Skip to main content

Author: Louise Stanley

International initiative to tackle heart health inequalities in cities to be led from Birmingham

Researchers from BHP founder the University of Birmingham will collaborate with international partners on an ambitious project aiming to help reduce the burden of cardiovascular disease in urban environments, as well as reducing the health inequality gap.

Cardiovascular disease is the leading cause of death globally, accounting for over 20 million deaths per year and costing the EU an estimated €282bn annually. To tackle this, the European Union Innovative Health Initiative has funded the new Cities@Heart consortium which will design, pilot and evaluate a series of city-level strategies to improve cardiovascular health for all.

Addressing cardiovascular disease in urban environments is challenging due to factors like poor access to healthcare and healthy food, exposure to pollution, and lack of safe spaces for physical activity. Urban infrastructure, food systems, and socio-economic disparities also contribute to adverse cardiometabolic outcomes.

While there are many interventions for cardiovascular disease, a lack of effective implementation means these often fail to reach individuals who would benefit most. This is particularly evident in underserved city populations such as those experiencing poverty, and in certain ethnic groups, disabled people, and women.

Addressing these complex issues requires a whole-city, integrated approach that changes health policy through co-production of suitable interventions with communities and community leaders.

The Cities@Heart project, starting in January 2026 and coordinated by the University of Birmingham, the University Medical Center Utrecht (Netherlands) and Novartis (Switzerland), will combine medical, technical, social and policy innovations to achieve a transformation in outcomes for communities experiencing health inequality.

Led by Professor Dipak Kotecha, the project will utilise existing infrastructure from seven city councils across Europe, embedding new health innovations and technologies from industry partners to tackle the challenge of urban cardiovascular disease on a significant scale.

The strategies will target obesity, hypertension, dyslipidaemia and diabetes, key drives of common and high-cost cardiovascular disease, such as heart attacks, stroke, heart failure, atrial fibrillation and vascular dementia. These disproportionately impact underserved and disadvantaged communities in urban areas.

Professor Dipak Kotecha, Professor of Cardiology at the University of Birmingham, researcher at the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, through which this project will be delivered, Honorary Professor at the University Medical Center Utrecht and Global Director of Cities@Heart said: “Huge strides have been made to better manage disease of the heart and circulation, but they still remain the world’s biggest killers. We will jointly develop approaches with affected citizens, community leaders, city councils, clinicians, health policy leaders and industry partners to achieve long-term change.”

Collaboration across Europe

The project consortium involves 34 international partners, including the World Health Organization (WHO) European Healthy Cities Network, World Heart Federation, European Heart Network, European Society of Cardiology, European Public Health Association and multiple European universities.

Birmingham joins another six cities committed to city-wide improvement that will test and implement strategies that can be scaled across the WHO’s network of more than 1,800 cities: Belfast (Northern Ireland), Cork (Republic of Ireland), Łódź (Poland), Izmir (Turkey), Udine (Italy) and Utrecht (Netherlands).

The vision of the consortium is that evidence-based prevention, early detection, and management of cardiovascular disease is universally accessible in urban areas, supported by new health technology developments. The Cities@Heart project aims to reduce the economic burden of cardiovascular disease on society and improve quality-of-life and life expectancy for millions.

Birmingham joins £50m MRC Centre for clinical trial innovation

Academics at BHP founder-member the University of Birmingham will be part of a new Medical Research Council Centre of Research Excellence in Clinical Trial Innovation (MRC CoRE) which aims to speed up patient and participant access to new medicines and trials, for improved patient care.

The Centre, in partnership with the National Institute for Health and Care Research (NIHR), will receive up to £50 million over 14 years to transform the landscape of clinical trials – shaking up approaches to trial design and delivery by developing pioneering new ways to accelerate processes and drive improvements in treatment and recovery.

The University of Birmingham will be one of six leading research intensive institutions to join forces to support MRC CoRE, with Professor Thomas Pinkney bringing his expertise in running complex surgical clinical trials including the ROSSINI-Platform trial, the UK’s largest ever surgical trial to make future operations safer.

