Dr Shiao-yng Chan, Clinical Lecturer in Obstetrics and Gynaecology, University of Birmingham
The role of monocarboxylate transporter 8 (MCT8) in human foetal brain development and the effects of intrauterine growth restriction
Approximately one in ten pregnancies is complicated by poor foetal growth, which is associated with low thyroid hormone levels in the foetus. Of those babies that survive, 10% suffer impaired neurodevelopment. Similarly, around 2-3% of pregnant women have borderline or low thyroid hormone levels. As thyroid hormones are crucial to normal brain development, their children are at risk of poor neurodevelopment, although the exact way the hormones affect the brain remains unclear.
The recently identified protein, MCT8, is thought to play a significant role in brain development, as it is the most effective gateway through which thyroid hormones enter nerve cells.
Shiao’s project will study the role of MCT8 in foetal brain development and determine its relationship with other factors contributing to the effects of thyroid hormones. Clarifying the responsibility of MCT8 and thyroid hormone action in the brain could lead to new strategies for reducing the risk of babies being born with mental difficulties.
Dr Anna Gilmore, Clinical Lecturer in Public Health, London School of Hygiene and Tropical Medicine
Developing and evaluating policies to reduce tobacco use and harm in the UK
While expensive medical interventions used to treat diseases caused by smoking place a considerable burden on NHS resources, the cost of preventing those effects (which include various cancers, heart disease and stroke) is considerably cheaper. Anna's work, which combines three strands into one research project, will help to reduce smoking rates and will prove that not only is prevention better than cure but, importantly, that it is more cost effective.
Building on preliminary evidence from America that significant reductions in heart disease occur as a result of smoking bans, Anna will evaluate the impact of Parliament's vote in 2006 to ban smoking in workplaces. Secondly, Anna will investigate the tobacco industry's attempt to influence policy both domestically and in the EU. Thirdly, Anna will examine the effects of a smokeless form of tobacco called snus (the Swedish version of snuff). By assessing evidence on its use in other countries, Anna's work can then be used to examine whether it provides a viable, safer alternative to cigarettes.
Dr Rajesh Jena, Specialist Registrar, University of Cambridge
Biological optimisation of radiotherapy treatment for patients with high-grade glioma
High-grade gliomas are aggressive brain tumours, proving fatal for the majority of patients within 12 months of them developing the disease.
Radiotherapy helps to prolong survival and improve symptoms for these patients. Previous studies have attempted to apply higher doses of radiotherapy to the tumour and, while this can improve the chances of survival, there is also an increased risk of damage to the surrounding, healthy brain tissue.
Raj has pioneered the use of new MRI-based imaging techniques to assist with the planning of radiotherapy treatment, and to give oncologists additional information about the way these tumours spread into adjacent brain tissue. Using this information, it is possible to focus the treatment on the tumour, delivering higher doses to the affected area and lower doses to the surrounding tissue.
Raj will lead a clinical study which will provide each patient with an individualised radiotherapy treatment plan, in which the radiotherapy dose is carefully tailored to the characteristics of each tumour. His research has the potential to improve outcomes for all patients with high-grade gliomas and ultimately aims to improve standards of care across the entire spectrum of patients who develop this disease.
Robert MacLaren, Honorary Consultant Vitreoretinal Surgeon, Moorfields Eye Hospital
Development of new transplantation treatments for patients suffering from retinal disease
Age-related macular degeneration (AMD) affects the retina and is the most common cause of blindness in the UK. Current treatments only slow, rather than halt, disease progression and, with medical advances leading to increased life expectancy, incidence is predicted to increase three-fold over the next 25 years.
Recent developments in surgical equipment have revolutionised approaches to retinal surgery. Robert’s work aims to build on these advances to develop new surgical techniques and biological treatments to repair the retina and restore vision in patients.
Preliminary clinical data demonstrates the potential for new treatments to restore vision in AMD sufferers. Laboratory work shows how there may be future potential to use embryonic or stem cells to regenerate retinal cells in patients suffering from inherited diseases such as retinitis pigmentosa, a common cause of blindness in people of working age.
Dr Andrew McIntosh, Senior Lecturer in Psychiatry, University of Edinburgh
Neurocognitive abnormality in individuals at high risk of bipolar disorder or schizophrenia for genetic reasons
Bipolar disorder (manic-depression) and schizophrenia are severe mental illnesses which jointly affect around one person in every 50. Although the fundamental cause of each disorder is unknown, they tend to be hereditary.
Unlike other genetic diseases, the form of the disorder may change from one generation to another, with some people developing schizophrenia while others develop other psychiatric problems. Although schizophrenia and bipolar disorder diagnoses are widely used in psychiatry, they often don’t adequately predict the best treatment or prognosis for a patient, as they are based on collections of individual symptoms, rather then definitive investigations, such as blood tests.
Andrew’s study intends to better identify definitions of psychosis, based on an analysis of brain structure and genetic profile in families with one or more affected members. After undergoing initial assessment, unaffected relatives will be re-interviewed 2-3 years later to find out whether the evaluation was accurate.
The identification of factors which predict the onset of illness some years later, could lead to the earlier prediction of illness in currently unaffected subjects and the more timely introduction of effective treatments.
Dr Stephen Till, Specialist Registrar, Imperial College London
Novel tolerance-inducing vaccines for allergic diseases caused by grass pollen
Allergic diseases represent a serious public health issue in the UK, with amongst the highest rates of incidence in the world. Diseases including asthma, eczema and rhinitis are widespread and the rates of allergies to foods and workplace materials are increasing.
Allergies are caused by white blood cells that mistake harmless allergens, such as pollen, for parasites and trigger an unnecessary immune reaction. Treatment usually involves drugs that suppress the immune system but these are sometimes ineffective and do not address the underlying cause.
Allergy vaccines currently involve a prolonged course of allergen injections to induce a state of tolerance to that particular allergen. Injections need to be given with resuscitation facilities available because injecting neat allergen can cause allergic attacks, as well as prevent them.
Stephen’s project will examine the benefits of administering vaccines through other means, such as fast-dissolving tablets under the tongue, which may provide safer and more convenient treatment for sufferers.