BMA Foundation for Medical Research – grant winners 2016

Dr Cristina Renzi, winner of the TP Gunton grant, and Professor Pali Hungin, President of the BMA, at the 2016 awards ceremony

Find out about the winners of the 2016 awards:

  • Dawkins & Strutt grant for research into psychological therapies in pain and medically unexplained symptoms
  • Doris Hillier grant for rheumatism and arthritis research
  • H C Roscoe grant for research into the common cold or other viral diseases
  • Helen H Lawson grant for research into technologies to assist patient care
  • Josephine Landsell grant for heart disease research
  • Margaret Temple grant for schizophrenia research
  • TP Gunton grant for research into public health relating to cancer
  • James Trust grant for asthma research
  • The Scholarship Grant for research into outcomes for those who have suffered from sexual abuse
  • Vera Down grant for research into neurological disorders

You can find out more about the winners and their projects by clicking through the tabs below.

See pictures and read stories from the awards ceremony

  • Dawkins & Strutt

    Dr Jeremy Howick BA MSc PhD  & Prof Paul Nicholas Aveyard BSc MBBS MRCP MPH MFPH PhD MRCGP FRCGP, University of Oxford

    Modifying practitioner empathy and patient expectations to enhance pain treatment: a systematic review and meta-analysis

    One in five us are in pain and for many the cause of pain is not going to go away. Many of us worry about the side-effects of painkillers, particularly for long-term use. When doctors appear empathetic and deliver hopeful messages, people often feel less anxious about the cause of pain and its future course. This, in turn, releases the body’s natural painkillers in the brain, such as endorphins.

    However, there are currently a number of barriers preventing this approach from being employed as standard practice. The main problem is that we don’t know how doctors can express their empathy best, how best to train doctors to behave in this way, and how they can deliver positive but realistic messages.

    In this project we will review all of the studies that have tried to train doctors to do this.  Using statistical methods to bring all the results together, we will identify the key behaviours doctors need to change and also the most effective and efficient ways of training doctors to behave in this way.

  • Doris Hillier

    Dr Meghna Jani MSc MBChB MRCP PhD, University of Manchester

    Pharmacological biomarkers in the prediction of adverse events and subsequent biologic response in rheumatoid arthritis patients treated with TNF-α inhibitors

    Biologic drugs used to treat rheumatoid arthritis (RA) act by targeting inflammatory molecules in the body. They are usually very effective but, in about 40% where biologics work initially, the treatment stops working a few months later, or patients develop a bad reaction and the drugs have to be stopped.

    At present, we do not know in which patients the treatment fails and/or who will get side-effects. In some cases, side-effects are thought to be due to the body producing antibodies to the drug, thereby interfering with how the drug acts.

    The proposed study, supported by the Doris Hillier grant, aims to investigate if such antibodies or having high levels of drug in the body can predict serious side effects and/ or future response to the next biologic if initial treatment fails.

    To do this, two of the largest national studies recruiting RA patients will be linked to study patients with blood samples who have long-term outcomes recorded. If promising, these tests could be incorporated into clinical practice. The ability to predict certain side-effects and lack of response at an early stage could help treat patients with the right drug as soon as possible, whilst ensuring greater clarity about the probability of benefit and harms to allow informed decision-making.

  • H C Roscoe

    Dr Lynda Coughlan BSc MSc PhD & Prof Adrian Hill DM DPhil FRCP, University of Oxford


    Investigation and exploitation of exosomes in the development of novel influenza vaccines with improved immunogenicity

    Inadequate immune responses and limited cross-protection against diverse influenza viruses are common failures of current influenza vaccines, leaving vulnerable groups at high-risk of severe infection. Improving immune recognition of influenza proteins or identifying pathways involved in effective vaccine responses could help address these issues.

    Exosomes are nano-sized cellular transporters. Following their release from cells, they act as a cellular "postal-system", facilitating cell:cell communication through the transfer of specific proteins and genetic information. As such, exosomes represent an exciting breakthrough in health-innovation and there is tremendous potential for intercepting and manipulating their communications with the immune system to improve vaccines.

    We will hijack this exosome "postal-system" by designing novel vaccines to artificially deliver influenza proteins to the exosome-surface. This strategy can increase uptake by specialised cells involved in immunity, dramatically improving immune responses. In a separate approach, we will investigate if genetic material contained within blood-derived exosomes is altered following vaccination. Identifying changes in the contents of exosomes may allow us to design vaccines to specifically stimulate the pathways involved in the generation of effective immune responses.