MRC CoRE will see UK trials move away from the current approach of testing a single intervention in a single disease one at a time. Finding efficient way to test multiple drugs in multiple diseases at the same time would be a game changer both for industry and the academic community.

Professor Pinkney said: “This new funding will give a major boost to the latent potential around the UK to design and run clinical trials for new treatments for participants and patients.

“Birmingham brings a huge breadth of clinical trials experience both here in the UK and around the world, including surgical trials, complex cancer trials including with children, and many more besides. In addition, the West Midlands offers a unique opportunity with clinical trials for working with a diverse population and socioeconomic background, and so we are ideally placed to help accelerate the development of medicines for patients.”

Professor Patrick Chinnery, Medical Research Council Executive Chair explained: “The UK medical research community is very effective at gaining insights about disease biology and developing potential new treatments and interventions, especially in underserved areas such as multiple long-term conditions and rare diseases.

“It is essential to quickly move such interventions forward to the right patients, at the right doses, durations and combinations.”

Leading the world in innovative trial design

A key area of focus are clinical trials aimed at identifying the minimum ‘intensity’ – such as duration, frequency, or dose required – for a drug to be effective. For instance, finding the lowest effective dose of a chemotherapy drug could help make cancer treatment gentler for patients by reducing side effects.

The MRC CoRE team will be led by Professor Max Parmar will build on the team’s past work which created the highly innovative ‘multi-arm multi-stage’ platform clinical trials. These designs have revolutionised clinical trials to be more flexible, able to add or remove new drugs for testing over time, depending on results and new breakthroughs.

The leadership group will include researchers from the University College London, London School of Hygiene & Tropical Medicine, University of Cambridge, University of Edinburgh, University of Birmingham, and Newcastle University.

Professor Max Parmar, Director of the MRC CoRE in Clinical Trial Innovation, said: “Basic science is rapidly producing more understanding of biology and consequently many new interventions to help us in a range of diseases – both by industry and academic routes. Clinical trials are the way in which we evaluate all these new treatments. However, they are too slow and costly meaning it takes some 20 years to get a new invention from the laboratory into routine clinical practice at a cost of some £2 billion. Our goal with this CoRE is to substantially reduce this time so that patients can benefit much sooner from new treatments and also bring the costs of testing new treatments down.”

Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care and Chief Executive Officer of the NIHR, said: “Success for this Centre will be having efficient adaptive trials becoming part of the mainstream, in the range of approaches to carrying out clinical trials. With increasingly complex interventions being developed for our diverse population, we’re excited for the UK to be taking a leadership role in innovative trial design and look forward to seeing effective and more targeted treatment regimes being evaluated at pace and informed by novel methodology approaches.”

ROH and Aston University establish international research group to develop novel bone cancer therapy

BHP members the Royal Orthopaedic Hospital NHS Foundation Trust and Aston University have come together with the Brazilian Aeronautics Institute of Technology (ITA) to found Biomedical Technologies for Regenerative Orthopaedics (BioTROCS) – a group aiming to advance research in the development, characterisation, and pre-clinical and clinical evaluation of novel biomaterials for bone regeneration and bone cancer applications.

ITA, Aston University and the Royal Orthopaedic Hospital have already been collaborating for several years to explore the use of gallium in treating bone cancer patients, and the formalisation of this alliance will make it easier for the three organisations to secure funding to further this ground-breaking research.

Dr Lucas Souza, Dubrowsky Regenerative Medicine Laboratory Manager at the Royal Orthopaedic Hospital, commented: “Collaboration is the core principle for groundbreaking research and solving real-world problems requires a multidisciplinary approach. BioTROCS is the officialisation of a long-term international collaboration between Brazil- and UK-based physicists, chemists, biologists and clinical researchers that has already made significant contributions to the advancement of technologies for the treatment of bone disorders such as critical-sized bone defects and bone tumours.

