North Staffs Researchers Boost Glaucoma Treatment Safety

North Staffs scientists have used a £10,000 charity grant to help make eye surgery safer for thousands of glaucoma patients.

The research team, based at Keele University’s Institute for Science and Technology in Medicine, were awarded the funding by charity the North Staffordshire Medical Institute.

They have used it to try and improve outcomes of the trabeculectomy surgical procedure, commonly used to treat the eye disease glaucoma.

The condition – which is Britain’s second biggest cause of sight loss – occurs when the optic nerve and retina are damaged, caused by a build-up of fluid that increases pressure inside the eye.

Trabulectomy

A trabeculectomy involves making a small hole in the wall of the eye so that fluid can drain away, relieving the excess pressure.

However up to 30 per cent of the operations fail due to the body’s natural healing processes, which cause the hole to heal up and close again.

The researchers, led by tissue engineer Professor Ying Yang, have been looking for better ways to stop the eye from forming scar tissue and closing the new drainage channels.

She said: “The surgical procedure is the creation of an opening to allow the draining of fluid, but the body is automatically programmed to react if there’s a wound to try and close it.

“If it closes, this kind of surgery will fail. But your body doesn’t realise there is a benefit to this wound.”

Eye Cells

To address the problem, Prof. Yang’s research team have used conjunctival cells to create a mimic of human eye tissue under lab conditions.

They have tested the tissue with various drug doses to find the most reliable way of preventing inflammation and wound healing, without damaging the surrounding cells.

She added: “It’s difficult to work with a human eye and if you use an animal eye they’re not very representative. So we’re able to generate material in the lab that you can use to test whatever you wish – generate artificial wounds, add different growth factors and cytokines or test drug treatments.

“This will help us to predict what will happen in the patient’s eye after glaucoma surgery.”

The team has also been testing a new medical device to treat glaucoma called the XEN gel stent, which involves injecting a tiny gelatin tube into the eye to keep the drainage channel open.

They hope to use the results of their research to attract funding for a larger study.

Prof. Yang said: “The value of the Institute’s grant is that it’s kind of like a seed. We’re not just relying on this funding – through this we’re able to generate the proof of concept to attract more clinicians to participate in our research.”

Research Funding

The original grant was allocated in 2014 as part of the NSMI’s annual awards, which are funded by a combination of public donations, bequests and the income from room hire at the charity’s base on Hartshill Road, Stoke.

Once Britain’s first postgraduate centre, the iconic building is now used as a conference facility.

While the annual funding for 2018 has now all been allocated, researchers will soon be able to apply for the Institute and UHNM’s Firelighter Awards of up to £10,000.

For more information, visit www.nsmedicalinstitute.co.uk, like us on Facebook or follow us on Twitter.

North Staffs Researchers to Seek New Therapy for Chemo-Resistant Cancers

North Staffordshire researchers have been awarded £18,450 to develop a new treatment for chemo-resistant cancers.

The group, led by research pharmacologist Dr Alan Richardson, hopes to extend the lives of thousands of patients with breast, ovarian and lung cancers that have stopped responding to chemotherapy drug paclitaxel.

They aim to develop a new drug to stop cancer cells producing a protein that makes them resistant to the therapy.

Dr Richardson and his team will receive the grant from Stoke-on-Trent charity the North Staffordshire Medical Institute.

He said: “Patients who get ovarian cancer respond well to chemo, but they often suffer a relapse and when they come back they become resistant to treatment. At that point the number of options left are limited and there’s not a lot that can be done.

“Our goal is to discover drugs that make cells sensitive again to chemo.”

Ending Drug Resistance

Paclitaxel is normally given to patients through an intravenous drip and works by stopping cancer cells from dividing and growing.

The scientists, based at Keele University’s Institute for Science and Technology in Medicine (ISTM), have found that paclitaxel-resistant cells make too much of a protein called branched chain keto-acid dehydrogenase kinase (BCKDK).

They plan to test a range of chemicals in the lab with samples of pure BCKDK in a bid to block the gene that tells cancer cells to produce it.

Dr Richardson said: “I used to work at the Institute for Cancer Research in London and I started a screen to identify genes that contribute to drug resistance.

“Since then we’ve identified one gene and if we inhibit it, it makes the cancer cells more sensitive to paclitaxel. So we’re going to make drugs to inhibit this gene and hopefully extend people’s lives.”

Dr Richardson’s team will use the money to buy the state-of-the-art equipment they need to set up the initial tests. This will help them to apply for more funding to develop the drug further and eventually test it in patients.

The grant was allocated as part of the NSMI’s annual awards, which are funded by a combination of public donations, bequests and the income from conferences and room hire at the charity’s base on Hartshill Road, Stoke.

Once Britain’s first postgraduate centre, the iconic building is now used as a conference facility.

While the annual funding has now all been allocated, researchers will soon be able to apply for the Institute and UHNM’s Firelighter Awards of up to £10,000.

For more information, visit www.nsmedicalinstitute.co.uk, like us on Facebook or follow us on Twitter. Anyone interested in making a bequest is asked to email manager Jacqui Robinson at jacqui@nsmedicalinstitute.co.uk.

