Professor Emma Baker (PhD, FRCP) is a clinical academic with roles in research, teaching and clinical medicine. She is the Head of the Clinical Pharmacology Unit, Lead for Prescribing Education and Assessment and Chair of the Drugs and Therapeutics Committee at St George’s.
People with chronic obstructive pulmonary disease (COPD) commonly have altered ability to metabolise glucose. This may present as diabetes mellitus, elevation of blood glucose (hyperglycaemia) during an acute illness or as insulin resistance. Professor Emma Baker is investigating mechanisms underlying these interactions and determining whether drugs that improve abnormal glucose levels can be used to prevent or improve the treatment of lung infections.
Current projects include a clinical trial of metformin in COPD exacerbations, funded by the Medical Research Council (MRC) and the British Lung Foundation. This investigator-led national, multicentre randomised placebo controlled trial is determining whether metformin during COPD exacerbations can control blood glucose and improve patient outcomes.
Professor Baker is also involved with an evaluation of anti-diabetic drugs in the treatment of respiratory disease (funded by an industry collaboration award with the MRC and Astra). This project (principal investigator Dr Deborah Baines) is based on the research group’s observation that glucose concentrations in lung liquid are elevated by lung inflammation and hyperglycaemia and that this increases pulmonary infection. The group are now determining whether anti-diabetic drugs can reverse these abnormalities and be used in the non-antimicrobial prevention and treatment of lung infections.
Professor Baker is also investigating insulin resistance and skeletal muscle dysfunction in COPD. Measurement of insulin resistance (oral glucose tolerance test) and skeletal muscle strength (quadriceps maximal voluntary contraction) and size (ultrasound cross sectional area) in COPD patients will allow us to determine whether there is an association between these 2 common co-morbidities in COPD patients towards interventional studies.
As part of her National Institute for Health Research portfolio studies, as respiratory specialty lead for London South Comprehensive Local Research Networks, Professor Baker supervises a research coordinator, Michael Tumilty, in setting up and running respiratory portfolio studies at St George’s and in south London.
Professor Baker's current external roles include Respiratory Specialty Group Lead, (London South Comprehensive Local Research Network) and Executive Editor of the British Journal of Clinical Pharmacology.
Professor Baker gained her PhD from Manchester University in 1996. She subsequently moved to St George’s and developed a research programme in epithelial transport and respiratory infection, with external funding from the Wellcome Trust and Medical Research Council. Her research has developed from early work in molecular biology to development and implementation of investigator-led clinical trials.
In teaching, Professor Baker was awarded a National Teaching Fellowship of the Higher Education Academy in 2003 and has received a St George’s undergraduate teaching prize in eight different years. She has co-authored a respiratory text book (Case-based respiratory medicine) and is currently leading her clinical pharmacology trainees in writing two new prescribing textbooks for publication in 2014.
As a clinician, she has a specialist interest in chronic obstructive pulmonary disease (COPD) and runs an outpatient service for patients with airways disease. She shares the inpatient care of respiratory patients with four colleagues and is on the on call rota for acute medical intaking.
Wells CE, Baker EH. Metabolic syndrome and diabetes mellitus in COPD. European Respiratory Monographs 2013; 59:117-134.
Garnett JP, Baker EH, Naik S, Lindsay JA, Knight GM, Gill S, Tregoning JS, Baines DL. Metformin reduces airway glucose permeability and hyperglycaemia-induced Staphylococcus aureus load independently of effects on blood glucose. Thorax. 2013;68:835-45.
Garnett JP, Nguyen T, Moffatt JD, Kalsi KK, Baker EH, Baines DL. Pro-inflammatory mediators disrupt glucose homeostasis in airway surface liquid. J Immunol 2012: 189:373-80
Archer JRH, Misra S, Simmgen M, Jones PW, Baker EH. Phase II study of tight glycaemic control in COPD patients with exacerbations admitted to the acute medical unit. BMJ Open 23 July 2011 doi:10.1136/bmjopen-2011-000210
Kalsi KK, Baker EH, Fraser O, Chung Y-L, Mace O, Tarelli E, Philips BJ, Baines DL. Glucose homeostasis across human airway epithelial cell monolayers: role of diffusion, transport and metabolism. Pflugers Arch 2009;457:1061-70 [Epub Sep 10, 2008]
Kalsi KK, Baker EH, Medina RA, Rice S, Wood DM, Ratoff JC, O’Connor BJ, Philips BJ, Baines DL. Apical and basolateral localisation of GLUT2 transporters in human lung epithelial cells. Pflugers Arch 2008;456:991-1003
Baker EH, Clark N, Brennan AL, Fisher DA, Gyi KM, Hodson ME, Baines DL, Philips BJ, Wood DM. Hyperglycaemia and cystic fibrosis alter respiratory fluid glucose concentrations estimated by breath condensate analysis. J Appl Physiol 2007; 102:1969-75.
Baker EH, Janaway CH, Philips BJ, Brennan AL, Baines DL, Wood DM, Jones PW. Hyperglycaemia is associated with poor outcomes in people admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease. Thorax 2006; 61:284-289.
Philips BJ, Meguer J-X, Redman J, Baker EH. Factors determining the appearance of glucose in upper and lower respiratory tract secretions. Intensive Care Med 2003; 29:2204-2210
Dr Andrew Hitchings - Clinical trial of metformin in COPD exacerbations (registered for PhD). Dr Claire Wells - Insulin resistance and skeletal muscle dysfunction in COPD (registered for MD(Res). Mr Michael Tumilty - Research coordinator. Dr Dagan Lonsdale. Dr Daniel Burrage.
Dr Deborah Baines
Dr James Garnett
Professor Paul Jones
Dr Jodi Lindsay
Dr Di Bilton
Dr Nicholas Simmonds, Department of Cystic Fibrosis, Royal Brompton Hospital
Professor Mike Polkey
Dr Nick Hopkinson, COPD and skeletal muscle, Royal Brompton Hospital
Professor Ian Adcock and Dr Paul Kirkham, Imperial College, London
Dr Dilys Lai, Chelsea and Westminster
John Taylor, Astra.
Medical Research Council. MICA: Evaluation of anti-diabetic drugs in the treatment of respiratory disease. 2013-2016. MRC contribution £466,813 (80 per cent). Industry collaborator (Astra Zeneca) around £230,000. Co-investigator (Principal investigator Deborah Baines).
London South Comprehensive Local Research Network. Strategic funding for research coordinator 2012-14, £110,858.91.
Medical Research Council. Developmental Clinical Studies - A clinical trial of metformin in COPD exacerbations 2012-2014, £282,131.
ASTRA. Internal Post-doctoral Scientist. Collaborative supervision.
British Lung Foundation. COPD 10/7. A randomised, double blind, placebo controlled trial of metformin for COPD exacerbations: a pilot study. 2011-2013, £44,287.38.
Wellcome Trust. 088304/Z/09/Z Effect of inflammation and insulin on glucose homeostasis in the airway epithelium. 2009-2013, £251,979.
USA Cystic Fibrosis Foundation Therapeutics. Development of breath glucose as a new pulmonary biomarker in CF. Oct 1 2007-Sept 30 2009, $215,691.
Professor Emma Baker is the lead for undergraduate prescribing education. She is the chief examiner of Prescribing Skills Assessment. Professor Baker is supervisor for BSc, Student Selected Component project students and she teaches on clinical firm.
Currently Professor Baker supervises one PhD and one MD(Res) student. She also supervises training of postgraduate non-medical prescribers.