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Image of the week: ‘ferning’ saliva

31 Oct, 2014

B0008610 Human saliva displaying ferning

The beautiful branching structure of these crystal formations may remind you of minature ferns. If so, you aren’t alone – our image this week depicts of a phenomenon known as “ferning”!  What you are looking at here is a microscope image of human saliva.

The ferning pattern of crystallization is used to identify when a woman is at their most fertile period in the menstrual cycle. The oestrogen spike during a woman’s most fertile period causes salt crystals to form in her saliva, creating this pattern when magnified.

Although studies suggest that the reliability of this as a measure of ovulation is relatively weak, research  has begun to investigate specific substances found in saliva during ovulation, creating potential for a non-invasive diagnostic marker for ovulation. Knowing when ovulation occurs is important in IVF and other fertility treatments, but the best methods currently involve taking blood or ultrasounds.

Saliva ferning has also been investigated as a way of diagnosing a condition called Sjögren’s Syndrome (SS). SS is an autoimmune disease in which tear and salivary glands are attacked by white blood cells. A ferning pattern in tears or saliva may be an indicator of damage to the glands producing them.

Image credit: Anne Weston, LRI, CRUK, Wellcome Images

Wellcome Images is one of the world’s richest and most unusual collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. Over 100,000 high resolution images from our historical collections are now free to use under the Creative Commons-Attribution only (CC-BY) licence.

Facts Not Fear: Will we find a cure?

30 Oct, 2014

B0009935 Ebola virus structure, illustration

In the last of our “Facts Not Fear” Ebola Q&A posts we focus on the research being done to find effective vaccines and treatments for Ebola. The Wellcome Trust has partnered with a number of organisations to fund vaccine safety trials, research potential therapies, and we initiated a fast-tracked funding scheme for public health research in this area.

This post aims to help answer some of the frequently asked questions about the work being done, and how long it might take to move from positive research results to delivery of vaccinations or treatments to those who need them most.

Who is most at risk of contracting Ebola?

Currently front-line workers in the West African countries affected by Ebola – for example those treating or caring for patients, burial workers, cleaners – are most at risk of contracting Ebola. Next most at risk are other people in these affected countries who have close contact with patients. The risk to the general population in places like the UK is very limited.

Is there a cure for Ebola?

At the moment there is no cure for Ebola. The treatment that is currently available includes supportive care such as fluid management, antipyretics (medication that reduces fever), analgesics (painkillers) and anti-emetics (drugs against vomiting and nausea)

What’s the difference between a vaccination and a therapy/treatment?

Vaccines aim to provide protection to healthy people at risk of contracting the disease, whereas therapies aim to treat those who have already contracted the disease.

We heard about experimental treatments like ZMapp – what are they and why are we not using them on more people?

ZMapp is an investigational drug that comprises three antibodies that target a surface protein of the Ebola virus. There is some evidence that the drug can be effective in animal models, however, there is no clear evidence that the treatment works in humans. Although ZMapp was used compassionately in a few sick healthcare workers, it has not yet been tested in any clinical trials to determine its true effectiveness.

Before potential treatments can be rolled out to everyone they need to be adequately tested for their safety and efficacy. This requires safety trials in healthy volunteers first, followed by efficacy trials in volunteers with Ebola disease. There are some potential drugs that have already been tested in humans for other diseases but have not been tried till now to see if they work against Ebola. Such drugs can go straight into efficacy trials.

In order to do these trials you need sufficient doses, and currently ZMapp doses have been depleted. As ZMapp is made in tobacco plants the whole process can take as long as six months to grow. Researchers are working hard to scale up production and to investigate alternative quicker non-plant mechanisms to make the drug, but this is not a simple task. There are supplies of other candidate drugs which may be deployed.

We hear that lots of research is being funded – when will we get results/a treatment that we can use?

The scientific community is working hard with the pharmaceutical industry, governments, civil society, philanthropic foundations and the WHO to fast-track research into potential treatments and vaccines.

Currently vaccine safety trials are being conducted in healthy volunteers in Europe, USA and Africa. If there are no safety issues the next step will be to carry out trials to test their efficacy in at risk volunteers in the affected countries. There is hope that these could start as early as December 2014, but even then clear results may not be available for several months.

It is really important that we move fast, but we also have to move safely. We also have to accept the reality that new drugs and vaccines will need to be tested in the three most affected countries, but their health resources are stretched to the limit and beyond, so it is not going to be easy for trials to be conducted against this background.

 

Read our previous “Facts not Fear” posts to find out why this outbreak has been so hard to control and what needs to be done to stop the spread of Ebola. Visit the Wellcome Trust news pages to find out what the Trust has been doing to help fund Ebola research.

Image: Ebola virus structure, illustration Credit: Maurizio De Angelis, Wellcome Images

Facts not Fear: How do we get the Ebola outbreak under control?

29 Oct, 2014

 

B0009934 Ebola virus structure, illustration

In the second of our “Facts not Fear” posts we ask the experts at the Wellcome Trust about the way the current Ebola outbreak is affecting people and explore some of the options for getting the epidemic under control.

What effect is the Ebola outbreak having on West Africa?

It is having a devastating impact on the whole of the region, and it’s not limited to those infected with Ebola. Malaria will be worse this year, childbirth facilities and schools are closed, and vaccinations of children are not happening in West Africa as well as they would normally. Economies just starting to recover have been dealt a cruel blow with long term consequences and trust will have been eroded between communities and authorities.

These issues are concerning, but we have to have a calm, sensible approach and not panic. We can deal with these issues as long as we retain a sense of proportion and work together. Outside of Liberia, Guinea and Sierra Leone, the spread of Ebola has so far been contained. But we must act now. We have been too slow. The longer we allow this epidemic to continue the harder it will be to eventually control, more lives will be lost, more children left as orphans, the costs will grow and we run the risk of the disease becoming endemic or spreading beyond the region.

What steps have been taken to keep the neighbouring countries safe? Are they prepared to deal with isolated incidents?

They have been preparing for this now for some time. Nigeria was able to control it very efficiently, and Ebola is not present in Nigeria today. The same in Senegal, but all the countries in the region have fragile health systems, and all remain at risk until we bring the epidemic to a complete end.

Preparation across the whole of West Africa is critical, but the best way of protecting it is to focus on the three countries affected, and bring the epidemic to an end in those countries. That will help them, the region and the rest of the world.

Is closing borders an effective way of stopping the spread of Ebola?

Closing borders is not a practical way to control the epidemic. In today’s modern world transport and movement of people and goods occurs at an ever-increasing rate. Few countries are self-sufficient or could manage with closed borders for even a few weeks.

Travel bans are not necessary from an epidemiological perspective and could make matters worse, they will lead to food shortages and block critical aid reaching the affected people, will instill even greater fear that could lead to uncontrolled migration and further spread of the disease.

What about screening at airports? Is that an efficient way to stop Ebola and other infectious diseases spreading?

Every infection is different and for some infections fevers are a good marker of whether someone might be infectious, but for many infectious diseases you can pass it on to someone else before you have a temperature.  With Ebola you are very unlikely to be able to pass the infection on before you have symptoms.

Screening at airports upon entry to a country is not very efficient. It may identify a small number of people and it will increase awareness – making people think twice before they fly if they have a fever – and allow information to be passed on to people (for instance access to clinical care, what to do if they develop a fever, etc) but it won’t solve the problem in itself.

Most people with a fever will not have Ebola and most fevers are minor and cause absolutely no problems. Introducing routine blanket screening for fevers across all airports in the world will increase the level of public fear while only identifying a very small number of cases if any. Screening for a fever at departure from the region and advising home monitoring for fever over the next three weeks does make sense.

What’s the mortality rate for Ebola in this outbreak?

In the current outbreak it is estimated that 70% of those infected by Ebola will die. That is 7 in every 10 people.

Would access to better healthcare reduce the death rate from Ebola in West Africa?

There is no doubt that the current death rate could be lower if the level of healthcare that we are lucky enough to have in developed countries was available.

The death rate in the UK would be significantly lower than it is in West Africa, but Ebola is an incredibly nasty infection and even in London or New York or Geneva, the death rate would still be high just because of how terrible the infection can be. We don’t have a specific treatment for it at the moment, but research is being done to develop one.  Although we don’t have a ‘drug for Ebola’ very good clinical care will reduce the death rate.

