Blog posts

Advancing liver health through microbiome research

Dr Benjamin Mullish

On World Liver Day, Dr Benjamin Mullish from the Department of Metabolism, Digestion and Reproduction, discusses the research being done on the microbiome and faecal (or ‘intestinal’) microbiome transplants (FMT), and how he hopes that can be converted from ‘bench to bedside’ to improve the lives of patients with liver conditions. 

When most of us hear the words ‘gut bacteria’, we think about germs that can cause infection and make people ill.  However, more recently, scientists and doctors have recognised that we also have billions of ‘beneficial’ bacteria (and other microbes) in our gut that play important roles in keeping us healthy.   The specific ‘mix’ of microbes that a person has in their gut, and the environment in which they live – now often called the gut microbiome – is distinct between different people like a fingerprint.  Furthermore, the gut microbiome is influenced by and altered by a number of factors, including our diet, our medications (particularly antibiotics), and how old we are.

Of further interest, we now think that our gut microbiome plays an influence over our vulnerability to developing a range of medical conditions, how the condition progresses if we do develop it, and even how well we might respond to different treatments used for the condition.  This includes a number of different liver diseases; the gut and the liver are very close physically within the body, and the gut microbiome seems to be an important factor that impacts upon how these two organs ‘talk to’ each other in health and disease.  Within the Section of Hepatology and Gastroenterology, one of our major areas of research relates to how an altered gut microbiome may contribute to different liver diseases, and whether we might be able to alter the gut microbiome as a new approach to treating them.

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Von Willebrand disease – hidden in plain sight

Dr Tom McKinnon

Every year on 17 April, World Haemophilia Day is recognised worldwide to raise awareness of haemophilia, von Willebrand Disease, and other inherited bleeding disorders. From his early days in lecture halls to his current work in research labs, Dr. Tom McKinnon, Senior Lecturer in the Department of Immunology and Inflammation, shares his expertise. He unravels the complexities of Von Willebrand factor (VWF), advocating for greater awareness of this commonly misunderstood condition. 

I can vividly recall an early morning undergraduate lecture I attended over 20 years ago now (has it really been that long?!). In a slightly hungover state, I listened to the lecturer describe a protein that helps blood cells stick together (clot) when you bleed called Von Willebrand Factor and Von Willebrand’s disease – a common inherited condition that can make you bleed more easily than normal. At the time, I didn’t think much about it, but two years and a BSc later, I found myself at Imperial undertaking a PhD investigating the structure and function of VWF, beginning my scientific journey into the world of the largest protein found in the blood, and in my humble opinion, the most fascinating.  

Circulating around the body, VWF is like a giant molecular ball of string that responds to the force of blood flow. When we damage our blood vessels, this ball of string sticks to the damage site, and unwinds and begins to capture platelets that are speeding past, thereby limiting blood loss.  

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Bladder problems: Can we be less shy about having a pee?

Prof Marcus Drake

Bladder problems affect millions of people around the world, yet they remain shrouded in silence and embarrassment. Professor Marcus Drake, Chair in Neurological Urology, explores why society continues to be shy about this topic, and highlights why more medical research is needed to improve bladder care.

People do not generally spend a lot of time thinking about their bladder. After all, each pee only takes about 20 seconds. Since we might go for a pee just six times a day, that means only a couple of minutes are given over to the bladder daily.

As well as not thinking about it much, we also seem to be reluctant to talk about it. This may be a reflection on society, since peeing is a vital function yet talking about it seems to be discouraged. Perhaps this does not matter so much for most people. But it does matter for anyone with a bladder problem. This reluctance means that people can leave it very late to get help. For many it makes the experience of getting help difficult too.

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Breaking stereotypes and creating role models

Fama MannehTo mark Women at Imperial Week, we’re spotlighting Fama Manneh, a 2nd-year PhD student, from the Department of Bioengineering and the National Heart and Lung Institute (NHLI) and her recent invite by the British Embassy in Madrid to speak on the topic of breaking stereotypes as a woman. As the President of Women in STEM she is a driving force inspiring women within and outside the University community. Read more about her experience in Madrid below.  

Recently, I had the honour of being invited by the British Embassy in Madrid to speak at an event organised by Beatriz Herranz. The event, “Women in Science: Breaking stereotypes and creating role models” was held at Fundación Ortega-Maranon. This historic venue, dating back to the early 20th century, was a Girls’ Residence (Residencia de Señoritas) that provided both housing and educational opportunities for young women pursuing higher education. It offered a supportive environment for female students to pursue arts, sciences, and humanities, fostering intellectual growth and independence.