    This study will lead to the design of more effective influenza vaccines for clinical investigation and pandemic preparedness, beneficially impacting patient health, society and the economy.
  • Helen H Lawson

    Dr Andriana Michaelidou MBBS BSc Inter MRCP FRCR MSc, Guys' & St Thomas' NHS Foundation Trust

    18F-FDG-PET in guiding dose-painting with intensity modulated radiotherapy in oropharyngeal tumours: A phase I feasibility study (FiGaRO)

    Locally advanced oropharyngeal cancer is treated with a combination of radiotherapy and chemotherapy. Radiotherapy works by using high energy x-rays to destroy cancer cells. Although many patients are cured by this treatment, not all of the cancer cells are destroyed and, in some, the cancer does come back.

    Studies have suggested that more efficient killing of cancer cells, and therefore, better cure rates, can be achieved by increasing the radiotherapy dose. However, in the past, this was not possible due to side effects.

    Intensity Modulated Radiotherapy (IMRT) is a relatively new technique that allows better shaping of the radiation dose. By using IMRT we can deliver an intentionally higher dose of radiation (boost) to small selected areas of tumour, whilst keeping doses to organs at risk within acceptable limits. 

    In this study we use 18F-FDG-PET (18F-fluorodeoxyglucose-positron emission tomography, also known as a ‘PET’ scan) to select areas of tumour that appear more active and may benefit form an IMRT boost. If we prove that this approach is well-tolerated, then we may be able to improve cure rates with this treatment. We will also establish a way of using 18F-FDG-PET in radiotherapy planning that can be used across different tumour sites.

     

    Miss Aphrodite Iacovidou MBChB MSc MRCS (ENT) DOHNS, Imperial College NHS Trust

    Study to evaluate the validity of the ThyroSeq V2 gene panel to reduce the need for diagnostic hemithyroidectomy in follicular lesions of the thyroid (Thy3F)

    Approximately 15 per cent of the population have thyroid nodules – which are small lumps in the neck area that may be cancerous. Furthermore, half of women and 20 per cent of men over the age of 50 have thyroid nodules.

    When these lumps are biopsied up to 15 per cent are identified as ‘suspicious lesions’ called Thy3f, and in most instances require diagnostic lobectomy. However, only 25 per cent of Thy3F lesions are diagnosed as cancer and therefore 75 per cent of patients undergo unnecessary surgery. This has implications both on healthcare resources and patient morbidity.

    The University of Pittsburgh Medical Centre Division of Molecular and Genomic Pathology have developed ThyroSeq® next-generation sequencing in an attempt to improve detection of cancer in indeterminate cases of Thy3F lesions. ThyroSeq v.2 detects point mutations and gene fusions in more than 60 thyroid cancer genes.

    Our aim is to validate this promising genetic assay and assess if it could improve detection of those with no mutations and prevent unnecessary operations, patient morbidity and healthcare cost.

  • Josephine Landsell

    Dr David Adlam BA BM BCh DPhil MRCP, University of Leicester

    Coronary Aneurysm Ectasia: Epidemiology, vascular pathophysiology and genetics

    Heart attacks are usually caused by blood clots forming on areas of narrowing which develop within the coronary arteries. However there are also some less common causes of heart attacks with a different underlying problem. Because these are more unusual, much less is known about the underlying disease process and the best treatment for patients who have these problems.

    Coronary aneurysms or ectasia (CAE) are rare abnormalities of the coronary arteries where localised dilations develop. Sluggish blood flow in these dilated segments leads to clot formation which may progress to block the vessel causing a heart attack. The spectrum of clinical presentations range from chest pain syndromes to myocardial infarction and sudden death.

    The cause of these conditions has not been extensively studied but there is some evidence to suggest an underlying genetic predisposition may be one important factor.

    We are a collaborative partnership of NIHR BRC/ BRUs with an interventional cardiology focus. We propose to carefully study a group of CAE-survivors invited after identification from angiographic archives and happy to support our research initiative. We will then investigate the underlying cause of this condition. The work has the potential, to improve our understanding of these conditions and to identify targets for preventative therapies.

  • Margaret Temple

    Dr Elvira Bramon MBBS PhD & Dr Johan Hilge Thygesen PhD MSc, University College London

    Investigating rare genetic variants that increase schizophrenia risk and their influence on brain function and structure

    Psychotic disorders including schizophrenia and bipolar disorder affect about 4% of the population. They emerge as a result of environmental and genetic risk factors. Genetic variants have recently been identified which are rare (found only in about 1 in every 100 people), but increase the risk of developing schizophrenia between 2 and 30 times.

    In our research we aim to

    1. identify carriers of high-risk genetic variants in a sample of families
    2. investigate the effects of these genetic variants on brain structure and function
    3. explore why some carriers develop schizophrenia, some develop different brain disorders, while many carriers remain well.

