Professor Emma Baker joined St George's, University of London in 1995 as a Clinical Lecturer, being appointed as Senior Lecturer and Consultant in 2000, Reader in 2004 and as Professor of Clinical Pharmacology in 2010.
Emma graduated in Medicine from the University of Edinburgh in 1988 and worked as a junior doctor in the NHS, before completing her PhD at the University of Manchester entitled 'the molecular biology of the amiloride-sensitive sodium channel (ENaC)' (1996). Her post-doctoral research at St George's investigated the role of ENaC mutations in the development of hypertension in people of African origin, which she did alongside clinical training in clinical pharmacology and therapeutics.
Research: As a Senior Lecturer, her interest in epithelial transport transferred to the airway and she developed a research programme in epithelial transport and respiratory infection, with external funding from the Wellcome Trust and Medical Research Council. She was the Respiratory Specialty Group Lead, for the London South Comprehensive Research Network from 2010-2015.
More recently she has led the clinical pharmacology team at St George's in developing a research portfolio focussed on 'making sure that patients get the best medicines'. The team portfolio includes research into disease mechanisms, pharmacokinetics, clinical trials, polypharmacy, pharmacogenomics and health services research. Emma has supervised 9 PhD, 5 MD(Res) and countless BSc research project students to successful completion and has led a thriving NIHR academic training programme in clinical pharmacology.
Education: Emma was awarded a National Teaching Fellowship of the Higher Education Academy in 2003 and has received student-led teaching awards at St George's in ten different years. She led her team in developing and delivering MBBS teaching on clinical pharmacology, therapeutics and prescribing at St George's. Team innovations have included the best-selling text book 'The Top 100 Drugs - Clinical Pharmacology and Practical Prescribing', now in its second edition, and the innovative 'Prescribing Scenarios at a Glance'.
In 2017, Emma was asked be the course director and co-founder of the UK's first BSc in Clinical Pharmacology at St George's, University of London. This exciting new venture aims to develop graduates ready for work or further study in drug development and research. The first student cohort arrived in September 2019.
For postgraduates, Emma is training programme director for Clinical Pharmacology and Therapeutics (CPT) specialty training in London for Health Education England (HEE) and sits on the national Specialty Advisory Committee. She has redeveloped and led national CPT training and trainee assessment over the last 3 years.
Policy: Emma is currently the Clinical Vice President of the British Pharmacological Society (BPS). In this role she leads implementation of strategic objectives to: raise the profile of the specialty, improve education and training and advance science. She is a member of the Clinical Pharmacology Skills Alliance (CPSA), a collaboration between the BPS, HEE, the Faculty of Pharmaceutics Medicine and the Association of the British Pharmaceutical Industry. The aim of the CPSA is to address the shortfall in skilled clinical pharmacologists.
Clinical Practice: Emma has been part of the respiratory team at St George's since 2000, seeing inpatients and outpatients with respiratory and general medical problems. More recently she has moved to the pharmacy and medicines directorate and with the support of the Chief Pharmacist at St George's is setting up innovative new services for patients with multimorbidity and polypharmacy in collaboration with GPs and pharmacists. She was the chair of the St George's Drugs and Therapeutics Committee from 2003-2019 and now chairs the South London Immunoglobulin Assessment panel. She was a member of the London Regional Medicines Optimisation Committee from 2017-19 and remains a member of the National Overprescribing Short Life Working Group, chaired by the Chief Pharmaceutical Officer.
The research portfolio of the clinical pharmacology team led by Emma Baker at St George's is focused on 'making sure that patients get the best medicines'. This page describes some of the areas of work relating to this.
Disease mechanisms
Epithelial transport, respiratory disease and infection. This bench-to-bedside research programme was the product of a longstanding collaboration between Professor Emma Baker and Professor Deborah Baines. Together we described the epithelial transport processes responsible for controlling glucose concentrations in airways surface liquid (ASL). In the laboratory studies, we demonstrated that these processes were disrupted by inflammation and hyperglycaemia, elevating ASL glucose concentrations. In clinical studies we found that ASL glucose concentrations were elevated in patients with diabetes or chronic lung disease, and particularly if they had both. We found that elevated ASL glucose increased clinical infections in patients and bacterial growth in laboratory models of airway epithelium. Through laboratory studies, industry collaboration and an investigator-led clinical trial we found that elevated ASL glucose could be lowered by drugs including metformin, which could be given safely to patients even during acute respiratory infection.
This review article in Chest and chapter in the book 'Lung epithelial biology in the pathogenesis of pulmonary disease', Elsevier give good overviews of this body of work
COPD and multi-morbidity.The Novel vascular manifestations of COPD (NoVasC) research programme investigated mechanisms underlying the development of vascular disease and comorbidities in people with chronic obstructive pulmonary disease (COPD). It explored the effects of inflammation, exacerbations, smoking, lung disease, respiratory failure and cardiovascular risk.
This clinical research programme was the product of a longstanding collaboration between Professor Emma Baker, Professor Paul Jones, Emeritus Professor of Respiratory Medicine and Dr Tom Barrick, Senior Lecturer in Image Analysis at St George's and Dr James Dodd, Senior Lecturer in Respiratory Medicine, Bristol University.
Pharmacokinetics
ABDose, This population pharmacokinetic study recruited 212 critically ill participants requiring treatment with beta-lactam antibiotics, with an age range from 2 days (gestational age 24 weeks) to 90 years old. The study produced a whole-life beta-lactam pharmacokinetic model and described the extent to which standard doses of these antibiotics achieve pharmacokinetic-pharmacodynamic targets associated with clinical cure.
The study was carried out by Dr Dagan Lonsdale as his PhD research with a collaborative supervisory team from clinical pharmacology (Professor Emma Baker), pharmacokinetics (Dr Joe Standing), paediatrics (Professor Mike Sharland) and intensive care (Dr Barbara Philips)
Clinical trials
Metformin in severe exacerbations of COPD. This investigator-led multi-centre, randomised, double-blind placebo-controlled trial from St George's demonstrated the feasibility and safety of acute treatment with metformin during acute exacerbation in patients with COPD, but did not lower blood glucose or reduce inflammation.
This trial was carried out by Dr Andrew Hitchings and Professor Emma Baker, in collaboration with Dr Dilys Lai at Chelsea and Westminster Hospital, London and Professor Paul Jones, Emeritus Professor of Respiratory Medicine.
CRN network trial delivery. The St George's clinical pharmacology team has contributed and recruited to diverse clinical trials in patients with respiratory infection and inflammation including COPD, asthma and pleural disease. In the COVID-19 pandemic they have contributed to early open label evaluation of immunomodulatory therapy and platform trials.
Polypharmacy and pharmacogenomics
We developed the clinical pharmacology structured review (CPSR) to form the basis of a specialist review for patients with complex polypharmacy and multimorbidity. We described the longitudinal exposure of English primary care patients to pharmacogenomic drugs to inform design of pre-emptive testing.
This work was done in collaboration with Professor Tess Harris, Professor of Primary care research, Dr Iain Carey, Senior Lecturer in Epidemiology and Professor Derek Cook, Professor of Epidemiology in the Primary Care Epidemiology Group of the Population Health Research Centre.