In the UK we are lucky to live in a country where healthcare is available and provided free through the NHS. If you compare our situation to the events in West Africa, the fragile nature of their health systems is one of the major contributing reasons for the epidemic.

How close are we to an effective pharmaceutical tool to fight Ebola?

We’re getting much closer, but we don’t know in fact whether ZMAPP works or how effective it might be, although initial reports look encouraging. Convalescent serum (using antibodies from the blood of people who’ve survived Ebola) might offer the best potential treatment for Ebola in the short term that could be scaled up if proven effective.

We need to collaborate, share all information and move quickly on this and other potential treatments, do research to make sure they’re safe, and we need to learn which ones are really effective.

Does the military have a role to play in stemming this outbreak of Ebola – or will their presence just create more fear about it?

It’s a very delicate balance, but when you start to plan logistics, particularly the organisation of getting large amounts of supplies to an area quickly, building hospitals and clinics, delivering aid or vaccines to remote areas when roads are washed away by the rainy season, there comes a point when the essential logistical support needed can only be provided by the military.

What we mustn’t have is military-style responses in terms of guns on the streets. Violence and coercion are not the way to deliver healthcare, but the military could be incredibly helpful in this epidemic to support the critical work done by organisations like MSF, Oxfam, Save the Children and the very brave healthcare workers who are on the front line.

Can we get this outbreak under control?

Yes. If the global community comes together and implements all of the various things we have all committed to; e.g. massive increase in clinical facilities, public health, diagnostics, drugs and vaccines, then this epidemic can be brought under control.

However we do need to bring all of that together in a coordinated way with clear leadership, and for the international community to live up to the promises that have been made. And we need to do that quickly. If we don’t do that, then the epidemic will continue to increase, it could become endemic, and it could spread beyond the three countries currently affected.

What are the key priorities for getting this Ebola outbreak under control?

The international community needs to work together. We need to call upon our governments to work in partnership with the affected countries and mobilise as many resources as possible to provide support. This could include support for public health workers to take leave and volunteer in the affected areas.

Infrastructure is needed on the ground in the affected countries – from beds and protective equipment to soap, chlorine, clean water, and electric generators. Increasing public health infection control measures is key to bringing the outbreak under control, but given the scale of the current outbreak, developing effective vaccines and drugs may also now be essential. Developing a treatment option for those who do get infected will hopefully save lives and will also help increase public trust and may encourage people to seek medical help earlier. This would have a major impact on the epidemic. There will inevitably be future Ebola epidemics and we need to be better prepared for those events.

Is there anything that individuals can do to help?

Yes, there is a huge amount of things we can all do, for example supporting what MSF, Oxfam, Save the Children and others are doing in West Africa, all of that is an enormous help and it’s a fantastic thing to do. The Disasters Emergency Committee launched an Ebola crisis appeal today to raise money to help get this outbreak under control. The UK Government will match the first £5 million donated.

But there are also other ways the situation can be helped – for example encouraging politicians and your MPs to appreciate how serious the situation is. We should also all be responsible about the way we discuss Ebola as a society. For example, there is no need for schools to ban students who have been in a completely different and unaffected part of Africa.

You can read our previous “Facts not Fear” post to find out why this outbreak has been so hard to control. Visit the Wellcome Trust news pages to find out what the Trust has been doing to help fund Ebola research.

Image: Ebola virus structure, illustration Credit: Maurizio De Angelis, Wellcome Images

An INDEPTH Look at Mortality Data

29 Oct, 2014

Screen Shot 2014-10-28 at 16.09.21

 

The INDEPTH network has today released a massive amount of information about cause of death from countries in Africa and Asia. Up until now such information was patchy, limited to single sites and often the underlying data were not available for investigation by other scientists. The head of Population Health at the Wellcome Trust, Jimmy Whitworth, explains why this release is so important and how it will change the way we approach research and policy on child death in low- and middle- income countries.

It is astonishing to find that in the 21st century there are still multitudes of people whose entire lives go officially unnoticed.

In sub-Saharan Africa, it is only in South Africa that there is comprehensive recording of births and deaths. Elsewhere on the continent populations are just estimates based on censuses that happen about every ten years.

Amongst other things, this situation is unsatisfactory for planners and policy makers. It is also a problem for those tasked with organising health systems and services, and those trying to report on the numbers (let alone the causes) of diseases and deaths. As a result most health reports from low- and middle-income countries are based on modelling projections rather than actual events.

One solution to this problem has been to set up long-term Demographic and Health Surveillance Sites (DHSS) where the whole population of a defined area can be observed. Typically survey teams will move from house to house once, or more often, each year recording births, marriages, migration, deaths and collecting health information from the inhabitants.

Indonesia VA pixellated

Dozens of these DHSS exist around the world and they are an invaluable source of information for national policy makers and planners. The value and validity of the information generated can be strengthened by collecting data to a common standard across many sites and comparing and contrasting the findings. For over a decade the Wellcome Trust has supported INDEPTH, a network of DHSS with a secretariat based in Ghana, which has recorded and analysed  cause of death data from sites across Africa and Asia.

Much of this work has been based on the development of computer-based methods to capture and combine information from different reporting systems at individual sites. Data covers a range of common causes of death such as malaria, HIV/AIDS, maternal deaths, communicable disease, and external causes such as accidental death, suicide and murder. One of the important datasets looks at childhood mortality, capturing information on over 28,000 child deaths.

The results show a wide range of infant and child mortality rates across the sites and also show a variety of patterns of causes of deaths. There are some key conclusions that can be drawn from the results.

Malaria is still a major cause of death for children in most of sub-Saharan Africa, especially in West Africa. HIV is a major cause of death of children in South Africa, while external causes, mostly drownings, are common in Bangladesh.

Some countries have several sites reporting in this study, and they often show varied patterns, demonstrating that the findings from one DHSS cannot necessarily be taken as representative of a whole country.

The causes of death were ascribed following a standardised set of questions administered by trained staff to close relatives of the deceased child. This technique, called ‘verbal autopsy’, has been shown to be reliable for identifying many broad causes of death, but it does have its limitations – reflected in the large proportion of ‘indeterminate’ deaths reported at some sites.

In line with Wellcome Trust policy, all of the information, including the individual data records, is being made openly accessible to anybody wishing to study the datasets further. This vast repository of rich information will be invaluable to population scientists, health planners and policy makers, especially those in low- and middle-income countries.

We would like to extend our congratulations to INDEPTH and the scientists at the individual sites are on their tremendous achievements so far.

You can find out more about INDEPTH in this press release and access all the available data via the INDEPTH iShare project website. The journal Global Health Action has just published a special issue which looks at the INDEPTH findings in more detail.

Image credit: INDEPTH network/Peter Byass

 

 

 

Ebola: Facts Not Fear

28 Oct, 2014

B0009931 Ebola virus structure, illustration

The latest WHO figures put the current death toll of the on-going Ebola outbreak at almost 5000, with over 10,000 cases reported in eight countries, mainly those in West Africa.

In a series of three posts this week we will be answering some of the most important and frequently asked questions on Ebola. Experts at the Wellcome Trust, including our director, infectious disease specialist Dr Jeremy Farrar, head of population health Dr Jimmy Whitworth, and international activities advisor Dr Marta Tufet, will help to provide answers.

There has been heightened media attention devoted to the Ebola outbreak in recent weeks, and many people are concerned about the epidemic. We would like to concentrate on facts, not fear, by sharing information from people working to help bring this epidemic under control.

In this first post, we look at the current situation and explore why this outbreak is worse than previous ones. Tomorrow we will look at the effects of the outbreak and what needs to be done to get the situation under control, and on Thursday we’ll focus on the research currently underway to help find a vaccine or treatment for the disease. We hope that you will find the Q&A format and the information of use.

Is Ebola really the deadliest disease known?

Ebola is certainly up there amongst the deadliest diseases, with up to 7 in 10 people who get infected dying. But other diseases, such as rabies, are almost 100% fatal and so even deadlier.

Is it true that Ebola is more infectious than AIDS (as US Senator Rand Paul claimed)?

Ebola is more infectious than HIV/AIDS, mainly because it can be spread by more routes. Any secretions from a person infected with Ebola, alive or dead, can be infectious. This is unlike HIV/AIDS, which can only be spread by sexual contact, infected needles or blood products, or from a mother to an infant.

