A joint venture between the Department of Biology and The Hull York Medical School

Profile

Biography

Charles Lacey is Professor of Medicine at Hull York Medical School (HYMS), and Honorary Consultant Physician in GU/HIV Medicine at York Hospitals Foundation Trust. He qualified from Guy’s Hospital Medical School, University of London, and undertook postgraduate training in Bristol, Bath, Cambridge, and Oman. He was appointed Consultant Physician in Genitourinary Medicine at the Leeds General Infirmary in 1982, and there developed his interest in sexually transmitted disease research, being awarded grants from the YCRC and MRC to study HPV and candidosis. He also led and advised on HPV and HSV vaccine development in collaboration with industry. In 1996 he was appointed Senior Lecturer in Genitourinary Medicine & Communicable Diseases at Imperial College London, and Honorary Consultant Physician, St Mary’s Hospital, London. He worked in Jonathan Weber’s group, both on HPV clinical and laboratory studies, and also developed a vaginal microbicide research programme, gaining funding from MRC, EC & NIH. In 2004 he moved to HYMS, initially as Reader, and then was appointed to the first Chair in clinical medicine in York in 2007.       

Career

• Guy’s Hospital Medical School (1968-74)
• L.R.C.P., M.R.C.S., 1974
• M.B., B.S. (University of London) 1974
• Postgraduate training (1975-82)
• MRCP (UK) 1977
• DRCOG 1979
• Dip Ven 1981
• General Infirmary, Leeds (1982-96)
• FRCP 1991
• Imperial College London (1996-2004)
• MD (University of London) 2006
• Hull York Medical School, University of York (2004 -)
• FRCP (Glasgow) 2010

 

Research

Overview

• Genitourinary medicine

Professor Charles Lacey's group conducts phase 1 clinical trials of mucosal vaccines and microbicides against HIV-1. The group is funded by awards from the Bill and Melinda Gates Foundation, the Wellcome Trust, the European Commission, and the NIH. As part of a Gates Grand Challenges award the group are conducting a phase 1 trial of a novel HIV vaginal vaccine utilising ZM96gp140, in conjunction with the Vaccine Institute, St George's, University of London. This is testing whether local mucosal and systemic immune responses can be generated in response to 9 immunisations with the gp140 into the female genital tract. The group has a number of other projects investigating genital tract immunology, including testing for Hepatitis B surface antigen-specific mucosal and systemic IgA and IgG responses, and aspects of genital tract Chlamydia immunology. Future projects include an investigation of whether the neonatal Fc receptor for IgG (FcRn), which has been shown to play a major role in regulating host IgG levels and transporting IgG and associated antigens across polarized epithelial barriers, is expressed in vaginal, ectocervical, endocervical, & endometrial tissues in healthy women.

Current projects

MUCOVAC 1 and 2

As part of a Gates Grand Challenges award the group completed a phase 1 trial of a novel HIV vaginal vaccine utilising CN54gp140, in conjunction with St George's, University of London (SGUL). The MUCOVAC 1 trial investigated whether local mucosal and systemic immune responses can be generated in response to 9 immunisations of gp140 into the female genital tract.

MUCOVAC 2 is an exploratory phase 1 trial of three immunisations with CN54gp140 vaccine formulations administered through the intramuscular, intranasal and intravaginal routes in a variety of combinations.  The study is in collaboration with SGUL and the Medical Research Council (MRC) Clinical Trials Unit (CTU). The project is funded by the Bill & Melinda Gates Foundation and the Wellcome Trust under the Grand Challenges in Global Health initiative and the UK HIV Vaccine Consortium.

MABGEL1

Funded by the European Commission EUROPRISE programme, the study assesses the safety and pharmacokinetics of C2F5, C2G12, and C4E10 monoclonal antibodies when administered together in a gel vehicle as a vaginal microbicide. Participants receive vaginal microbicide gels containing either (a) high-dose monoclonal antibodies (b) low dose monoclonal antibodies, or (c) a control placebo vaginal microbicide gel.

Chlamydial immunology

This is a study looking at aspects of Chlamydia immunopathogenesis, in particular local and systemic antibody responses to C. trachomatis infection in women, and explores the correlation between antibody responses and load of C. trachomatis.