    In order to do this we have recruited 14,000 participants and have examined their DNA, collected brain scans, electroencephalograms, psychological and clinical assessments. We will now use this information to identify high risk variants amongst this sample and investigate the function of these variants in increasing the risk of schizophrenia.

    Most studies compare cases versus controls, but the family design in this research project means that we can examine rare genetic factors, and to do a combined analysis across multiple countries.

    A better understanding of the genetics of schizophrenia is crucial to develop new treatments.

  • TP Gunton

    Dr Cristina Renzi MD SPHM MSc, University College London

    Reducing emergency diagnosis of gastro-intestinal cancers: a longitudinal data-linkage study

    Cancer survival in the UK is lower than in other European countries. As many as 1 in 4 colorectal cancers, 1 in 3 gastric cancers and 1 in 5 oesophageal cancers are diagnosed following an emergency presentation. Emergency presenters have particularly poor survival. Reducing emergency diagnoses is a key public health target considering the number of affected patients, their poor cancer outcomes and the still unresolved socio-economic inequalities.

    The aim of this study is to identify opportunities for reducing emergency diagnoses and provide population-based evidence that can inform interventions for diagnosing cancer earlier and improve cancer outcomes. Our study will include approximately 10,000 colorectal and 4,000 oesophago-gastric cancers diagnosed in England.

    We will examine clinical events during the pre-diagnostic period using cancer registration data linked to anonymised primary care and hospital care records. We will take patients' socio-demographic and clinical characteristics into account.

    This research will provide evidence to inform the development of public health policies and interventions aimed at reducing emergency presentations. This will be useful for improving patient experience, quality of care and cancer survival.

    The project is a collaboration between University College London, the London School of Hygiene and Tropical Medicine and the University of Exeter.

  • James Trust

    Prof Peter Bradding BM DM FRCP, University of Leicester

    Ion channel regulation of type-2 innate lymphoid cell (ILC2) biology

    Asthma is a common disease affecting 5 million people in the UK. In 10% of patients it is poorly controlled with current therapies. New approaches to treatment are therefore required.

    A type of white blood cell called an ILC2 cell has been discovered recently, and these cells are thought to be important for the development of asthma, as well as day-to-day symptoms and exacerbations (attacks). Inhibiting the function of these cells might offer a new and more effective way of treating asthma.

    For cells to work normally, they need to move ions such as calcium (Ca2+) and potassium (K+) in and out of the cell. This process is controlled by proteins in the cell membrane called ion channels. Many drugs used today in medicine work by blocking ion channels. We believe that blocking ion channels in ILC2 cells may be a very effective way of inhibiting their activities that drive asthma.

    The aim of this work is to spend 12 months identifying the ion channels present in human ILC2 cells and the effects of blocking these channels on ILC2 function. This research has the potential to lead to new treatments for asthma within 10 years.  

  • The Scholarship Grant

    Dr Andrea Goddard MB BS MSc FRCPCH, Imperial College Healthcare NHS Trust

    Meeting the needs of children and their carers following sexual abuse: evaluating experience and outcomes associated with a new model of service delivery

    The Havens are specialist centres in London for all those, including children, who have been sexually assaulted and abused. They provide acute medical and psychological care, advocacy and support for victims and help with obtaining evidence for police investigations. An enhanced Havens service for children and young people (CYPHavens) opened in May 2016. 

    The views of sexually-abused children and their carers are essential to inform and shape the design of services aimed at helping and supporting them. However there is very little information about how children feel about the care they get in services like CYPHavens.

    This project will investigate the extent to which children and carers feel able to access, use and engage with the new Havens service model and other services offered, and which features of the service provision enhance or hinder these ends.  Research in this area will help us understand how to better meet the needs of sexually abused children.

  • Vera Down

    Dr Benedict Daniel Michael MBChB (Hons) MRCP PhD, University of Liverpool

    Identifying immunomodulatory targets to reduce leucocyte infiltration in viral encephalitis

    Encephalitis is a devastating disease of brain swelling, characterised by migration of white blood cells (WBCs) into the brain, most commonly due to the cold sore virus. Even with the use of current drug treatment, up to 30% of patients die and most survivors have significant brain-injury.

    During my PhD I identified specific inflammatory proteins that were associated with coma and death amongst patients with encephalitis. These proteins were found to be related to the regulation of interleukin-1 and leakiness of the blood-brain barrier, which is responsible for the migration of WBCs entering the brain.

    The Vera Down grant will make it possible to build on these findings and to interrogate them in a scientific model. The proposed study will use fluorescent white blood cells to identify key inflammation proteins, and visualise the attraction of these cells within blood vessels and into the brain in real-time.  Establishing this will mean that we can test blocking these inflammation proteins to reduce white blood cell migration into the brain and ultimately improve patient outcome.