How late in the stage of having Ebola do you become contagious? From the moment you catch it or only in the very late stages? 

Ebola only becomes contagious once a person develops signs of illness, such as fever, muscle aches and sore throat. This normally doesn’t occur until several days after a person has become infected. This allows time for health authorities to find people incubating the disease and isolate them.

People who might have been exposed to a person with Ebola should report to the health authorities as soon as possible, and immediately if they develop any signs of infection.

What level of contact do you have to have with the bodily fluids of an infected person in order to contract it? In short: how vigorously would I have to wash up my cups if someone who has Ebola came to tea?

Nobody with any signs of Ebola is going to be well enough to come for tea with you. If they are infected but still incubating the disease, with no signs of illness, they will not be contagious. So a quick rinse with hot water and washing up liquid will be fine.

Is there a danger of getting infected by pets? (In light of the Spanish nurse’s dog that got put down) 

Pet animals are a minimal hazard. There is no reason to believe that they spread Ebola. Even the pets of infected people can be managed by giving them a wash and putting them in quarantine for 21 days just to be on the safe side.

Why is this Ebola outbreak so much worse than previous outbreaks?

This outbreak is bigger than all other outbreaks put together. Transmission of this infection in major cities is what’s different compared to previous epidemics. It’s in urban areas as well as rural areas, and that’s what’s allowed the disease to spread more widely. The concentration of infected people living in very big urban centres is a key reason this epidemic has been so hard to control.

In addition, weak health systems are more likely to blame than unprecedented virulence or a different form of transmission. Two of the countries involved have been weakened by prior years of war.

Why is Ebola so hard to control? 

An outbreak of Ebola is not hard to control if it is caught early. If cases are detected, diagnosed and managed correctly, and contacts are identified and isolated, then it can be quickly controlled. In urban, crowded areas where people are more mobile and have a larger number of contacts this becomes much more challenging.

In Senegal and Nigeria, authorities acted quickly and decisively to the first cases detected and managed to control the spread of Ebola very rapidly. This is what would happen in the UK if any cases were to occur, as our public health services are alert and prepared. It is only once an outbreak has been allowed to spiral out of control and many cases are occurring in several different places that it becomes hard to control.

In addition, there are currently no drugs or vaccines on the market that are effective to treat Ebola, although these are in development.

Should we be worried about the way that this outbreak of Ebola is progressing?

We should be concerned about the situation in West Africa – the impact Ebola is having on the health of the people and on their societies. This is where all our focus must be.

The current risks to Europe are minimal, and if the international community, including ourselves, all act on the commitments we have made, this epidemic can be brought under control.

Do you think that this particular strain of Ebola has mutated to be more infectious than previous outbreaks?

There’s no evidence that this virus is mutating at a faster rate than previous epidemics. But this particular virus does get to higher levels in the body than we’ve seen previously, and that may contribute to how infectious it is.

Will the Ebola virus mutate so it can spread via air?

The way the virus is spreading is consistent with what we’ve seen in all previous 25 outbreaks, only transmitting through blood and bodily secretions. There is no precedent for a virus changing its mode of transmission so drastically. Other viruses such as HIV – which transmit in similar ways, have passed through millions of humans, and are known to mutate more than Ebola – have not become airborne.

The chances of Ebola becoming airborne are extremely small. It’s important that we retain a sense of proportion and not exaggerate the risks for it changing and becoming airborne – there is already enough fear and misinformation surrounding this epidemic.

Rather than causing people to panic, we need to focus our efforts on trying to stop this outbreak before Ebola establishes itself in West African countries.

You can find out more about the Wellcome Trust funding for Ebola research on our website.

Image Credit: Ebola virus structure, visualisatoin – Maurizio De Angelis, Wellcome Images

Empowering UK Universities to Support Their Researchers

28 Oct, 2014

The Wellcome Trust has a wide range of funding schemes for researchers and institutions, but we’re also keen to allow universities to define their own priorities and ensure that they are able to support their researchers in a timely manner. The Wellcome Trust’s Institutional Strategic Support Fund (ISSF) is there to do just that, and today we have announced the 25 universities to receive funding from the scheme…

Unlike other Wellcome Trust funding schemes, universities that receive ISSF awards have the freedom to decide how best to spend the grant to support activities at their institutions. They might use the funds to support cross-disciplinary working, promote innovation, accelerate the clinical application of research, support early career researchers or facilitate public engagement – wherever the university judges there to be an opportunity.

As a result, many universities use the ISSF to support multiple activities.  Bristol University has used its award to establish the Elizabeth Blackwell Institute which funds fellowships, project support for basic, translational and collaborative research and public engagement activities.

Today we have announced the 25 universities in the UK who have received grants in this round of funding from the Institutional Strategic Support Fund (ISSF).

As this graphic illustrates, the awards are spread across the country at some of the UK’s most research-intensive universities. This is the second time that the ISSF has been awarded, and this year five universities will receive ISSF funding for the first time.

ISSF map

Birkbeck, University of London, is one of the universities receiving an ISSF award for the first time this year. They are using the money to develop a co-ordinated public engagement strategy, support early career researchers, and support interdisciplinary conferences and inter-institutional collaborations.

At the University of Glasgow, ISSF funding has already been used to underpin the work of the Glasgow Polyomics facility (led by Professor Mike Barrett), which specialises in the collection, analysis and integration of biological datasets.

Universities have the flexibility of choosing how best to spend the money to support the work of their researchers, and they are also required to match the amount they receive to increase the fund available for developing their research strategies.

Wellcome Trust Director Jeremy Farrar recognises the importance of allowing universities to choose how to direct the funding. “Having spent the last year listening to universities across the UK I know that the Institutional Strategic Support Fund is one of our most valued schemes.

“The scheme is distinctive because it allows universities themselves to identify where money can be most usefully spent in pursuit of their and our strategic objectives, ranging from supporting the early careers of researchers to focusing on resources needed to develop really excellent public engagement or investment in cutting-edge research.”

To find out more about the ISSF scheme and who to contact about funding at your university, visit the ISSF page on the Wellcome Trust website.

Wellcome Trust Research Round-Up: 27.10.14

27 Oct, 2014

Our fortnightly round-up of research news from the Wellcome Trust community…

Treating diabetes with light-activated drugs

A new method of treating type 2 diabetes has been developed by researchers at Imperial College London and LMU Munich. They have adapted currently used drugs so that they can be selectively activated using blue light. The hope is that this technique will improve treatment of diabetes by having fewer side effects than current treatments.

Dr David Hodson, one of the principal investigators on the project, said: “In principle, this type of therapy will give patients better control over their blood sugar because they can switch it on for a short time when it’s needed after a meal. It should also reduce complications by targeting drug activity to where it’s required in the pancreas”

Drugs called sulfonylureas stimulate the pancreas to produce more insulin and are widely prescribed to treat type 2 diabetes. However they can cause organ damage or stimulate too much insulin production, leading to serious drops in blood sugar levels. To avoid this, the team including Dr Hodson, Professor Guy Rutter, Professor Dirk Trauner and Johannes Broichhagen adapted this drug type to change shape when exposed to blue light.

The study, supported by the Wellcome Trust, was recently published in Nature Communications. It describes the adapted drug, named JB253 which is inactive until it is switched on using blue LEDs stuck to the skin, and switched off again in the absence of blue light.

Initial tests found that JB253 successfully stimulates insulin release from pancreatic cells in the lab. The next step is for tests on animals and clinical trials. If both of these stages are successful then it is hoped that the drug could be available within 10 years.

New drug could provide step forward in treating norovirus

Scientists funded by the Wellcome Trust have found that an experimental drug reduces, and in some cases eliminates, norovirus in mice.

B0009541 Norovirus, illustrationThe drug, favipiravir, is currently being trialled in treatment of Ebola and Influenza. The research by Professor Ian Goodfellow and his team, published the journal eLife, found that it reduces the amount of norovirus found in mouse tissue and faeces, which may help in reducing the severity of the disease and onward transmission.

“Norovirus is an unpleasant bug that spreads quickly,” says Prof Goodfellow, a Wellcome Trust Senior Fellow. “Most of us will have experienced it at some point and will know that the only option is to ride out an infection, drinking plenty of fluids. But some patients get infections that can last months or years, and this has a real impact on their quality of life.

