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Draft:Andrew Conway Morris

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Dr
Andrew Conway Morris
MRCP, FRCA, FFICM
Born1978
Cambridge
EducationHills Road VIth Form College
Alma materUniversity of Glasgow, University of Edinburgh
Parents
  • Simon Conway Morris (father)
  • Zoe Conway Morris (mother)
RelativesRoderick Conway Morris (Uncle)
Scientific career
InstitutionsUniversity of Cambridge, Addenbrooke's Hospital
Thesis Complement mediated neutrophil dysfunction in critical illness
Doctoral advisorA John Simpson

Andrew Conway Morris is Associate Professor in Anaesthesia at University of Cambridge and a medical scientist working on the immunology of critical illness, host-pathogen interactions and pneumonia.

Research

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Neutrophil biology

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Andrew studies the role and consequences of immune function and dysfunction in critical illness, illnesses severe enough to require exogenous organ support in intensive care. During his doctoral thesis.[1] he identified a defect in neutrophil phagocytosis in patients with the severe infection, ventilator-associated pneumonia. This defect was driven by the pro-inflammatory complement component C5a[2]. He went on to identify the mechanisms underpinning this C5a-mediated dysfunction, which involved PI3Kdelta, RhoA inhibition and failure of actin polymerisation[3] and identified further defects in phagosomal maturation and bacterial killing[4]. The defects in neutrophil function could be reversed with the growth factor GM-CSF[3], with a similar effect being demonstrated in a subsequent clinical trial[5]. Andrew also found that C5a-mediated neutrophil dysfunction preceeded and predicted subsequent nosocomial infection, in interaction with impairmed monocyte and T-cell function[6][7]. This work is being used to help guide trials of immunomodulatory therapies with the aim of preventing nosocomial infection.

Pneumonia

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Andrew's other major focus is on pneumonia, where his research focuses on the diagnosis and management of this condition. Whilst working on ventilator-associated pneumonia he identified highly elevated levels of the cytokines IL-1β and CXCL8 in the alveolar space of patients with positive bronchoalveolar lavage cultures[8][9], developing a diagnostic test that was then deployed in a randomised trial seeking to reduce use of antimicrobials[10]. Although the test worked it failed to alter clinician prescribing behaviour.

He has also worked on a number of pathogen-focussed molecular diagnostics, using PCR to detect a range of respiratory pathogens in respiratory samples from patients with pneumonia[11] [12] [13]. The most recent iteration of these devices[13] did demonstrate an impact on antimicrobial prescribing with improvement in antimicrobial stewardship. Using the TaqMan array cardduring the COVID-19 pandemic he was one of the first to confirm the high rates of nosocomial pneumonia amongst patients with COVID-19[14], a finding that was only partially related to the use of glucocorticoids to improve SARS-CoV-2 pneumonitis[15]

In investigating compartmentalised inflammation in the lungs of patients with pneumonia, Andrew worked with colleagues to identify an effect of obesity on pulmonary immune cell function in patients with COVID-19[16]. These patients were found to have reduced interferon production, which likely explains the impaired viral clearance and highetend lung damage seen in obese patients with COVID-19. He has recently characterised and validated three distinct pulmonary endotypes, termed 'pneumotypes', in patients with pneumonia and lung injury[17], with distinct mechanistic underpinnings that point to the potential to respond differentially to immunomodulatory therapies.

Other work

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Beyond the work on pneumonia and critical illness immunology, Andrew was part of the team that demonstrated the ability of portable HEPA filters to remove SARS-CoV-2 from the air of hospital wards[18]. This has subsequently been tested in the quasi-experimental Addenbrookes Air Disinfection Study (AAirDS), which found a modest effect on SARS-CoV-2 transmission in hospital[19], likely due to imperfect longer-term adherence with the HEPA filter intervention.[20]

Wider academic and clinical leadership work

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Andrew is one of the editors of the Oxford Textbook of Respiratory Critical Care, was chair of the European Society of Intensive Care Medicine Infection section from 2021-2023 having been deputy chair from 2018-2021. He is the pathway director for the ESCIM antimicrobial stewardship learning pathway

In 2024 Andrew was appointed as the Charity Medical Director for Sepsis Research FEATthe UK's only dedicated sepsis research charity.