The selection of this venue for the Women in Science event holds symbolic significance, as it reflects the continuation of the Girl’s Residence mission to empower women through education and knowledge. The choice pays homage to the pioneering women who once resided there, aiming to inspire current generations of female scientists, engineers, and technologists.

At the event, Teresa Guerrero of El Mundo Science expertly moderated a thought-provoking roundtable discussion. I shared the panel with distinguished figures, including Silvia Rueda Pascual, a Cabinet Advisor at the Ministry of Science and Innovation and Director of the Women and Science Unit; María A. Blasco, the Director of the Spanish National Cancer Research Centre (CNIO); and Cynthia Cabanas, a PhD student and representative of the Spanish Researchers in the United Kingdom (SRUK/CERU).

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Shining a Light on Ovarian Cancer

Christina Fotopoulou

To mark Ovarian Cancer Awareness Month, Professor Christina Fotopoulou, Chair in Gynaecological Cancer Surgery and Professor of Gynaecological Cancer in the Department of Surgery and Cancer, and consultant gynaecological oncologist at Imperial College Healthcare NHS Trust—reflects on Imperial’s recent breakthroughs in the field. Delving into Imperial’s pioneering efforts to enhance diagnosis, treatment, and understanding of this complex disease, Christina also sheds light on some of the unique challenges faced. 

The time has come once again for Ovarian Cancer Awareness Month in the UK. This is our annual opportunity to shine a spotlight on ovarian cancer and increase awareness of a disease that has been a significant challenge for women for centuries (see fig. 1).  

Imperial and Imperial College Healthcare NHS Trust have made significant strides towards improving the diagnosis and management of ovarian cancer for many years, and there is even long-term hope of a cure in the future. Through pioneering systemic and surgical therapeutic strategies and conducting ground-breaking research, the Imperial clinicians and researchers  have established themselves as global leaders in the field of gynaecological cancer.  

For example, James Flanagan recently received half a million pounds from Cancer Research UK (CRUK) for his Early Diagnosis programme and Anke Nijhuis was awarded a £1 million Career Development Fellowship from CRUK to establish her own independent research within the Department of Surgery and Cancer. Additionally, the Parasol foundation has generously awarded over £1 million to support research into drug resistance, tumour heterogeneity, and more personalised, predictive imaging.  

The fight continues for better care, improved quality of life and increased survival rates for patients. 

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Psychedelics – how modern neuroscience research is leading to new treatments for brain disorders

Psychedelic therapies have the potential to vastly improve the treatment of mental health disorders such as depression. The Imperial Centre for Psychedelic Research is paving the way in exploring these innovate treatments using psilocybin – the active ingredient in magic mushrooms. Here, Professor David Nutt from the Department of Brain Sciences discusses. 

When most people think of psychedelics, the first thing that comes to mind is LSD-inspired Flower Power during the 1967 Summer of Love in the USA, with its associated revolution in art and music. This explosion of use was seen to be fuelling the protests against the war in Vietnam and so rapidly led to LSD and related psychedelics such as psilocybin (the active ingredient in magic mushroom) being banned, first in the USA and then later globally. This ban still exists today and has effectively censored research for over 50 years. The ban is very unfortunate as prior to this there were hundreds of studies that showed psychedelics were effective treatments for a range of mental illnesses as well as some other brain disorders. Millions of patients may therefore been denied access to potentially life-saving treatments.

This situation is beginning to change with several universities setting up psychedelic research groups including the Centre for Psychedelic Research at Imperial, which was the first and is now five years old. The impetus to these new research centres is twofold. First, today we have much more powerful neuroimaging methods to examine the impact of psychedelics on the brain and second, these neuroimaging studies have revealed possible mechanisms underpinning the therapeutic activity of psychedelic drugs, so encouraging more clinical research. This research has revealed remarkable efficacy in a number of patients who have not responded to prior conventional treatments and may be the start of a whole new phase of novel therapies for mental illnesses.

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‘It can make a massive difference’: How to be a trans ally

Every student deserves to be treated with dignity, respect and fairness at University. Unfortunately, this isn’t always the case for transgender students. So, how can you step up and be an authentic ally for the transgender student community? Medical student, Elliot, discusses all things allyship.

Treating people with respect and dignity is the utmost priority for many people at university, however meeting someone who is transgender can be confusing and new for a lot of people. With ever changing laws, media output and opinion, it’s easy to feel overwhelmed and swept up when trying to care about those around you. I have compiled the some tips for supporting the trans (non-cis) people in your life, so that you know where to start. 