Leishmaniasis Vaccine

This project is in collaboration with the Kaye and Smith groups in CII investigating the development of a therapeutic CD8+ T cell-biased vaccine for visceral leishmaniasis. A new adenovirus-based vaccine is being developed, which will be taken into a phase 1 trial to assess safety and immunogenicity in York in 2011.

PIVOT

This is an MRC multicentre trial funded by the NHS R&D Health Technology Assessment (HTA) programme, UK. It is and RCT which compares switching to boosted protease inhibitor monotherapy versus continuing combination antiretroviral therapy for the long-term management of HIV-1 infected patients.

FcRN Study

This is a study investigating mechanisms of immunoglobulin transport within the female genital tract. It is investigating whether FcRn is expressed and functional in the vagina, cervix, and endometrium. Such knowledge can be proposed as central to the goals of HIV vaccine development.

CHAARM

This is a European Commission Framework 7 research programme, studying Combination Highly Active Anti-Retroviral Microbicides. Within a large research programme, the Lacey groups and other partners from CHAARM will develop a combination ARV microbicide gel, and take this into a phase 1 trial.

Research group(s)

• Lacey research group (Experimental medicine, Immunology)

Publications

Selected publications

• Marc Arbyn, Silvia de Sanjosé, Mona Saraiya, Mario Sideri, Joel Palefsky, Charles Lacey, Maura Gillison, Guglielmo Ronco, Nicolas Wentzenzen, Julia Brotherton, You-Lin Qiao, Lynnette Denny, Laurent Abramowitz, Jacob Bornstein, Massimo Tommasino, Joseph Monsonego. (2012) EUROGIN 2012 roadmap on prevention and treatment of HPV-related disease. International Journal Cancer, in press.
• Maroof A, Brown N, Smith B, Hodgkinson MR, Maxwell A, Losch FO, Fritz U, Walden P, Lacey CJ, Smith DF, Aebischer T, Kaye PM. (2012) Therapeutic vaccination with recombinant adenovirus reduces splenic parasite burden in experimental visceral leishmaniasis. J Infec Dis; 205:853-63.
• Lacey CJ, Woodhall SC, Wikstrom A, Ross J. (2012) European guideline for management of anogenital warts. JEADV; Mar 12. Doi: 10.1111 (Epub ahead of print)
• Oakeshott P, Aghaizu A, Reid F, Howell-Jones R, Hay P, Sadiq T, Lacey CJ, Beddows S, Soldan K. (2012) Risk factors for prevalent, incident and persistent genital carcinogenic human papillomavirus infection in sexually active, young, multiethnic women: community-based cohort study. Brit Med J; in press.
• Portman MD, Lacey CJ (2012) Apparent low-level HIV RNA viraemia related to sample processing time. HIV Medicine; in press.
• Lewis DJ,  Fraser CA, Mahmoud A,  Wiggins RC, Woodrow M, Cope A, Cai C, Giemza R, Jeffs SA, Manoussaka M, Cole T, Cranage MP, Shattock RJ, Lacey CJ. (2011) Phase I randomised clinical trial of an HIV-1CN54, clade C, trimeric envelope vaccine candidate delivered vaginally. PLoS ONE;6(9):e25165. Epub 2011 Sep 30.
• Woodhall SC, Jit M, Soldan K, Kinghorn G, Gilson R, Nathan M, Ross JD, Lacey CJ, on behalf of the QOLIGEN study group. (2011) The impact of genital warts: loss of quality of life and cost of treatment in eight sexual health clinics in the UK. Sex Transm Inf 87:458-63
• Morris G.C. and C.J.N. Lacey. (2010) Microbicides and HIV prevention: lessons from the past, looking to the future. Current Opinion in Infectious Diseases. 23: 57-63
• Kamali A, Byomire H, Muwonge C, Bakobaki J, Rutterford C, Okong P, Profy A, Byaruhanga R, Namukwaya S, McCormack S, Grosskurth H, Nunn AJ,  Lacey CJN. (2010) A randomised placebo-controlled safety and acceptability trial of PRO 2000 vaginal microbicide gel in sexually active women in Uganda. Sex Transm Inf 86:222-6
• Lacey CJN. (2010) Genital warts and genital papillomavirus disease. Medicine 338(6):271-5
