After medical school in Nottingham, Jamie Rylance completed junior posts in General Internal Medicine, Emergency Medicine and Respiratory Medicine.
For two years he has worked in Songea Regional Hospital, Tanzania as a Medical Officer with VSO. This work focussed on health service development, particularly on the quality of medical care given to critically unwell patients.
His further specialty training in General Internal Medicine and Respiratory Medicine incorporated a Wellcome Trust Clinical PhD. This examined Household Air Pollution (HAP) in Malawi as it affects innate immunity and redox balance in the lung, and sought mechanistic explanations for HAP related respiratory infection.
Mucosal immunity in the respiratory tract
PhD findings: HAP exposure, even in asymptomatic and healthy adults is associated with reduced antibacterial capacity of the alveolar macrophage, and increased buffering against oxidative stress in the lung epithelial lining fluid. Extending this work, Jamie is investigating the interaction of tuberculosis with HAP particulate exposed alveolar macrophages.
As part of the LSTM Experimental Human Pneumococcal Carriage collaboration, we are using human models of pathogen carriage to understand the protective effect and risks of disease posed by nasophayngeal carriage of Streptococcus pneumoniae.
Clinical care of acute respiratory disease
Identification of patients at high risk of deterioration is a priority in the UK, and in more resource limited settings. Providing timely and appropriate respiratory support, including oxygen provision, is critical. Jamie Rylance has been examining how well severity scores predict deterioration, and the use of new modes of oxygen delivery. This includes humidified oxygen in acute asthma [UK] and the appropriate technology in resource limited settings (for example high flow oxygen concentrators).
In patients with respiratory infections complicated by sepsis, there is a high mortality in all settings. We are investigating additional (adjunct) treatments which might be used to improve patients’ immunity to infection. To support this work, we are developing near-patient tests to identify which patients might benefit from a “boost” to their immunity.
Collaboration in respiratory research in resource limited settings
Jamie Rylance collaborates with the ZENITH study in Zimbabwe which examines the respiratory effects of vertically acquired HIV infection. In particular, this aims to understand how clinical patterns of disease correlate with abnormalities of lung function and chest radiography.
- LSTM: Diploma in Tropical Medicine & Hygiene (DTM&H)
- LSTM: Medical Bacteriology
- LSTM: HIV in Resource Limited Settings
- Resuscitation Council (UK): Advanced Life Support Course (ALS)
- University of Liverpool: Undergradute teaching (MBChB) in Respiratory Medicine
- Aintree University Hospital: Clinical MRCP preparation
- University of Birmingham: BMedSci International Health projects
- LSTM: MSc projects
- Wellcome Trust Liverpool Glasgow Centre for Global Health Research: MRes / Clinical PhD projects
- Contribution to expert to the most recent WHO “Integrated Management of Adolescent and Adult Illness (IMAI) District Clinician Manual”, and the guidelines on WHO “Management of the Patient in Severe Respiratory Distress”.
- 2008- 2012: Wellcome Trust Clinical PhD for “Research priorities in the developing world” (£320,000)
- 2015 - : Confident in Concept award for whole blood phagocytic assay as a biomarker of sepsis (£50,000)