Blog posts

Getting to the Heart of the Matter: Sex Differences in Cardiomyopathy

Artwork by Mengmeng Tu, MSc Science Communication student

This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

Could variation in the architecture of men and women’s hearts explain why their risk of cardiomyopathy differs? Dr Paz Tayal, Clinical Senior Lecturer in Cardiology at the National Heart and Lung Institute is investigating this with the aim of improving outcomes for patients affected by this disease of the heart muscle. Dr Tayal also discusses the ‘juggle struggle’ of balancing work and family life, and the importance of truth telling in academic medicine.

As winter sets in, I start to pack away the summer dresses and bring out the woolly jumpers and sturdy boots. When I do this, I will not be going into my husband’s closet to find things that fit me, nor indeed will I be wearing his shoes.

That seems obvious right, because we are different sizes.

We don’t think twice about that, yet in medicine, we are only just beginning to realise that male and female patients might need to have tailored ways to diagnose and treat disease.

Even in health, male and female hearts are not the same. At birth, the hearts of male and female babies are about the same size. However, at puberty, male hearts have a faster period of growth compared to female hearts. Whilst this eventually settles down, throughout adult life the mismatch persists, and the female heart remains smaller.

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The Fleming Centre: Driving the fight against antimicrobial resistance.

Prof Ara Darzi, Chair, The Fleming Centre Initiative 

In the relentless pursuit of global health, few adversaries loom as large as antimicrobial resistance (AMR). AMR poses a pervasive threat to both different disease areas and public health as a whole. It has the potential to undermine modern medicine, as previously treatable common infections and injuries may once again become life-threatening. As the gravity of this crisis intensifies, The Fleming Centre will stand at the forefront of a burgeoning global movement to combat AMR. On World Antimicrobial Awareness Week,  Professor Ara Darzi, Chair of The Fleming Centre Initiative, writes about the pivotal role this centre will play in the fight against AMR and the far-reaching impact it promises to deliver.  

AMR poses a significant threat to global health, making it one of the most pressing challenges of our time. Drug-resistant infections occur when the bacteria responsible for the adaption and evolution of infections, gain the capacity to withstand drugs intended to kill them. The overuse and misuse of antimicrobial drugs, such as antibiotics and antifungals, in both humans and animals is only accelerating this process. As a result, AMR has been linked to more than one million deaths worldwide each year; a sign common infections are becoming increasingly difficult to treat as the medicines we all rely on become less effective. With people across the globe already dying from drug-resistant infections, the threat of more drugs losing their potency, will put more lives at risk.  

Deaths attributed to AMR every year
Source: Wellcome Trust (https://wellcome.org/sites/default/files/wellcome-global-response-amr-report.pdf)

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The one with a Nobel prize winner

Hadi Sallah, PhD student in John Tregoning's lab, working on RNA vaccines.
Hadi Sallah, PhD student in John Tregoning’s lab, working on RNA vaccines.

Dr John Tregoning, Professor in Vaccine Immunology, recounts his experience of working with Dr Katalin Karikó, Nobel Prize winner and the tenacious force behind the mRNA vaccines that helped change the course of the COVID-19 pandemic. Their recently published study investigates how RNA modifications impact the body’s immune response to infection, with the hopes of aiding the development of more effective mRNA vaccines.

Science is collaborative, we work with lots of different people to understand the world around us. Working with other people is one of the joys of the job. In our recently published study, Reducing cell intrinsic immunity to mRNA vaccine alters adaptive immune responses in mice, we had the privilege of working with Dr Katalin Karikó, joint winner of the 2023 Nobel prize in Physiology or Medicine.

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Why not eliminate HTLV-1 while eliminating HIV-1? We need HTLV-1 PEP/PrEP clinical trials.

Dr Goedele Maertens and Dr Fabiola Martin

HTLV-1 PrEP Open Letter to Gilead & ViiV 

Human T Lymphotropic/Leukaemia Virus-1 (HTLV-1) is a sexually transmitted infection (STI) closely related to human immunodeficiency virus-1 (HIV-1). HTLV-1 causes chronic infection, can be transmitted from mother to baby and is associated with significant disease burden and mortality, preceded by years of suffering and poor quality of life for victims.   

Therefore, HTLV-1 is one of the 2030 elimination targets of the World Health Organization’s global STI elimination strategy.  

Although there is currently no drug or vaccine available to cure HTLV-1, we now know that the very same drugs that effectively treat patients with HIV or prevent people from getting HIV-1, called HIV PrEP, also prevent the transmission of HTLV-1 in our laboratory testing (Reviewed in Bradshaw and Taylor, Frontiers in Medicine 2022). We believe that these compounds are likely to block the transmission from mother to child. 

