controls will undergo screening and one visit only coinciding with the 12 month visit for the atopic participants. Discussion The trial will end in April 2017. The trial is registered with ClinicalTrials.gov and the trial identifying number is NCT02005627. Trial registration: Primary Registry: ClinicalTrials.gov, Trial Identifying number: NCT02005627, Secondary identifying numbers: EudraCT number: 2013-003732-72 REC: 13/EM/0351, Imperial College London (Sponsor): 13IC0847, Protocol Version 6.0, Date: 16.05.2014 Electronic supplementary material The online version of this article (doi:10.1186/s13601-015-0087-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Esther Helen Steveling
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Mongkol Lao-Araya
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Christopher Koulias
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Guy Scadding
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Aarif Eifan
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Louisa K James
- Allergy and Clinical Immunology, Randall Division of Cell and Molecular Biophysics, King's College London, New Hunt's House, Guy's Campus, London, SE1 1UL UK
| | - Alina Dumitru
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Martin Penagos
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Moisés Calderón
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | | | - Mohamed Shamji
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
| | - Stephen R Durham
- Allergy and Clinical Immunology, Section Inflammation, Repair and Development, National Heart and Lung Institute (NHLI), Imperial College London, Dovehouse Street, London, SW3 6LY UK
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