In 2017 he was appointed Consultant in Intensive Care Medicine in the John V Farman Intensive Care Unit at Addenbrooke's Hospital

Awards and accolades

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Royal College of Anaesthetists Macintosh Professor 2023

Australia and New Zealand Intensive Care Society Global Rising Star Fellow 2018

Intensive Care Society Research Gold Medalist 2010

Early career and training

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Son of Simon Conway Morris and Zoe Conway Morris, Andrew was born in Cambridge Maternity Hospital, the site of the former Cambridge Union workhouse

Andrew was a secondary school pupil at Chesterton Community College and sixth form student at Hills Road Sixth Form College

He studied Medicine at the University of Glasgow before undertaking training in Anaesthesia and Intensive Care Medicine in South East Scotland NHS Deanery

during which time he undertook his PhD under the supervision of Professor A John Simpson. He subsequently moved back to Cambridge to complete his Anaesthesia and Intensive Care training before taking up fellowships from the Wellcome Trust and Medical Research Council.

References

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  1. ^ Conway Morris, Andrew (2011). "Complement-mediated neutrophil dysfunction in critical illness". PhD Thesis.
  2. ^ Conway Morris, Andrew; Kefala, Kallirroi; Wilkinson, Thomas S.; Dhaliwal, Kevin; Farrell, Lesley; Walsh, Tim; Mackenzie, Simon J.; Reid, Hamish; Davidson, Donald J.; Haslett, Chris; Rossi, Adriano G.; Sallenave, Jean-Michel; Simpson, A. John (2009-07-01). "C5a Mediates Peripheral Blood Neutrophil Dysfunction in Critically Ill Patients". American Journal of Respiratory and Critical Care Medicine. 180 (1): 19–28. doi:10.1164/rccm.200812-1928OC. ISSN 1073-449X. PMC 2948533. PMID 19324972.
  3. ^ a b Morris, Andrew Conway; Brittan, Mairi; Wilkinson, Thomas S.; McAuley, Danny F.; Antonelli, Jean; McCulloch, Corrienne; Barr, Laura C.; McDonald, Neil A.; Dhaliwal, Kev; Jones, Richard O.; Mackellar, Annie; Haslett, Christopher; Hay, Alasdair W.; Swann, David G.; Anderson, Niall (2011-05-12). "C5a-mediated neutrophil dysfunction is RhoA-dependent and predicts infection in critically ill patients". Blood. 117 (19): 5178–5188. doi:10.1182/blood-2010-08-304667. ISSN 0006-4971. PMID 21292772.
  4. ^ Wood, Alexander J.T.; Vassallo, Arlette M.; Ruchaud-Sparagano, Marie-Hélène; Scott, Jonathan; Zinnato, Carmelo; Gonzalez-Tejedo, Carmen; Kishore, Kamal; D’Santos, Clive S.; Simpson, A. John; Menon, David K.; Summers, Charlotte; Chilvers, Edwin R.; Okkenhaug, Klaus; Morris, Andrew Conway (2020-08-06). "C5a impairs phagosomal maturation in the neutrophil through phosphoproteomic remodeling". JCI Insight. 5 (15). doi:10.1172/jci.insight.137029. ISSN 2379-3708. PMC 7455072. PMID 32634128.
  5. ^ Pinder, Emma M; Rostron, Anthony J; Hellyer, Thomas P; Ruchaud-Sparagano, Marie-Helene; Scott, Jonathan; Macfarlane, James G; Wiscombe, Sarah; Widdrington, John D; Roy, Alistair I; Linnett, Vanessa C; Baudouin, Simon V; Wright, Stephen E; Chadwick, Thomas; Fouweather, Tony; Juss, Jatinder K (October 2018). "Randomised controlled trial of GM-CSF in critically ill patients with impaired neutrophil phagocytosis". Thorax. 73 (10): 918–925. doi:10.1136/thoraxjnl-2017-211323. ISSN 0040-6376. PMC 6166597. PMID 30064991.