It is well known that many HIV PrEP clinical trials are conducted in countries where HTLV-1 is common. So, by adding in HTLV-1 testing to these HIV-PrEP trials we could measure if the HIV PrEP drugs also prevent HTLV-1 transmission. The beauty of such an outcome would be that these HIV-1 drugs are already licensed to be used in humans.  

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Tackling syncope – a significant diagnostic challenge for many

Syncope–a transient loss of consciousness–occurs in 42% of people by the age of 70. Professor Richard Sutton, Emeritus Professor of Clinical Cardiology, discusses this common medical problem, and how he has pioneered a “true but still insufficiently small interest” in it.

I have been Emeritus Professor of Clinical Cardiology at Imperial since 2011. Prior to that, I had trained in Cardiology at St George’s Hospital, the University of North Carolina, and the National Heart Hospital in London, becoming Consultant Cardiologist at Westminster Hospital in 1976. There I focused on cardiac pacing as a subspecialty. From a clinical perspective, cardiac pacing eradicated syncope (transient loss of consciousness) in patients with conduction tissue disease of the heart. So, I sought to extend the role of pacing into related syncope conditions.

My primary interest therefore became the symptom of syncope. I began this in the late 1970s, and formed a close relationship with Worthing Hospital which carried a heavy load of older patients, many of whom presented syncope. I founded an outreach clinic at Worthing which led to the receipt of many challenging patients with syncope in whom there was no obvious cause.

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A new dawn for disease modelling and precision medicine at Imperial College London

Tamas Korcsmaros

In a ground-breaking stride towards advancing medical research, earlier this year, the NIHR Imperial Biomedical Research Centre (BRC) proudly inaugurated the state-of-the-art Organoid Facility. This monumental achievement is the result of years of meticulous planning and the outstanding contributions of researchers like Tamir Rashid, Gary Frost, Nick Powell, and Harry Leitch, who laid the foundation for what promises to be a revolutionary venture in the field of organoid science. Generously backed by five years of strategic funding from the NIHR, the Organoid Facility is poised to become a pivotal resource, not just within Imperial College but across the academic community. Dr. Tamas Korcsmaros, Senior Lecturer in Intestinal Epithelial Biology for the Department of Metabolism, Digestion and Reproduction shares more about the launch of the Facility and how they hope to transform precision medicine.

Understanding diseases better and improving how we model them has been the focus of biomedical research for the last couple of decades. Relevant, scalable and useful animal models have been established to understand the basic biology of cellular and mammalian systems in vivo – experiments conducted for research purposes on whole living organism. Rodent models have been used for preclinical and toxicology testing of promising drug molecules. To complement these efforts, immortalised, cancer-related human cell lines have been used to understand in vitro (experiments conducted for research purposes outside of a living organism e.g., test tube) how these systems work in a human cell. However, all these systems possess different limitations: Animal models are often not completely resembling human processes, especially when we are thinking of host-microbe interactions for example, where a mouse gut is very different from a human gut. Human cell lines are often altered due to their immortalization. In addition, many cell types cannot be kept in cell lines, resulting in no data or testing option on key cell types. Around 15 years ago a new technology started to emerge based on isolating and differentiating specific stem cells of an organ. With this approach, a simplified but 3D models of an organ, mostly containing only its epithelial layer can be developed. They are called organoids.

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Imperial College researchers conducting national pilot on supporting return to work

Some of the EMBED study team.

Researchers at Imperial College London are spearheading a national pilot aimed at revolutionizing the way we approach work and health. With soaring levels of economic inactivity due to ill health in the UK, the team at The Self-Care Academic Research Unit has joined forces with occupational health clinicians and experts from the Department for Work and Pensions. Together, they are implementing a pioneering study that embeds job centre work coaches and disability employment advisors within GP surgeries. Dr Lara Shemtob, Academic Clinical Fellow in General Practice and Occupational Health Physician at Imperial College London writes more about this exciting initiative, the EMBED study, below.  

Researchers at Imperial College London are working on a solution to the high levels of economic inactivity due to ill health in the UK. Together, with occupational health clinicians and a team at the Department for Work and Pensions, researchers at The Self-Care Academic Research Unit (SCARU) are delivering and evaluating a pilot study that places job centre work coaches and disability employment advisors in GP surgeries, where people’s work and health needs can be addressed together. 

‘This project represents a watershed for work and health in the UK, and a first step to universal access to occupational health.’ - Dr Shriti Pattani, National Expert in Occupational Health & Wellbeing and Honorary Senior Lecturer, Imperial College, London 

This topic is high on the policy agenda as levels of economic inactivity due to ill health continue to rise. The challenge of helping people work through ill health will only get more prevalent as the population ages. This could have significant consequences on public sector services in the next future with less people contributing to government revenues through work, and instead becoming more reliant on state support.  