“The ease with which infections spread, particularly in places such as hospitals, schools and cruise ships, and the potentially serious health problems norovirus can cause people with weakened immune systems means that we desperately need a way to treat infection.”

The University of Cambridge team has found that the drug works by causing errors in the virus’s genetic information which build up as the virus replicates – known as lethal mutagenesis. These errors make the virus unable to function properly and prevent further spread of the virus.

This is one of the first demonstrations of this method successfully fighting viruses in their natural hosts and suggests that it may be possible to tackle other viruses in the same way.

Skin cancer cells may spread through body by following molecular trail

Scientists at the Cancer Research UK Beatson Institute in Glasgow have found that a molecule directs the movement of melanoma cells, which are responsible for the most serious form of skin cancer.

B0003294 Human melanoma cell dividingThe study, published in PLOS Biology and supported by the Wellcome Trust, found the molecule lysophosphatidic acid (LPA) is used as a signal that gives melanoma cells the “green light” to travel around the body.

The researchers found that in cancer cell lines and in mice that tumour cells first break down nearby sources of LPA molecules. Once these levels of LPA are depleted, the cells then move out of the tumour in search of more. This creates a trail leading to the bloodstream and onto a new site in the body.

Lead author, Professor Robert Insall said: “The next step will be to find how the melanoma cells break down the LPA molecules to see if this sparks ideas for new ways to stop the cancer from spreading. At the moment our research is still in early stages but we hope this could help doctors to make sure this cancer doesn’t spread.”

Over 13,000 people are diagnosed with melanoma every year in the UK. Each year, around 2,200 people die from the disease.

In other news…

Congratulations to Wellcome Trust Senior Research Fellow Vikram Patel from the London School of Hygiene and Tropical Medicine who has been awarded the Institute of Medicine’s prestigious Sarnat Prize for his research on global mental health. Professor Patel, produced epidemiological studies which linked mental health issues to poverty, and also demonstrated the potential for realistically treating these conditions in low and middle income countries using evidence based methods.

Virologist Paul Kellam from the Wellcome Trust Sanger Institute has collaborated with playwright Sarah Woods to create a five-part radio drama My Life with Flu airing on BBC Radio 4. The show developed from a workshop held by the Wellcome Trust and BBC, where Paul and his PhD student met Sarah. Tune in to BBC Radio 4 on October 27th at 10:45 to catch the first show.

The 2014 MQ Fellows have been announced – with over £900,000 to support four early career research fellows who will be carrying out cutting-edge, innovative mental health research. Their projects address some of the major questions we face in mental health, exploring new ways to understand, treat and prevent mental illness. The 2014 MQ Fellows are: Dr Jeremiah Cohen, neuroscientist based at The Johns Hopkins University School of Medicine, building a ‘map’ of serotonin to improve our understanding of the biology of mood, Dr Helen Fisher, interdisciplinary scientist from King’s College London exploring the biological, psychological and social aspects of adverse childhood experiences to understand the development and trajectory of psychotic symptoms in childhood, and Dr Sergiu Pasca, biologist based at Stanford University is generating in a dish live human neurons from patients with schizophrenia to gain insights into how schizophrenia develops and to identify new therapeutic targets and Dr Andrea Reinecke, an Oxford University clinical psychologist developing an innovative, effective, single-session Cognitive Behavioural Therapy treatment for anxiety disorders.

Image credits: Diabetes drug graphic – Imperial College London, Norovirus illustration – Anna Tanczos, Wellcome Images, Human melanoma cell dividing – Paul J.Smith &Rachel Errington, Wellcome Images

Image of the Week: Science Makes You Happy

24 Oct, 2014

science makes you happy (Pharrell Williams) from KEMRI WELLCOME TRUST RES. PRO on Vimeo.

This week we’re taking a departure from our usual static image of the week to bring you a moving image of happiness!

As part of the 25th anniversary celebrations of the KEMRI-Wellcome Research Programme in Kenya, the team wanted to express their happiness. What better way to do that than by joining in the craze of creating videos to accompany Pharrell’s upbeat track “Happy”?

“It was quite a task getting guys to loosen up” says KEMRI-Wellcome’s Cynthia Mauncho, “but because it included all the programme staff we approached it in a fun easy-going way and the results are fantastic”. (We agree!)

The 25th anniversary celebrations are in full flow today and Kenya’s President, Uhuru Kenyatta, will be joining in the festivities and touring the labs at the centre. There is an exhibition telling the story KEMRI-Wellcome’s history and the new Mbuyuni Training Complex will be officially opened.

We’d like to take this opportunity to congratulate you on 25 years of excellent research that has led to 75 PhDs, changed policy and helped improve health in Africa. Here’s to a very happy future!

Celebrating 25 Years of the KEMRI-Wellcome Trust Research Programme

23 Oct, 2014

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The KEMRI Wellcome Trust Research Programme (KWTRP) in Kenya began life in a single building beside the county hospital in Kilifi. 25 years on, this thriving research centre has a string of research breakthroughs under its belt, and is home to an international team of researchers working to improve health in Africa. Professor Kevin Marsh directed the programme from its inception in 1989, until August of this year. He shares some of KWTRP’s success stories and his memories of the past 25 years…

It’s an exciting time for science in Kenya – not only is it the 25th anniversary of the creation of the KWTRP, but this year is also the 50th anniversary of the partnership between the Wellcome Trust and the Government of Kenya to support health research in the country.

There is a real sense of pride in the programme’s achievements, so we’ve been marking this anniversary year with a whole series of events. Many of our celebrations have been based in the communities around Kilifi on the Kenyan coast, where the programme is headquartered.

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The programme is a partnership between the Kenya Medical Research Institute (KEMRI), which is the national body with a responsibility for heath research, Oxford University and the Wellcome Trust.

When we began there were around a dozen of us working on a single project trying to understand what led to some children developing life-threatening malaria. Now KWTRP is an internationally recognised multidisciplinary programme employing around 800 people tackling the biggest issues in health that are facing Kenya and many other African countries.

KEMRIPICAlthough headquartered in Kilifi, several of the programme’s major groups are located in Nairobi, Kenya’s capital. They have made major contributions in areas such as health systems research, including a programme of work with the Ministry of health to improve the management of children in hospital across Kenya, and large-scale mapping of the malaria burden across Africa, which is used by governments and international bodies in planning and monitoring the battle against malaria.

I am often asked what’s the most important work we have done? It’s an impossible question to answer given the sheer breadth of disciplines involved. But we are all proud that much of the work – from landmark studies on impregnated bed nets and work on new vaccines, through large scale studies on the management of sick children – has had direct impacts on national and international policy and guidelines, and contributed to improving the lives of millions of children.

Perhaps the thing that has given me most personal satisfaction has been our role in supporting the development of Kenyan science and scientific leadership, with many of the programme’s alumni going on to important leadership positions in other centres in Kenya and elsewhere.

On a personal level I am excited to be returning to the programme for the celebrations – even though it’s only been two months since I left! That time has already allowed me a bit of distance to look back over the last 25 years.

Kemri before and afterLooking at the purpose-built KEMRI centre now with its state-of-the-art laboratories and support facilities, it’s amazing to think that in 1989, programme researchers were housed in a single dilapidated building in the grounds of Kilifi County hospital. Importantly, the close relationship with the hospital still remains with many programme researchers actively involved in patient care.

People often ask me what the key to our success has been. The question makes me nervous as I suspect many of the things that look planned in life have had a large element of plain good luck, but the one thing that is absolutely clear is the importance of people.

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We have been incredibly fortunate to have a wonderful group of colleagues – some of whom were there from the start, others joined later – but all of whom have made the programme what it is.

It’s because of the great team at KWTRP that I am sure the programme will continue to go from strength to strength – I’m already looking forward to my invite to the 50th anniversary celebrations in 2039!

KEMRI-Wellcome’s celebrations come to a climax this week with a two day scientific meeting, followed by a day of celebration including the opening of a new training building. There will also be exhibitions of the programme’s work that will be attended by many guests from within Kenya and around the world. For more information see http://www.kemri-wellcome.org/

Wellcome Trust Science Writing Prize 2014: The winners are…

22 Oct, 2014

 

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The winners of the fourth Wellcome Trust Science Writing Prize were announced this evening at a ceremony held at Wellcome Trust HQ in London. With over 600 entries to choose from, picking a single winner in each category was no simple task…

IMG_0959“Communicating with the public in getting their insight into the work you do can help inform your research questions,” says Wellcome Trust Director Jeremy Farrar. That’s one of the reasons it is so important for us to nurture the next generation of science writers and encourage scientists to think about ways of communicating their work.