  6. ^ Conway Morris, A.; Anderson, N.; Brittan, M.; Wilkinson, T.S.; McAuley, D.F.; Antonelli, J.; McCulloch, C.; Barr, L.C.; Dhaliwal, K.; Jones, R.O.; Haslett, C.; Hay, A.W.; Swann, D.G.; Laurenson, I.F.; Davidson, D.J. (November 2013). "Combined dysfunctions of immune cells predict nosocomial infection in critically ill patients". British Journal of Anaesthesia. 111 (5): 778–787. doi:10.1093/bja/aet205. PMID 23756248.
  7. ^ Conway Morris, Andrew; Datta, Deepankar; Shankar-Hari, Manu; Stephen, Jacqueline; Weir, Christopher J.; Rennie, Jillian; Antonelli, Jean; Bateman, Anthony; Warner, Noel; Judge, Kevin; Keenan, Jim; Wang, Alice; Burpee, Tony; Brown, K. Alun; Lewis, Sion M. (May 2018). "Cell-surface signatures of immune dysfunction risk-stratify critically ill patients: INFECT study". Intensive Care Medicine. 44 (5): 627–635. doi:10.1007/s00134-018-5247-0. ISSN 0342-4642. PMC 6006236. PMID 29915941.
  8. ^ Conway Morris, A.; Kefala, K.; Wilkinson, T. S; Moncayo-Nieto, O. L.; Dhaliwal, K.; Farrell, L.; Walsh, T. S; Mackenzie, S. J; Swann, D. G; Andrews, P. J.; Anderson, N.; Govan, J. R.; Laurenson, I. F; Reid, H.; Davidson, D. J (2010-03-01). "Diagnostic importance of pulmonary interleukin-1 and interleukin-8 in ventilator-associated pneumonia". Thorax. 65 (3): 201–207. doi:10.1136/thx.2009.122291. ISSN 0040-6376. PMC 2866736. PMID 19825784.
  9. ^ Hellyer, Thomas P; Conway Morris, Andrew; McAuley, Daniel F; Walsh, Timothy S; Anderson, Niall H; Singh, Suveer; Dark, Paul; Roy, Alistair I; Baudouin, Simon V; Wright, Stephen E; Perkins, Gavin D; Kefala, Kallirroi; Jeffels, Melinda; McMullan, Ronan; O'Kane, Cecilia M (January 2015). "Diagnostic accuracy of pulmonary host inflammatory mediators in the exclusion of ventilator-acquired pneumonia". Thorax. 70 (1): 41–47. doi:10.1136/thoraxjnl-2014-205766. ISSN 0040-6376. PMC 4992819. PMID 25298325.
  10. ^ Hellyer, Thomas P; McAuley, Daniel F; Walsh, Timothy S; Anderson, Niall; Conway Morris, Andrew; Singh, Suveer; Dark, Paul; Roy, Alistair I; Perkins, Gavin D; McMullan, Ronan; Emerson, Lydia M; Blackwood, Bronagh; Wright, Stephen E; Kefala, Kallirroi; O'Kane, Cecilia M (February 2020). "Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation". The Lancet Respiratory Medicine. 8 (2): 182–191. doi:10.1016/S2213-2600(19)30367-4. PMC 7599318. PMID 31810865.
  11. ^ Gadsby, Naomi J.; Russell, Clark D.; McHugh, Martin P.; Mark, Harriet; Conway Morris, Andrew; Laurenson, Ian F.; Hill, Adam T.; Templeton, Kate E. (2016-01-07). "Comprehensive Molecular Testing for Respiratory Pathogens in Community-Acquired Pneumonia". Clinical Infectious Diseases. 62 (7): 817–823. doi:10.1093/cid/civ1214. ISSN 1058-4838. PMC 4787606. PMID 26747825.
  12. ^ Jones, Nick K.; Conway Morris, Andrew; Curran, Martin D.; Parmar, Surendra; Sule, Olajumoke; Enoch, David A.; Aliyu, Sani H.; Zhang, Hongyi; Jalal, Hamid; Navapurkar, Vilas; Murphy, Michael E. (2020). "Evaluating the use of a 22-pathogen TaqMan array card for rapid diagnosis of respiratory pathogens in intensive care". Journal of Medical Microbiology. 69 (7): 971–978. doi:10.1099/jmm.0.001218. ISSN 1473-5644. PMID 32552987.
  13. ^ a b Navapurkar, Vilas; Bartholdson Scott, Josefin; Maes, Mailis; Hellyer, Thomas P; Higginson, Ellen; Forrest, Sally; Pereira-Dias, Joana; Parmar, Surendra; Heasman-Hunt, Emma; Polgarova, Petra; Brown, Joanne; Titti, Lissamma; Smith, William PW; Scott, Jonathan; Rostron, Anthony (2022-10-12). "Development and implementation of a customised rapid syndromic diagnostic test for severe pneumonia". Wellcome Open Research. 6: 256. doi:10.12688/wellcomeopenres.17099.3. ISSN 2398-502X. PMC 9617073. PMID 36337362.