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From Britpop to breakthroughs: Reflecting on 30 years of HIV testing and treatment

Born on what would eventually be recognized as World AIDS Day in the 1970s, Dr Mike Emerson, now affiliated with the National Heart and Lung Institute, relocated to vibrant London during the early 1990s amidst the fervour of the Britpop era. In the backdrop of Blur and Pulp melodies, 1990s London faced the AIDS crisis. Three decades later, he is at the helm of a team investigating cardiovascular ailments in people with HIV. In this piece, Dr Emerson reflects on the advancements in HIV diagnosis and therapy, and reiterates the ongoing importance of  National HIV Testing Week. 

I was born on what was to become World AIDS day way back in the 1970s, and moved to the big smoke in the early 90s. London was exploding with Britpop excitement, and in the absence of mobile tech, we went out every night to the sounds of Blur and Pulp. 90s London was also the epicentre of the UK’s bit of the global AIDS crisis. People in their early 20s, as I was, were dying (of ignorance the government told us). I quickly learnt not to hold birthday celebrations in Soho; celebrating and mourning young friends and sons don’t mix well. Exactly 30 years later, I lead a team investigating cardiovascular disease as people live with HIV for decades and succumb to the diseases of old age. This week is HIV testing week, so it’s a good time to reflect on how far we have come and remind ourselves of the importance of HIV testing. 

Back in 1981, a couple of obscure articles noted incidences of fatal pneumonia and rare skin cancers in otherwise healthy young American men. Oddly, these men were all gay. Within months, there was an explosion of terrifying fatal illness amongst the gay communities of New York, San Francisco and, not far behind, London. People became infected with HIV following blood transfusions, and babies were born with the condition and died. When HIV tests became available, the prospect of one was terrifying, involving a week-long wait for results and a recommendation to take a friend when results were due to be delivered. 

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Queer in the field: The unique challenges of LGBTQIA+ scientists conducting international research

LGBTQIA+ scientists can face nuanced challenges when travelling abroad to conduct research. Bethan Cracknell Daniels, Research Postgraduate in the School of Public Health, reflects on her time in Ghana supporting infectious disease control, and how the  LGBTQIA+  International Support Group are advocating for a more inclusive global scientific community.

While applying for my PhD in Infectious Disease Modelling at Imperial in 2019, I wanted to gain hands-on experience in infectious disease control. At the time, I was an undergraduate student studying Immunology at the University of Manchester. I applied for an internship with a laboratory on the edge of Accra, Ghana, providing infectious disease diagnosis to a local hospital. I was excited to be accepted and immediately went about booking flights and organising my visa.

It was only a week before my flight that I learned Ghana criminalises homosexuality, with physical homophobic attacks against LGBTQIA+ individuals being common. As a queer woman with a same-sex partner, I was nervous. Living in Manchester, with its famous gay village, I was very open about my sexuality and thought nothing of walking down the street holding hands with my girlfriend. Unsure of how to navigate being gay in Ghana, I eventually decided to tell people I didn’t have a partner, effectively returning myself to the closet.

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Unravelling the mystery of smaller lungs in low- and middle-income countries

Andre Amaral

In low- and middle-income countries (LMICs), a notable number of individuals have smaller lungs for their sex, age, and height, especially in South and East Asia, as well as sub-Saharan Africa. The key question: Why does this pattern persist in these regions?

This phenomenon extends beyond physiological concerns, and as indicated by recent studies, reveals a troubling link between smaller lungs and heightened risks of suffering from heart disease and diabetes. Dr André Amaral, an epidemiologist at the National Heart and Lung Institute (NHLI), explores this phenomenon.

The BOLD study

Chronic lung diseases affect millions of people of all ages worldwide. Approximately 20 years ago, the Burden of Obstructive Lung Disease (BOLD) study was set up by Imperial College London to find out more about the prevalence and determinants of chronic obstructive pulmonary disease (COPD), which back then, was already considered a leading cause of disability and death.

The BOLD study was conducted in 41 sites across Africa, Asia, Australia, Europe, the Caribbean and North America, and recruited more than 30,000 adults aged 40 years and over. The large coverage of world regions, and ethnic groups, as well as the large number of participants, all answering the same questions and undergoing the same measurements in a standardised manner, makes the BOLD study unique. Participants in this study provided information on several characteristics of their life. This included whether they had been diagnosed with lung disease, a heart disease, or diabetes, whether they smoke or ever smoked, their weight and height, and their highest level of education. The level of their lung function was measured through a medical test called spirometry, which measures how much air a person can breathe out in one forced breath.

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