The Wellcome Trust science writing prize, run in conjunction with the Guardian and the Observer, is an opportunity for aspiring science communicators to write about research that inspires them, and we’re always delighted with the high quality and number of entries that we receive.

Split into two categories – professional scientists (postgraduate and above) and non-professionals (including undergraduates) – the entries are read by over 40 representatives from the Wellcome Trust, the Guardian and the Observer before a final shortlist is selected by a judging panel, this year headed up by materials scientist and broadcaster Mark Miodownik.

Competition is stiff, so we congratulate all of those who earned a place on the shortlist. Pushed to make a decision, after a passionate, four hour long meeting, the judges picked Richard Stephens and Kate Széll as this year’s winners.
SWP2014 winners

Richard’s piece on smiling – ‘Don’t say cheese, say cheeks’ – earned him the crown (okay, trophy!) in the professional scientists category, while Kate’s article on facial blindness ‘Prosopagnosia – a common problem, commonly overlooked’ the winner of the non-professional and undergraduate category. Commenting on Kate’s piece, Presenter Mark Miodownik said that the judges were amazed it could be true. “We were quite bamboozled by it, but we fact checked it all and it checked out” he said.

Both winners were presented with prize money of £1,000 and their articles will appear in full in the Guardian/the Observer and on the Wellcome Trust blog in the coming weeks.

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Science and health stories are on the front pages on a daily basis with the continuing Ebola outbreak in West Africa, and there is a continuing need for people who are able to accurately and engagingly explain scientific issues. We hope that the Wellcome Trust Science Writing Prize, schemes such as the Wellcome/New Statesman Scholarship and the science journalism funding we offer will help to develop the next generation of science journalists and communicators. For tips on how to start a science blog, how to avoid common mistakes in science writing, and even how to pitch to an editor, check out our science writing ‘How to’ guides on the blog.

Researcher Spotlight: Dr Kenneth Baillie

20 Oct, 2014

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Dr Kenneth Baillie is a consultant in critical care medicine at the Intensive Care Unit of Edinburgh Royal Infirmary. He holds Wellcome Trust Intermediate Clinical Fellowship and works at the Roslin Institute at the University of Edinburgh where he is looking into the genetics of why some people are more likely than others to get flu. We asked him to tell us more about his research and the motivation behind it..

What are you working on?

My main interest is trying to find human genes that make people susceptible to flu.

The flu virus mutates so quickly that it evolves resistance to antiviral drugs with terrifying speed, but we know that it depends on our own proteins to replicate. My hope is that the genes that make some people get very sick, or even die, from flu will lead us to drug targets that we can use to make susceptible patients become resistant.

Similar approaches can yield important insights in other diseases too. Ultimately my aim is to exploit the information from genomics to better understand and treat critical illness.

What does your average day involve?

Much of my research is computational, so I spend most of my time sitting in front of a computer. To an observer it would look boring, but when I think I’m onto something good (which is most days, but usually a false positive) I sit at my desk with my heart racing.

I think one of the biggest selling points for a career in science is the freedom to follow whatever ideas you like. I can have an idea on the way to work and then spend a week obsessing over it, and no-one bats an eyelid.

I always have several active projects, and I try to work on whatever is exciting me at a particular moment.

Why is your work important?

I have a lot of statistics to show that flu is a big killer, and that pandemic flu is potentially a very serious threat, but the same argument can be made for many diseases. For me, as I think is the case with most doctors who do research, the importance is more personal. I think the biggest single factor that pushed me to work on this problem was the incredulity of a bereaved relative of one of my patients – how can a young, healthy person die of flu in the 21st century?

I share that incredulity with respect to many common problems in critical care: we see people deteriorate over days, one organ failing after another, all from the host response to infection. It must be possible to prevent it, but we still haven’t found effective ways to intervene to help people survive.

What do you hope the impact of your work will be?

I want to find new treatments for critical illness, particularly flu.

Probably the surest way for me to do that would be to become a trialist and start resolving some of the many therapeutic questions in critical care medicine, but my work is primarily basic science, where we work on the assumption that understanding disease will one day help us to treat it.

The hope is that we will come up with completely new approaches that will be more effective than the current treatments. In critical care that bar is very low: besides antimicrobials, we have very few treatments that make any direct difference to the progression of disease.

How did you come to be working on this topic/in this field?

B0006927 Influenza virusI chose to train in critical care medicine because I love the physiology, and the mystery of sepsis and critical illness. There are so many unanswered questions that I can’t imagine ever running out of challenges.

Another reason is that, back in 2003, it seemed like a field that was taking off. Three big studies were published that promised to radically cut mortality: early goal-directed therapy, intensive glycaemic control, and activated protein C. Unfortunately all three were to some extent discredited in the following decade, but by then I was already hooked.

How has Wellcome funding helped you/your research/your career?

It has been completely invaluable.

Wellcome funded my clinical academic training through the Edinburgh Clinical Academic Track (ECAT) scheme. I can’t overstate the impact of this scheme on my progression. In particular it gave me access to the best mentorship I could hope for, and guided me into the field I now work in.

Right now Wellcome funding is enabling me to establish my lab and follow up on some very exciting findings, and to visit Broad Institute, where I am working with some of the most brilliant people in biological science.

What’s the most frequently asked question about your work?

“Can you predict who will get sick from flu?”

People make the assumption that genetics is about prediction. But predicting who will get sick is no use unless you can do something about it.

I don’t want to find a better way to tell which of my patients should write a will. I want to find a way to send them home alive. Genetics is potentially a very powerful way to do that, but it will take a long time.

Which question about your work do you most dread – and why?

“How long will it take to find a cure?”

A perfectly understandable question, but the answer can only be known in retrospect. Also the word “cure” makes it impossible to answer without sounding extremely unrealistic.

Tell us something about you that might surprise us…

It isn’t a world record, but to my knowledge no-one has ever completed the circumnavigation of the Baltic Sea by bicycle relay faster than a team of 15 people, including me, in 2000. (It took 13 days, 10 hours, and 23 minutes, in case you are wondering.)

What keeps you awake at night?

My kids. Particularly when they are ill.

Also since I presumably share genetic susceptibility to viral infections with them, when they get sick, I get sick. A sensible approach would be for all of us to swap children on day one so that we get fewer of the nursery bugs.

What’s the best piece of advice you’ve been given?

Before I chose my PhD project, Derek Angus (University of Pittsburgh) told me: “Find the best scientist in your university, and go work for them”.

The chain reaction question, set by the previous spotlit research Dr Helen Lee is: “What lessons have you learned from doing your research that could help other scientists?”

I’m really just starting out as an independent scientist, so I have a great deal yet to learn. So far I think the biggest lesson has been to tackle important questions.

It is quite daunting to think of how many brilliant people are already working on flu already – it seems almost arrogant to think that I could make any contribution on top of their efforts. But everyone has a different approach, and the more perspectives we have, the better chance we’ll make big advances.

You can find out more about Dr Kenneth Baillie’s work on the Roslin Institute website or by reading his papers on Targeting the host immune response to fight infection and A promoter-level mammalian expression atlas.

Image Credit: Representation of influenza virus, Anna Tanczos, Wellcome Images

Image of the Week: Celebrating science

17 Oct, 2014

Evening Standard The 1000 event 2014

Last night the grounds of Crick Institute played host to an event celebrating scientific ambition and global humanitarianism in the capital. Supported by the Wellcome Trust and the Bill and Melinda Gates Foundation alongside the Crick Institute, this year’s Evening Standard list of the 1000 most influential Londoners had a special focus on science. Sir Paul Nurse, Director of the Crick Institute, welcomed guests and spoke of his hopes for the institute (opening in 2015) to become a global hub for science collaboration.

This week’s image above shows of one of the science-based entertainments, from the evening. An installation enabling guests to get an answer to the question “Am I attractive?”

There was no danger of causing offence since the judges of “attractiveness” were hungry mosquitoes, contained in the orb and cube shown above. Putting your hand in special slots enabled the mosquitoes to detect chemicals in your sweat and if they liked what they found they moved in close to take a bite.

Thankfully a mesh barrier prevented partygoers from getting bitten, even if they were particularly attractive to captive mosquitoes!