  14. ^ Maes, Mailis; Higginson, Ellen; Pereira-Dias, Joana; Curran, Martin D.; Parmar, Surendra; Khokhar, Fahad; Cuchet-Lourenço, Delphine; Lux, Janine; Sharma-Hajela, Sapna; Ravenhill, Benjamin; Hamed, Islam; Heales, Laura; Mahroof, Razeen; Soderholm, Amelia; Forrest, Sally (December 2021). "Ventilator-associated pneumonia in critically ill patients with COVID-19". Critical Care. 25 (1): 25. doi:10.1186/s13054-021-03460-5. ISSN 1364-8535. PMC 7797892. PMID 33430915.
  15. ^ Conway Morris, Andrew; Kohler, Katharina; De Corte, Thomas; Ercole, Ari; De Grooth, Harm-Jan; Elbers, Paul W. G.; Povoa, Pedro; Morais, Rui; Koulenti, Despoina; Jog, Sameer; Nielsen, Nathan; Jubb, Alasdair; Cecconi, Maurizio; De Waele, Jan; for the ESICM UNITE COVID investigators (2022-08-03). "Co-infection and ICU-acquired infection in COVID-19 ICU patients: a secondary analysis of the UNITE-COVID data set". Critical Care. 26 (1): 236. doi:10.1186/s13054-022-04108-8. ISSN 1364-8535. PMC 9347163. PMID 35922860.
  16. ^ Guo, Shuang A.; Bowyer, Georgina S.; Ferdinand, John R.; Maes, Mailis; Tuong, Zewen K.; Gillman, Eleanor; Liao, Mingfeng; Lindeboom, Rik G. H.; Yoshida, Masahiro; Worlock, Kaylee; Gopee, Hudaa; Stephenson, Emily; Gao, Catherine A.; Lyons, Paul A.; Smith, Kenneth G. C. (2023-03-01). "Obesity Is Associated with Attenuated Tissue Immunity in COVID-19". American Journal of Respiratory and Critical Care Medicine. 207 (5): 566–576. doi:10.1164/rccm.202204-0751OC. ISSN 1073-449X. PMC 10870921. PMID 36095143.
  17. ^ Jeffrey, M; Bartholdson Scott, J; White, Rj; Higginson, E; Maes, M; Forrest, S; Pereira-Dias, J; Parmar, S; Heasman-Hunt, E (2024-09-03), Pulmonary inflammation in severe pneumonia is characterised by compartmentalised and mechanistically distinct sub-phenotypes, doi:10.1101/2024.09.02.24312971, retrieved 2024-10-17
  18. ^ Conway Morris, Andrew; Sharrocks, Katherine; Bousfield, Rachel; Kermack, Leanne; Maes, Mailis; Higginson, Ellen; Forrest, Sally; Pereira-Dias, Joana; Cormie, Claire; Old, Tim; Brooks, Sophie; Hamed, Islam; Koenig, Alicia; Turner, Andrew; White, Paul (2022-08-24). "The Removal of Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Microbial Bioaerosols by Air Filtration on Coronavirus Disease 2019 (COVID-19) Surge Units". Clinical Infectious Diseases. 75 (1): e97–e101. doi:10.1093/cid/ciab933. ISSN 1058-4838. PMC 8689842. PMID 34718446.
  19. ^ Brock, Rebecca C.; Goudie, Robert J.B.; Peters, Christine; Thaxter, Rachel; Gouliouris, Theodore; Illingworth, Christopher J.R.; Morris, Andrew Conway; Beggs, Clive B.; Butler, Matthew; Keevil, Victoria L. (October 2024). "Efficacy of Air Cleaning Units for preventing SARS-CoV-2 and other hospital-acquired infections on medicine for older people wards: A quasi-experimental controlled before-and- after study". Journal of Hospital Infection. doi:10.1016/j.jhin.2024.09.017. PMID 39374708.
  20. ^ Love, Catriona; Street, Anna; Riddell, Edward; Goudie, Robert J.B.; Brock, Rebecca C.; Thaxter, Rachel; Gouliouris, Theodore; Conway Morris, Andrew; Beggs, Clive B.; Peters, Christine; Butler, Matthew J.; Gould, Dinah J.; Keevil, Victoria L. (September 2024). "Acceptability of Air Cleaning Units on Inpatient Wards: help for infection control or hindrance for ward occupants?". Journal of Hospital Infection. doi:10.1016/j.jhin.2024.09.010. PMID 39341284.
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