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Embracing doubt in science

Nana-Marie Lemm, Clinical Research Fellow

Why is ‘doubt’ an important resource in science? How can we support the kind of science that takes intellectual risks – and takes time? Nana-Marie Lemm, Clinical Research Fellow at the Department of Infectious Disease, gives her reflections on the recent Day of Doubt conference, organised by the Good Science Project. 

What are the motivations for becoming a scientist? It might be the search for truth or to understand how things work, or to work towards a greater good. But how does that idea compare to the reality of the day-to day work of science, and the culture of doing science? 

The Day of Doubt was the first conference of its kind at Imperial College London. Organised by The Good Science Project, the conference aimed to reflect on research culture at the university level and beyond. It provided a space for discussion, reflection, and the opportunity to ask fundamental questions.  

So, what is ‘doubt’ and why might it be important in science? The team behind the Good Science Project have helpfully created a thesaurus of doubt and a memo document on the day. In the latter, Dr Anthea Lacchia writes:  

“If we take doubt to be the opposite of complacency, it is associated with pause, with thoughtful hesitation. Yet, this act of questioning, of taking necessary time before making a decision, seems at odds with the push for success, publications, and the need for high impact results. In truth, science is full of conflicts, some internal, some relating to wider culture.”  

On the day, there was the opportunity to take time to engage in the act of questioning. Reflective sessions ranged from questioning concepts such as, ‘public engagement,’ ‘interdisciplinarity,’ ‘excellence,’ ‘expertise,’ to delving into philosophical discussions surrounding the nature of scientific truth. 

A key question to speakers in the first session of the conference that resonated with me was,  “How do you talk about doubt when you don’t come from a position of seniority and confidence?” 

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Imperial College WHO Collaborating Centre for Public Health Education and Training (WHOCC) receives its 5th re-designation by the World Health Organization

Outside-WHO-building-Geneva.

The Imperial World Health Organization Collaborating Centre for Public Health Education & Training (WHOCC) was created in 2007 to support the work of the World Health Organization and its founding objective: ‘the attainment by all peoples of the highest possible level of health’. Established by the WHO Global Committee with the support of the British Government, the WHOCC has a special focus on global health issues and health services research, in addition to public health education and training.  This year, Imperial WHOCC was redesignated for another four years- a huge achievement. Hear from Rachel Barker, Support Officer, at the WHO Collaborating Centre and Department of Primary Care and Public Health, about the WHOCC’s work.  

Following an intensive and rigorous process, the World Health Organization Collaborating Centre of Public Health Education and Training (WHOCC) Imperial College London, has been re-designated for another four years, securing its vital work in improving global health and wellbeing until 2027.  During the previous designation period, Imperial WHOCC shared its expertise with Low-and-Middle-Income-Countries (LMIC)  to assist them with their endeavors towards meeting the UN Sustainable Development Goals (SDG). In respect to SDG 3, ‘Good Health and Well-Being’, Imperial WHOCC has collaborated with stakeholders, countries, and international organisations on improving access to Universal Health Coverage (UHC).  

Commenting on the news, Professor Salman Rawaf shared his congratulations to the Imperial WHOCC team, “The WHOCC re-designation is quite the feat – thank you to our team for their hard work. This is our fifth re-designation – a record achievement for any WHO CC at a global level. As a direct result of our work, the WHO and many member states have benefited from the excellence of Imperial College London and its affiliated NHS institutions in research, service development, education and training. A sincere thanks to Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, Azeem Majeed, Chair in Cancer Epidemiology and Prevention at the School of Public Health, Professor Elio Riboli, and Professor Deborah Ashby, Interim Dean of the Faculty of Medicine for their continued support over the years.” 

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Sharing dumplings, jetlag and the stage: co-presenting at conferences, the way forward

Dr Lindsay Dewa, Advanced Research Fellow in Mental Health, and Pelumi Fatayo, co-producer of Nexus, reflect on their experiences of presenting together at an international conference, and the value of putting co-production into practice. 

“Oof – long day that wasn’t it! Is it 11pm or 7am? Is it Friday or Saturday? I’m so confused!” – Lindsay

That was a question I had asked Pelumi following over 24 hours of travelling from London (and Manchester for Pelumi) to South Korea. But I could see it was already well worth the trip before we’d even stepped out of the taxi – the bright lights, the heat… the friendly taxi driver trying to figure out where our hotel was on his five digital devices… we were excited! But what I was most looking forward to was co-presenting about co-production in mental health research at a prestigious international conference – ISQua – with one of my young co-producers, Pelumi. The conference theme was “Technology, culture and co-production: Looking to the horizon of quality and safety” so we felt it was perfect for us to share our experiences.

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