This year’s list, described by Trust director Jeremy Farrar as a good way of “celebrating the connectivity of people from all walks of life”, includes a number of Trust staff and researchers.

We would like to congratulate all those from the Wellcome community who have been recognised on the list – including UCL’s Dr Molly Crockett, Prof Sir Mike Stratton, director of the Wellcome Trust Sanger Institute, Prof Nazneen Rahman from the Institute of Cancer Research, together with our director Dr Jeremy Farrar, Wellcome Trust Chair Sir Bill Castell and head of investments, Danny Truell.

Wellcome Trust Research Round-up: 13/10/14

13 Oct, 2014

Our fortnightly round-up of news from the Wellcome Trust research community…

Identifying the genetic factors of height is a tall order

N0011513 Child development; measuring heightAn international collaboration of scientists has identified a fifth of the genetic factors that cause height to vary between individuals.

A study which examined data on DNA from more than 250,000 people, published in Nature Genetics, roughly doubles the number of known genome regions involved in height to more than 400. It also revealed that more than half of the factors involved in determining height are explained by simple common genetic variation – the sort of genetic variation that exists in more than 1 in 10 people.

The research team checked more than 2 million common genetic factors – those shared by at least five per cent of participants. From this they found 697 genetic variants in 424 regions of the genome that are related to height. The findings represent a massive stride forward in an area of research in which virtually nothing was known as recently as 2007.

Professor Tim Frayling from the University of Exeter Medical School, who oversaw the study, said: “It’s common knowledge that people born to tall parents are more likely to be tall themselves. Most of this is down to the variations in our DNA sequence that we inherit from our parents – the different versions of all our genes. We have now identified nearly 700 genetic variants that are involved in determining height.”

He added: “[This research] is also a step forward towards a test that may reassure parents worried that their child is not growing as well as they’d hoped – most of these children have probably simply inherited a big batch of “short genes”.

The collaboration, aptly named the GIANT consortium, is co-led by the University of Exeter Medical School and part-funded by the Wellcome Trust.

Watching molecules ‘wiggle’

A new crystallographic technique developed is set to transform scientists’ ability to observe how molecules work.

A research paper, published in the journal Nature Methods, describes a new way of doing time-resolved crystallography, a method that researchers use to observe changes within the structure of molecules.

The new method will allow researchers across the world to carry out dynamic crystallography and is likely to provide a major boost in areas of research that rely on understanding how molecules work, such as the development of novel smart materials or new drugs.

Understanding how structure and dynamics are linked to function is key to designing better medicines that are targeted at specific states of molecules, helping to avoid unwanted side effects.

“A time-resolved structure is a bit like having a movie for crystallographers,” said Professor Arwen Pearson, who led the team at the University of Leeds. “Life wiggles. It moves about and, to understand it, you need to be able to see how biological structures move at the atomic scale. This breakthrough allows us to do that.

The research was funded by the Wellcome Trust and was conducted at the University of Leeds and the Diamond Light Source.

First pictures show how BRCA2 protein works to repair damaged DNA

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Mutations in the gene that encodes BRCA2 are well known for raising the risk of breast cancer and other cancers. Although the protein was known to be involved in DNA repair, its shape and mechanism have been unclear, making it impossible to target with therapies.

Researchers at Imperial College London and the Cancer Research UK London Research Institute (LRI) purified the protein and used electron microscopy to reveal its structure and how it interacts with other proteins and DNA. The results are published in Nature Structural and Molecular Biology.

Around 1 in 1000 people in the UK have a mutation in the BRCA2 gene. The lifetime risk of breast cancer for women with BRCA2 mutations is 40 to 85 per cent, depending on the mutation, compared with around 12 per cent for the general population. Many women who test positive for BRCA1 and BRCA2 mutations choose to undergo surgery to reduce their risk of breast cancer. Mutations can also raise the risk of other cancers, such as ovarian, prostate and pancreatic cancer.

The BRCA1 and BRCA2 genes encode proteins involved in DNA repair. The DNA in our cells undergoes damage thousands of times a day, caused by toxic chemicals, metabolic by-products and ultraviolet radiation. Repair mechanisms correct most of this damage, but unrepaired damage can lead to cancer.

“This study improves our understanding of a fundamental cause of cancer,” said Professor Xiaodong Zhang, a Wellcome Trust Senior Investigator, who led the research along with Dr Stephen West at the LRI. “It’s our first view of how the protein looks and how it works, and it gives us a platform to design new experiments to probe its mechanism in greater detail.”

In other news…

B0007437 Dame Kay DaviesWellcome Trust governor Professor Kay Davies and Wellcome Trust Senior Fellow Professor Jane Clarke have been shortlisted for the 2014 WISE Lifetime Achievement Award and WISE Champion Award respectively. WISE (Women in to Science and Engineering), is an organisation whose mission is to increase the gender balance in the UK’s STEM workforce.

The Wellcome Trust is collaborating with Merck Serono (the biopharmaceutical division of Merck) and the Institute of Cancer Research to identify inhibitors of tankyrase, an enzyme of the poly (ADP-ribose) polymerase family, with the goal of bringing a new cancer therapeutic drug to patients. The agreement follows on from an existing drug discovery program at the ICR, which supported by a Seeding Drug Discovery Award.

Image credit: Kay Davies – Anne-Katrin Purkiss, Wellcome Images

The Help We’ll Need to Fight Ebola

10 Oct, 2014

C0105595 Dr Felicity Hartnell. Ebola vaccine trial

With the Ebola epidemic continuing to grow – the World Health Organisation reports 10,000 cases and expects a further 10,000 before the epidemic is over – Dr Jeremy Farrar, director of Wellcome Trust and Dr Piot, director of the London School of Hygiene and Tropical Medicine, call for unprecedented action to be taken with regards to testing potential treatments. The following joint statement first appeared in the Wall Street Journal on 9th October 2014.

The imported cases of Ebola in the U.S. and Spain are almost certainly not the harbingers of extensive and sustained outbreaks in developed countries. But neither will they be the last of their kind. For as a long as Ebola continues to rage in West Africa, more infected people can be expected to make their way to Europe, the Americas and beyond. More cases of secondary transmission, as has happened in Spain, are to be anticipated too.

Small outbreaks of this sort will be contained in countries with good hospital systems and infection control, but the developed world will still pay a human and financial price for its failure to respond quickly to the catastrophe in Guinea, Liberia and Sierra Leone. The case for increased action by Western nations against the epidemic remains first and foremost a matter of moral and humanitarian urgency. But there is self-interest at stake as well.

What, though, should the rich world be doing? The key to containing any epidemic infectious disease is a concept called R, the reproductive number. This is the number of people that each person with the disease will themselves infect. When R is greater than one, an epidemic is growing. When it is less than one, it is dying out. In this Ebola epidemic, R is currently estimated at between 1.3 and 1.8, and at some hotspots of infection it is higher still. Getting this down is the overwhelming priority. For R to reach one, models suggest 70% of Ebola patients must be isolated. Containment and care efforts must concentrate on achieving that, to reduce transmission in the community while reducing mortality through supportive care.

One approach would be to invest in ways to proactively identify and isolate cases, but that may be too resource-intensive to be implemented with the necessary speed. And if it is at all coercive in nature, it also risks further undermining public trust in already fragile health systems. A better option may be to provide incentives for people who might be infected to seek care earlier—both for the sake of their own survival and so they can be appropriately isolated to prevent transmission for others.

This means creating community clinical facilities—tents or converted buildings will do—where these people can expect good care, nutrition and infection control, so that those who have Ebola don’t pass it on to those who do not. Such facilities would ensure that people suspected of having Ebola are isolated from the community until infection is confirmed and they are transferred to treatment centres, or they test negative and are discharged. But it requires building public confidence that seeking care will help, not hinder, an individual’s chances of survival. That requires investment in facilities and, above all, listening to people to understand their concerns and beliefs.

Supporting the provision of community facilities and treatment centres has rightly become the focus of most recent international interventions, such as the U.K. and U.S. military deployments, and contributions from China, Cuba and France. This global response is scaling up, and it will make a tangible difference.

More resources, however, are still urgently required. Models already suggest that thousands of beds will be needed. Any delay in supplying them will increase the number needed as the epidemic gets worse. Underinvestment in the international response would cost us much more in the long run.