• Lacey CJ, Woodhall S, Qi Z, Sawant S, Cowen M, McCormack S, Jiang S. (2010) Unacceptable side effects associated with a hyperosmolar vaginal microbicide in a phase 1 trial. Int J STD & AIDS 21:714-17
• Wiggins R, Morris G, Deasy A, Ramsey T, Lacey CJ. (2010) Local and systemic antibody responses in genital tract chlamydia trachomatis infection and the relationship to chlamydial load. Proceedings of the 12th International Symposium on Human Chlamydial Infections 20-25th June 2010 In press
• Everett DB, Baisely K, Changalucha J, Vallely A, Watson-Jones D, Cook C, Knight L, Ross DA, Mugeye K, McCormack S, Lacey CJ, Jentsch U, Hayes RJ. (2009) Suitability of simple HIV rapid tests in clinical trials in community-based clinic settings. J Clin Microbiol 47:1058-62
• Woodhall S, Jit M, Cai C, Ramsey T, Sadique Z, Crouch S, Birks Y, Newton R, Edmunds J, Lacey CJ. (2009) Cost of treatment and QALYs lost due to genital warts: data for the economic evaluation of HPV vaccines in the United Kingdom. Sex Transm Dis 36:515-21
• Gilson RJC, Ross J, Maw R, Rowen D, Sonnex C, Lacey CJN. (2009) A multi-centre, randomised, double-blind, placebo-controlled study of cryotherapy versus cryotherapy and podophyllotoxin cream as treatment for external anogenital warts. Sex Transm Inf 85:514-9
• Woodhall S, Ramsey T, Cai C, Crouch S, Jit M, Birks Y, Edmunds J, Newton R, Lacey CJ. (2008) Estimation of the impact of genital warts on health-related quality of life. Sexually Transmitted Infection 84:161-6
• Fakoya A, Lamba H, Mackie N, Nandwani R, Brown A, Bernard EJ< Gilling-Smith C, Lacey C, Sherr L, Claydon P, Wallage S, Gazzard B. (2008) British HIV Association, BASHH, and FSRH guidelines for the management of the sexual and reproductive health of people living with HIV infection. HIV Medicine 9:681-720
• Lacey CJN, Wright A, Profy A, Weber JN. (2006) Direct measurement of in vivo vaginal microbicide levels of PRO 2000 achieved in a human safety study. AIDS 20:1027-30
• Monteiro EF, Lacey CJN, Merrick D. (2005) The interrelationship of demographic and geospatial risk factors between four common sexually transmitted diseases. Sexually Transmitted Infection 81:41-6
• Chen F, Day SL, Metcalfe RA, Sethi G, Kapembwa MS, Brook MG, Churchill D, de Ruiter A, Robinson S, Lacey CJ, Weetman AP. (2005) Characteristics of autoimmune thyroid disease occurring as a late complication of immune reconstitution in patients with advanced human immunodeficiency virus (HIV) disease. Medicine (Baltimore) 84:98-106
• McCormack S, Jespers V, Low-Beer N, Gabe R, Kaganson N, Chapman A, Nunn A, Lacey CJ, Van Damme L. (2005) A dose-ranging phase 1 study of dextrin sulphate, a vaginal microbicide, in HIV-negative and HIV-positive female volunteers. Sexually Transmitted Diseases 32:765-70
• Vandepapeliere P, Barrasso R, Meijer CJLM, Walboomers JMM, Wettendorff M, Stanberry LR, Lacey CJN. (2005) Randomised controlled trial of an adjuvanted HPV6 L2E7 vaccine: multiple HPV type infection of external anogenital warts and failure of therapeutic vaccination. Journal of Infectious Diseases 192:2099-107
• Bakobaki JM, Lacey CJ, Bukenya MI, Nunn AJ, McCormack S, Byaruhanga RN, Okong P, Namukwaya SW, Grosskurth H, Whitworth JAG. (2005) A randomised controlled safety and acceptability trial of Dextrin sulphate vaginal microbicide gel among sexually active women in Uganda. AIDS 19:2149-56

Teaching

Undergraduate

I deliver a plenary lecture to the 2nd year medical students on HIV and International Health, and I am also involved in supervising SSC students.

External activities

Memberships

• HPV in Africa Research Partnership [HARP]
  Chair of International Scientific Advisory Group
  
• British Association for Sexual Health and HIV
  Fellow
• British HIV Association
  Fellow
• North East Yorkshire & North Lincolnshire CLRN
  Board member
• National Infectious Diseases & Microbiology Speciality Group
  Member