NSMI-funded scientists seek genetic treatments to fight frailty in older people

North Staffs researchers have won a £19,985 grant to investigate whether gene therapy can stop older people becoming frail.

The group, led by Dr Adam Sharples, hopes to pave the way for new treatments that will reduce falls and weakness in the elderly by switching off the genes that cause muscle wasting.

They will study tissue samples donated by hip and knee replacement patients to find which genes cause unused muscles to break down – with the help of the funding from local charity the North Staffordshire Medical Institute.

Dr Sharples said they expect to find these genes are ‘marked’ by special chemical ‘tags’ that tell them to be active or inactive, known as epigenetic modifications.

The discovery could eventually allow doctors to give patients medication that will replace the effects of exercise.

He said: “It’s very difficult to persuade an older person who’s never exercised in their life to take up a fitness regime. If we identify genes that we already know there are drugs for we can give them to people who don’t want to or can’t exercise due to frailty.”

Discovery

The team, based at Keele University’s Institute of Science and Technology in Medicine, has previously found muscles can remember periods of growth, so they can grow larger later in life.

They will investigate whether the opposite applies after wasting – meaning muscles may break down more quickly if an injury is repeated.

If so, the muscle memory could potentially be ‘switched off’ in older people hurt in a fall, slowing down the wasting process that makes them more likely to fall again.

He added: “Can we intervene if a patient has had a fall and lost muscle to prevent that from happening again and make people less frail? The cost of frailty to the NHS is on the increase, especially with an aging population.

“The thing it impacts on is quality of life, so people can’t do simple tasks like walking upstairs or opening a can of beans. So our aim is not necessarily to extend life but to improve quality of life as people get older.”

Using the latest genome wide techniques, the team will study more than 850,000 sites on the DNA of patients with muscle wasting after an operation. They will then compare them to a control group of normal muscle samples.

Dr Sharples said: “What we’re going to do is take a chunk of muscle about the size of a broad bean, usually from the quadricep, and look at the difference between someone who’s had a trauma or an injury and had to have an operation and someone who hasn’t.

“Normally those people have some kind of muscle wasting in a very short period, even in two or three weeks where the limb is suspended.”

Grant

The grant was allocated as part of the NSMI’s annual awards, which are funded by a combination of public donations, bequests and the income from room hire at the charity’s base on Hartshill Road, Stoke.

Once Britain’s first postgraduate centre, the iconic building is now used as a conference facility.

While the annual funding has now all been allocated, researchers will soon be able to apply for the Institute and UHNM’s Firelighter Awards of up to £10,000.

For more information, visit www.nsmedicalinstitute.co.uk, like us on Facebook or follow us on Twitter.

Institute set to announce research grant winners

Researchers across the region will find out this week if their projects will be funded by the North Staffordshire Medical Institute.

A committee of experts has been sifting through applications for the charity’s annual research grants and is set to announce its decisions following a meeting on Monday, February 19th.

It will award sums of up to £20,000 towards three schemes designed to enhance understanding of disease and create more effective treatments. Previous recipients have included research groups investigating cancer, diabetes, heart disease and premature birth.

Jacqui Robinson, manager at the Institute, said they were keen to attract as many applications as possible to ensure the best possible quality. She said: “There’s only a limited amount of funds available so we consider what’s most appropriate and in line with the Medical Institute’s guidelines.

“The committee is made up of established scientists and researchers so they know whether or not it’s going to work and whether it’s feasible.”

The committee also includes several lay members to provide a different perspective on which projects are worth funding.

They sift through up to 20 applications each year, which must already have been through an independent peer review process and gained approval from a local ethics committee if patients will be involved.

She added: “If they need ethical approval and we don’t receive a copy they won’t get any money.

“We encourage as many people as possible to apply and it’s open to any allied health professionals in North Staffordshire. We need to be sure that the quality is there though.”

Researchers are invited to apply for the annual awards – normally worth around £60,000 a year – via the Institute’s website every autumn.

Applications are now closed for the 2018 research awards, but are due to open shortly for the Firelighter Awards in collaboration with the University Hospital of the North Midlands NHS Trust.

For more information keep an eye on our website, like us on Facebook or follow us on Twitter @nsccentre

North Staffordshire scientists invent new home test for diabetics

A North Staffs research team hopes to save patients time and the NHS millions with a new home testing kit for diabetics.

The scientists, led by Clinical Biochemist Dr Chris Duff, want to end the need for Britain’s four million patients with diabetes to visit a clinic for routine haemoglobin testing every four months.

Their DIY version of the HbA1c test will be similar to the finger prick kit some diabetic patients currently use to monitor their own blood sugar.

Patients will be shown how to collect tiny samples of blood using the kits, which will be delivered to their homes at regular intervals then returned by post for laboratory testing.

The project, based at Keele University and University Hospital of North Midlands, has been funded in part with a £7,515 grant from the North Staffordshire Medical Institute.

Time-saving innovation

Researcher Kathryn Ford explained: “We’re trying to help patients do their diabetes monitoring at home rather than coming into hospital because it’s inconvenient.