C0105554 Ebola vaccine trial at Oxford University

Another investment priority is the development of drugs and vaccines. Safety trials of vaccines are already under way. If one proves even partially effective, it could have a transformative effect on the progress of the epidemic. Drugs matter too, even though they would do little directly to stem transmission. Besides potentially reducing mortality, their availability would provide a critical incentive for people with symptoms to seek medical care. It is so much easier for health-care systems to build trust when there is at least a little hope to offer.

Which is also why we believe that as candidate drugs begin to be tested, the West shouldn’t insist on randomised, controlled trials of the sort generally required by our regulatory systems. Randomising patients to receive an investigational drug or conventional care is neither ethical when conventional care means 70% mortality, nor practical when health-care systems and civil order are breaking down. It might even threaten the trust we need to build. There are other ways to achieve the safety and efficacy data that the World Health Organisation will need to identify the most beneficial options, with greater speed and community acceptance.

Ebola is out of control, but it is certainly controllable. Now that international resources are finally being mobilised and deployed, it is crucial that they go where they can make a difference and save most lives.

 

Image of the Week: Florence Nightingale’s Moccasins

10 Oct, 2014

L0057412 Florence Nightingale's moccasins, 1850-1856This week we’ve discovered some footwear which may have helped keep some very famous feet warm! These moccasins from the Science Museum are purported to have belonged to Florence Nightingale while she worked in Scutari military hospital, in what is now Istanbul, Turkey.

The “lady with the lamp” is commonly known for reducing the death rates on the wards – from a whopping 42%, down to 2% in two years. However there is still debate amongst historians as to her role in this, as well as her impact on modern healthcare. A traditional interpretation is that by enforcing cleanliness, altering diets and efficient running of the hospital, Nightingale reduced the death rate. However recent analysis suggests that her changes initially facilitated the spread of diseases such as Cholera, Dystentry and Typhoid. The death rate only dropped after a commission was sent out six months after her arrival to clean sewers and improve ventilation, preventing the spread of the water-borne diseases.

One thing that most agree on however is Nightingale’s meticulous records and use of data. Florence Nightingale was innovative in her use of statistics and an evidence base in nursing. She used visual representations of statistics to persuade decision makers– an early trendsetter for infographics!

Do you want to hear how Florence spoke as well as her choice of footwear? The Wellcome Collection has a recording of Florence Nightingale’s voice on display as part of their A-Z of the Human Condition which closes in just two days on Sunday the 12th of October – so head over quickly!

Image credit: The Science Museum, Wellcome Images

Wellcome Images is one of the world’s richest and most unusual collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. Over 100,000 high resolution images from our historical collections are now free to use under the Creative Commons-Attribution only (CC-BY) licence.

Researcher Spotlight : Dr Helen Lee

6 Oct, 2014

helen leeDr Helen Lee is  the Director of Research at the Diagnostics Development Unit at Cambridge University, where she leads the development of diagnostics for diseases such as HIV and chlamydia. She is also President and CEO of spin-out company Diagnostics for the Real World , which  takes these diagnostics  to market. This week she tells us about her work, what motivates her and how she got to where she is today.

What are you working on?

My group develops technologies and translates them into diagnostic assays for the detection of infectious diseases specifically for resource-poor settings. Due to the limitation of infrastructure and lack of highly-trained personnel, the tests need to be simple, robust and yet with high-performance. Our goal has always been to DELIVER these assays to rural areas where they can be used to give rapid results while the patients are still on site. I have always said that if all we do is to develop a prototype assay or publish papers, then we would have failed.

What does your average day involve?

I interact a great deal with the development team with different yet complementary skills that are necessary for the development of diagnostic platforms. The team is made up of a kaleidoscope of molecular biologists, clinical trial, regulatory and quality control specialists, hardware and software engineers, plastic component designers, mechanical engineers, project or product managers and production assemblers.
 

Why is your work important?

 I would not necessarily describe our work as important, but I do think it is very useful — particularly to those living in rural areas of developing countries who do not have access to timely diagnostic tests and therefore appropriate treatment. By providing simple and yet effective diagnostics that do not require highly-trained personnel or cold chain transport/storage, we aim to make a difference.

What do you hope the impact of your work will be?

 For anyone who has visited rural clinics in sub-Saharan Africa, s/he cannot help but be struck by the image of women with one child on her back and others tethered to her hand, waiting on the lawn because there is no waiting room. Some of them must have slept over night there since they are waiting in the early morning. I do not know how they get there since I do not readily see public transport. I hope our rapid test which can lead to a clinical action during one such visit will make their life a little easier and better.

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How did you come to be working on this topic/in this field?

 I used to work in industry, at one of the fortune 500 diagnostic companies. A group of us wanted to do something about the diagnostic needs in developing countries where the prevalence are highest and resources the poorest. For obvious and in fact legitimate reasons, the company’s responsibility was to the shareholders. Consequently, we decided to put our money where our mouth was and left industry to academia, where profit is not the motive and where we could find an environment to develop technologies specifically for resource-poor settings.

 

How has Wellcome funding helped you/your research/your career?

 What we do has little or no commercial value, even though it can be extremely useful. If it had not been for the funding from the Wellcome Trust throughout the years, we would not be where we are today.

What’s the most frequently asked question about your work?

 People often ask me what makes innovation? And my answer has always been that innovation is not just about intelligence – most people are pretty intelligent. Rather, it is about being able to deal with failures, day in and day out. In fact, if something is that easy to do, someone would have done it already. So for me, innovation is rooted in perseverance. More than anything else, it is about finding a way to do what needs to be done and never give up.

Which question about your work do you most dread – and why?

 I do not dread any question about my work. I do dread that I am not efficient at my work, and I often am not, alas.

Tell us something about you that might surprise us…

 I am an avid football fan and for a Chinese woman working in academia, this often surprises people. In fact, I only came in to finish this interview today after the Arsenal and Chelsea game. Although my husband is French and we tend to support Arsenal, Chelsea deserved to win today and Wenger made a mistake in not taking Cesc Fabregas back…

What keeps you awake at night?

 Failure to deliver the tests to where it is needed – and after all this effort over the years. I worry the most about failing those who have worked so hard and so long alongside with me and who have believed in what we are trying to do.

What’s the best piece of advice you’ve been given?

 Something my mother told me many years ago: If you really want to do something, and if what you really want to do is truly worthwhile, the world will step aside and let you go through.

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And finally, the “chain-reaction” question set by our previous spotlit researcher Professor Helen McShane: Do you love what you do?

Absolutely!  In the past 20 years, I do not ever remember dreading on a Sunday evening that I have to go to work the next day. I often think how lucky I am — not rich but earning a good enough living, doing something that is intellectually challenging but also useful, and having the freedom to work on what I believe in.  Working has been a privilege to me.

If you want to explore Dr Helen Lee’s work further then take a look at this  short film about Helen’s work, or read some of  her recent published work : Performance of a New Rapid Test for the Detection of Hepatitis B Surface Antigen in Various Patient Populations, SAMBA HIV Semiquantitative Test, a New Point-of-Care Viral-Load-Monitoring Assay for Resource-Limited Settings

 

 

Image of the Week: Thuja seed

3 Oct, 2014

B0006894 Seed head of a thuja tree.

This week we bring you a wrinkly, dull coloured seed. Whilst we certainly have some more stunning images in the collection, it’s the story behind this plant that makes it worth seeing.

This is a seed head from the Thuja tree – a genus of plants which have been used to make antimicrobial ointments to combat everything from thrush to warts and ringworm. Thuja oil was popular with herbalists in the 19th century and is still used in alternative medicine, where it remains a popular treatment for venereal warts!

Whilst experimental evidence for the antimicrobial properties, or indeed safety for medical use, of Thuja is lacking, many clinically-trialled antimicrobial medicines do have roots (no pun intended) in plants and fungi. Notably quinine, from the Cinchona Tree and artemisinin, from Artemisia annua are plant-derived treatments for malaria that were previously used in traditional medicine.

The ability of some plants and fungi to kill or stop the growth of pathogens has been well exploited, most famously in the development of antibiotic penicillin from the Penicillium fungus. Unfortunately, over use of antimicrobials has often led to pathogens evolving resistance to them. Antimicrobial resistance is an issue that the Wellcome Trust has been very involved with, working closely with the UK government. Different ways of combating resistance include using existing medicines more wisely, developing new antimicrobials, and using a variety of antimicrobials for treatment. Interestingly, looking to traditional medicine and plant derived products is often part of these solutions.

