How can we bring together imaging technology, art and philosophy to shape scientific research?
When we think of vascular health we are often guilty of presuming that we are primarily discussing the heart. Clearly the heart has a major role to play in regulating your blood flow; once our blood has exited the heart it must supply nutrients to every organ of our body and back to the heart in a cycle that takes about one minute. Any hindrance from a cholesterol-blocked artery or blood clot can have catastrophic results – however by the time we reach retirement our circulation will have exceeded 30 million laps around the body! This incredible feat is made possible by our blood vessels that not only form a vast network during your development in the womb, but are also constantly growing and remodelling throughout our life time. Our Vascular Science research group at the National Heart and Lung Institute is particularly interested in endothelial cells – the cells that line every blood vessel in our body. We want to understand how they work together to grow and form new vessels (a process called angiogenesis), as well as how they maintain these structures in response to injury and disease.
The abundance of blood vessels throughout all our tissues and organs has often meant that, in disorders such as chronic liver disease, the striking changes in vessel organisation, has been cited as a consequence of the disease. However, in our most recent study we challenge this perception by describing how changes in endothelial cells might play a central role in how liver disease begins and progresses to irreversible liver damage associated with conditions such as alcoholic liver disease. This change in perspective may also provide new avenues for both diagnostics and treatments of liver disease, which are currently largely restricted to abstinence and transplantation.(more…)
It was extremely challenging for me to stare back at the four rejections that faced me. Four rejections from four separate medical schools. Four independent reviewers telling me I was not to be a doctor. I had to endure seemingly unending encouragements and sympathies from friends and family. Their attempts were well-meaning, but often repetitive. My particular favourite was “I believe Edward Jenner didn’t get into medical school the first time round”. This, of course, was a complete fabrication. I think I always had this naïve cockiness about me, an artless assumption that I had the necessary experiences to stroll into medical school. Perhaps rejection had a subduing effect on my ego, though, I probably would presume most of those who know me would thoroughly disagree.
Nevertheless, it occurred to me that I had a year to convince the doctors of now that I could be a doctor of the future. But then I thought again. I had an entire year to do what I wanted. I found myself avoiding medical work of any sort, and take up a job in a bakery. I normally stop here when I want to impress people, to give the impression that I mastered the art of conjuring delicious, enticing pastries. In fact, it is due to my semi-duplicitous nature that many people still think of me as a great baker. But I’m not. In reality, my primary role was to serve customers, clean and wash up (as well as outline the difference between spelt bread and gluten-free bread: a distinction I still don’t understand to this day). It was an enjoyable job, and it provided me with some money to fuel some travelling later on. Moreover, I had the blessing of taking home two full bags of artisan breads untouched by the day’s customers — a perk which became more and more hedonistic as the year went on. (more…)
I was always a sickly child – when I was eleven years old, doctors injected my forearm with tuberculin in order to check whether my immune system raised a response to the bits and bobs of dead tuberculosis (TB) bacteria in it. If it did, it meant my immune system had already been prodded into battling TB, that is, it had previously encountered or was currently encountering an infection with TB bacteria. The injection site swelled like a furious bee sting, the doctors decided TB was the root cause of all my troubles, and I was intensely medicated for the next six months. My symptoms improved, and I have since evolved (visibly even!) towards the hale and hearty end of the healthiness spectrum.
In retrospect, now that I am medically trained and pursuing a PhD in TB immunology, I can appreciate all that my care team must have had to consider before starting an eleven-year-old child on a rigorous anti-TB treatment based on an educated guess. My symptoms were not typical of classical lung TB, the most common and infectious form of TB, they were mostly gastrointestinal, but then TB has also been known to stitch the gut into uncomfortable knots. My mother had recently been diagnosed with a cold abscess, due to TB of the bone, and though this could not possibly be infectious (based on centuries of observation) it still raised flags as it meant I had a history of contact with a TB patient. I showed an immune response to the tuberculin skin test (TST), but then I had received the BCG vaccine, which is a close relative of TB bacteria. This meant I could elicit a cross-reactive immune response and result in a positive TST even in the absence of TB infection due to the similarity of the two bacteria. (more…)
Magazines and newspapers are full of so-called ‘tips’ or ‘advice’ for the image conscious, detailing extreme diets followed by the rich and famous to achieve dramatic weight loss, or new diets apparently supported by the latest scientific research. One example is the gluten-free diet, made fashionable particularly in the sporting world by former world number one tennis player Novak Djokovic (1). Having had a reputation for being physically weaker than his rivals, Djokovic was eventually diagnosed with coeliac disease and the resulting gluten intolerance. Eliminating gluten from his diet transformed his career.
Many have since adopted the gluten-free diet with the hope of boosting their own energy levels, but have had mixed results. Recent studies show that being ‘gluten-intolerant’ is hardly a medical condition that can be diagnosed and scientists have struggled to establish a mechanism for supposed gluten intolerance. So unless you suffer from coeliac disease triggered by gluten, following a gluten-free diet could do more harm than good, as gluten-free foods are often low in fibre and key nutrients, and high in sugar. (more…)
Smoking is a leading cause of preventable death and disease in the world. It is estimated that the society costs associated with smoking are approximately ₤12.9 billion a year, including the NHS cost of treating smoking related diseases and loss of productivity.
Chronic obstructive pulmonary disease (COPD) is one of the major diseases caused by smoking. The disease ranks third among the leading causes of death worldwide. Around 1.2 million Britons suffer from the disease (Source: British Lung Foundation). The usual clinical picture is that of a smoker with symptoms that include shortness of breath and chronic cough. The muscle lab team at the Royal Brompton Hospital’s BRU, led by Professor Michael Polkey and Dr Nicholas Hopkinson is looking at different ways to improve COPD care, and at the different mechanisms by which interventions improve patient outcomes in the disease.
In recent years, it has been discovered that the negative consequences of the pulmonary disease are not just limited to within the rib cage. The wider effects of the disease on multiple body systems has a large and solid evidence base to support it. More than half of COPD patients suffer simultaneously from at least two other conditions known to often occur alongside the disease (so-called ‘comorbid’ conditions); the presence of which is commonly used as an indication of disease severity (1). The disease burden usually takes its toll on the patients’ quality of life, daily physical activities and social interactions. (more…)