“At the moment they have to take time off work, then they have to go to the hospital, they have to park.

“We want them to be able to do a finger prick at home and send it in on a card rather than coming in to have their blood taken.”

The team have already developed the test and shown that the dried blood can survive the postal system until it is reconstituted in the laboratory.

Their next step will be to create the kit itself and recruit patients to take part in a pilot scheme.

She added: “I need to get a focus group of about 20 patients with diabetes and ask them if they would like to take part in the trial.

“We can then get patient feedback and hopefully roll it out.”

Preventing Complications

The HbA1c test measures the levels of glycated haemoglobin in a patient’s blood to see how well they have been controlling their diabetes over the previous months.

A healthy level for non-diabetics is below 42 mmol/mol, whereas diabetics are told to aim for around 48mmol/mol.

Higher levels of the substance show a patient’s diabetes is badly-controlled, putting them at risk of serious complications like blindness, heart disease and limb amputations.

Kate said: “You can end up with kidney disease, heart disease, eye problems, numbness in your hands. It’s all very unpleasant.

“We want them to test every three to four months but to get patients to test every three to four months is very difficult.

“By sending the kits out at the right time we can better control the frequency of the testing and by doing that we can optimise monitoring.”

Professor Shaughn O’Brien, chairman of the North Staffordshire Medical Institute, said: “I expect this to be a very real advance in diabetic care.

“As well as the convenience for the patients improved blood sugar control is likely to be very much improved.

“I look forward to seeing the data on the cohort being presented at next year’s annual research awards event.”

The North Staffordshire Medical Institute is a charity funded by public donations that provides grants for vital medical research in the Staffordshire area.

To find out more about our work, visit nsmedicalinstitute.co.uk.

By Meg Jorsh

Understanding Grief – an Interview with Linda Machin

By Meg Jorsh

Grief affects all of us at some point in our lives. When a loved one dies we may feel crushed, overwhelmed. Then it fades to a quiet pain that hides behind everything we do until we finally learn to live with it.

But for some of us, relief never comes. The waves of sadness continue to mount, so that everyday life seems tiny by comparison. For these people bereavement holds risks of its own – depression, anxiety disorders, substance misuse, sudden cardiac events and potentially suicide. They need professional help to adjust to their new way of living.

Unfortunately it can be hard to tell the difference between those treading water and those not waving, but drowning. It has been the life’s work of bereavement expert Dr Linda Machin to better understand the landscape of loss and the ways individuals grieve. Her pioneering research has helped countless professionals to understand grief and bereaved people to feel better understood.

“I think a lack of understanding can make grief longer-lasting than it needs to be,” says Dr Machin. “It can bubble along even worse for some people if they feel misunderstood and their care isn’t addressed appropriately.

“People who begin to grieve chronically can also become depressed and anxious, the ultimate potential risk is suicide. You only have to look at the media attention to Princes William and Harry and their comments about losing their mother to appreciate the long-lasting and persistent nature of grief. They were young people then but it can apply to people at any stage of their lives.”

Models of Bereavement

Dr Machin is best-known in her field as the creator of the Range of Response to Loss model and Adult Attitude to Grief scale. These psychological tools allow professionals to categorise a bereaved person’s  grief according to their levels of overwhelmed, controlled and resilient reactions. A more overwhelmed person may be so distressed they feel they can never be happy again, whereas a more controlled person may refuse to accept the reality of their loss. On the other hand, a resilient mourner may feel they are able to cope with their pain.

“The AAG scale is a kind of a triage system,” Dr Machin explains. “The interventions that are deemed appropriate are based on the scale. Some people who are very overwhelmed by their grief will need a very different intervention to someone who’s closed down on their grief but is still not coping.”

“NICE have produced guidance for bereavement intervention – the first group is one where people simply need signposting to practical advice and support from family and friends. The second is one where people do need some opportunity to talk about things that are troubling to them. Then the third are the group who are most vulnerable and are likely to need longer-term intervention by therapists.”

Further Research

The more recent development of the AAG scale to identify  vulnerability was funded by the North Staffordshire Medical Institute for research with two Marie Curie hospices (Hampstead and Belfast), the Dove Service bereavement support team in Stoke-on-Trent and the bereavement service of St Giles’ Hospital in Lichfield. It is now being used by a range of UK organisations including Marie Curie and Cruse Bereavement Care, as well as internationally by groups in Canada, Iceland, Portugal, Australia, Pakistan and the USA. Dr Machin is also working on a modified version for people affected by terminal illness.

“It’s  looking at the whole question of mental health and loneliness,” she says. “The ultimate aim is that this is a method that allows the practitioner to enhance their work with people as  they progress from end of life care  to bereavement.”

Dr Machin and her team, based at Keele University, received a £4,500 grant from the North Staffordshire Medical Institute in 2011. For more information on the medical research charity or to make a donation, visit our website at http://nsmedicalinstitute.co.uk/. You can also like us on Facebook at @nsmedicalinstitute or follow us on Twitter at @nsccentre.