Image credit: Annie Cavanagh, Wellcome Images

Wellcome Images is one of the world’s richest and most unusual collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. Over 100,000 high resolution images from our historical collections are now free to use under the Creative Commons-Attribution only (CC-BY) licence.

Director’s Update: Changes to the Wellcome Trust’s structure and leadership

1 Oct, 2014

Dr Jeremy Farrar, Wellcome TrustSince he joined us this time last year, Jeremy Farrar, Director of the Wellcome Trust, has been listening – to staff, to researchers, to members of the Wellcome community, and more. In this post he explains some changes to our organisational structure and leadership team…

A year ago today, I became Director of the Wellcome Trust. It has been a fantastic twelve months and a wonderful journey, in the course of which I have been listening to people’s views about this great organisation, and learning much about it, from within and from outside. I am very grateful to everyone who has come to talk to me, to share your ideas, your work and your thoughts for the future.

New leadership is always an opportunity to look afresh at an organisation’s direction and structure, and it has been my priority over the past year to think over how best to take forward our vision, together with colleagues from across the Trust and the Board of Governors. In July, I announced an evolution of our funding framework, with a focus on broadening our funding opportunities for younger researchers, for teams, for people with innovative ideas and to give us the space to act more strategically and all with a global perspective. We hope to be able to share further details of this next month.

Today, I am also delighted to announce some changes to the organisational structure and executive leadership of the Trust, which I believe will help us to achieve our goals and deliver our mission.

Following the decision by David Lynn to retire early, for personal reasons, from full-time work and the position of Director of Strategic Planning and Policy, we have created a new division of the Trust, Strategy. It will be tasked with refining and articulating the Trust’s ambitious vision of improving human and animal health, embedding our new strategic funding framework, and helping us to track our progress. It will nurture and develop our external relationships and influence (in the UK and globally), and sit at the heart of the Trust so it can draw on expertise from across the organisation. It will bring together the existing teams of Strategic Planning and Policy, Evaluation, Communications, Education and Grants Management, along with a new “Incubation Unit” for developing new projects. This last unit will include the Sustaining Health initiative led by Ted Bianco.

I am delighted that Clare Matterson has agreed to lead this new Division as Director of Strategy. Over the past decade, Clare has proved herself to be visionary leader as Director of Culture & Society, where she has overseen a significant expansion of the Trust’s investment in humanities, social science, public engagement and education, as well as launching the critically-acclaimed and much-visited Wellcome Collection.

We hope to appoint Clare’s successor as Director of Culture & Society soon, to continue to build on her inspiring work at a time when the resources available for it are increasing. Clare will look after both divisions until this process is complete. We are also beginning the search for a Director of Innovations to succeed Ted Bianco.

We will also be creating a second new division, People & Development. The greatest asset in any organisation is its people, and I want the development, careers, leadership and recruitment of individuals and teams to be central to discussions at the Executive Board. I also think the Trust could do more to support leadership and personal and team development in our wider research community. To that end, we will appoint a Director of People & Development, with a focus on finding and encouraging talent and leadership both internally and externally.

Finally, recruitment is now advanced for a Chief Financial Officer, to lead the Finance & IT division that has a crucial role in providing assurance and guidance on our spending, as well as bringing creative and resilient technological solutions to enable us in our work. The responsibilities previously held so ably by Simon Jeffreys, who stepped down as Chief Operating Officer earlier this year, will be divided between Finance & IT, People & Development, Strategy and Legal.

Wellcome Trust Research Round-up: 29/09/14

29 Sep, 2014

Our fortnightly round-up of research news from the Wellcome Trust community…

Immune system of newborn babies is stronger than previously thought

The immune system of a newborn baby, although very different to an adult’s, may still be able to mount a strong immune defense, according to new findings that go against the received wisdom on this topic.  Baby, newborn Credit:Anthea Sieveking

The study, published in Nature Medicine and funded by the Wellcome Trust, found that the immune T cells of newborn babies may have the ability to trigger an inflammatory response to bacteria. Up to now, it was generally believed that babies have an immature immune system that doesn’t allow this. Although babies need to protect themselves from the harmful pathogens they are exposed to from birth, it was thought that their T cells were suppressed to some extent to prevent inflammatory damage to the developing child.

Now, a team at Kings College London has discovered that whilst T cells in newborn babies are largely different to those in adults, it is not because they are immunosuppressed. Rather, they manufacture a potent anti-bacterial molecule known as IL8 that has not previously been considered to be a major product of T cells, and that activates neutrophils to attack the body’s foreign invaders.

Deena Gibbons, lead author at King’s College London, says: “We found that babies have an in-built anti-bacterial defense mechanism that works differently to adults, but nevertheless may be effective in protecting them. This may also be a mechanism by which the baby protects itself in utero from infections of the mother. The next stage of our work will be to better understand the pathways that result in the immune cells of newborns being so different to those in adults.”


Statins associated with modest increases in weight and diabetes risk

The mechanism by which statins increase the risk of type 2 diabetes has been investigated in a large-scale analysis from an international team led by researchers from UCL and the University of Glasgow, using information from genetic studies and clinical trials.

HMG-CoA reductase Credit:T. Greenhough & A. ShrivePublished in The Lancet, the work received support from a number of funders including the Wellcome Trust, the Medical Research Council, British Heart Foundation, Rosetrees Trust and National Institute for Health Research University College London Hospitals Biomedical Research Centre.

Among nearly 130 000 participants from clinical trials that previously tested the effect of statins on heart disease and stroke, those assigned statins vs. placebo, or higher vs. lower doses of statins, were noted to have a small increase in the risk of developing type 2 diabetes, of about 12% over a four-year period, and also to gain an excess of 240g (around half a pound) in weight.

“Weight gain is a risk factor for diabetes which might help explain the small increased risk of diabetes observed in people taking statins”, explains co-lead author Dr David Preiss of the University of Glasgow Institute of Cardiovascular and Medical Sciences.

Statins work by reducing the efficiency of a liver enzyme involved in cholesterol production, which causes liver cells to trap more low-density lipoprotein (LDL-) cholesterol from the bloodstream, reducing its circulating level. This mechanism is thought to underlie the efficacy of statins in lowering the risk of stroke and heart disease.


HIV-infected individuals receiving therapy are still susceptible to TB disease

People infected with HIV, but who are stable and taking a combination of potent antiretroviral drugs (known as ART), are still more susceptible to developing TB disease than those who are not HIV-infected because of problems with TB-specific immune responses in their lungs, according to a new study.

HIV particles Credit:R. Dourmashkin

TB is an opportunistic infection which commonly infects and kills people who have HIV. A new study, conducted by researchers at the Malawi-Liverpool Wellcome Trust Clinical Research Programme, explains why people taking ART who have undetectable concentration of HIV viruses in their blood and a high T cell count (indicating a good response to ART and a strong immune system) are still susceptible to developing TB disease.

The study, published in the American Journal of Respiratory and Critical Care Medicine, examined blood and lung samples from 35 HIV-uninfected, 25 HIV-infected ART-naïve (those who were not taking ART), and 50 HIV-infected ART-treated adults.

They found that immune cells found in the lungs called ‘alveolar macrophages’ and T cells that respond specifically to the presence of the TB-causing bacteria or its proteins do not work properly in HIV-infected adults who have taken ART for less than four years, partly explaining why they are susceptible to developing TB disease.

Dr Kondwani Jambo, a postdoctoral fellow funded by the Malawi Health Research Capacity Strengthening Initiative (HRCSI), which is part-funded by the Wellcome Trust, and Dr Henry Mwandumba, a Wellcome Trust Intermediate Clinical Fellow, are among the authors of the study. Dr Mwandumba said: “These findings underscore the need for strategies to augment ART to improve lung immune cell function and reduce the incidence of TB. The use of vaccines that promote repopulation of the lungs with TB-specific immune cells and the use of preventive TB treatments, especially during the early years of ART when HIV-infected individuals are most vulnerable, ought to be considered.”


Image credits:
Newborn baby – Anthea Sieveking, Wellcome Images; Model of human enzyme inhibited by statins – T. Greenhough & A. Shrive, Wellcome Images; HIV particles – R. Dourmashkin, Wellcome Images. 

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