“This new phase represents the first step to establishing a strategic partnership that aims to facilitate the flow of researchers, materials, and data between participating institutions to foster an even richer research environment to accelerate discoveries in the field of biomaterials for bone regeneration and bone cancer.”

The new research group has successfully secured funding to further the group’s development of an injectable paste for use in bone cancer surgeries. The funding includes a PhD scholarship in Brazil, with the student also coming to Aston University for a 12-month placement.

Professor Dr Joao Lopes, Aeronautics Institute of Brazil, added: “The formalisation of the BioTROCS group is a key step in strengthening international scientific cooperation and represents a strategic opportunity to expand our research efforts in cutting-edge therapies for bone regeneration and bone cancer treatment. This partnership between institutions in Brazil and the UK not only enhances the development of novel biomaterials and advanced therapies, but also significantly increases our ability to secure funding from agencies that offer exclusive calls for international collaborative projects. In addition to enabling the exchange of researchers and knowledge, BioTROCS fosters a more dynamic innovation ecosystem that supports the development of high-impact clinical and technological solutions.”

Professor Richard Martin, Aston University, commented: “Aston University and the Royal Orthopaedic Hospital have successfully collaborated for five years in this area of research and the formation of an international research group will help drive forward the use of biomaterials for bone regeneration and bone cancer.

“This area of research has huge potential – for example in September 2024, our tests found that bioactive glasses doped with gallium have a 99% success rate of eliminating cancerous cells and can even regenerate diseased bones. My team at Aston University is looking forward to hosting the new PhD researcher who will help further advance our research.”

Members of the BioTROCS team in Brazil

Clinical use of nitrous oxide could help treat depression

Patients with major depressive disorder, including those who have not responded to first-line antidepressants, may benefit from short-term nitrous oxide treatment, say researchers from BHP members the University of Birmingham and Birmingham and Solihull Mental Health NHS Foundation Trust, working with colleagues from the University of Oxford.

The largest meta-analysis of global trial data has been published in BioMedicine and assessed the best available clinical information to show how clinically administered nitrous oxide (N2O) can offer fast-acting depressive symptom relief for adults with major depressive disorder (MDD) and treatment-resistant depression (TRD).

TRD is characterised as depression that isn’t effectively managed after a patient tries two different antidepressants. It affects approximately 48% of UK patients who experience limited benefit from standard treatments, according to a previous study led by the research team.

Researchers assessed seven clinical trials and four protocol papers published by investigators from around the world. Each research study looked at the use of nitrous oxide, also used as pain relief in a range of medical situations, for treating depressive disorders, including MDD, TRD and bipolar depression.

The team found that a single treatment of inhaled clinical nitrous oxide at 50% concentration (in three trials), produced rapid and significant reductions in depressive symptoms within 24 hours, although these effects were not sustained at one week. In contrast, repeated dosing over several weeks led to more durable improvements, suggesting that multiple treatment sessions (compared to a single dose) may be required to maintain clinical benefit. It is thought to target glutamate receptors in a similar way to ketamine, another rapid-acting antidepressant, and this may help explain why improvements in mood can be observed soon after inhalation.

Professor Steven Marwaha from the University of Birmingham, Honorary Consultant Psychiatrist at Birmingham and Solihull Mental Health NHS Foundation Trust, and senior author of the study said: “This is a significant milestone in understanding the potential of nitrous oxide as an added treatment option for patients with depression who have been failed by current treatments. This population has often lost hope of recovery, making the results of this study particularly exciting. These findings highlight the urgent need for new treatments that can complement existing care pathways, and further evidence is needed to understand how this approach can best support people living with severe depression.”

Kiranpreet Gill, a PhD researcher funded by the Medical Research Council at the University of Birmingham and first author of the study, said: “Depression is a debilitating illness, made even more so by the fact that antidepressants make no meaningful difference for almost half of all patients diagnosed with it. There is a growing body of research on repurposing treatments from other clinical domains to alleviate low mood. This study brings together the best possible evidence indicating that nitrous oxide has the potential to provide swift and clinically significant short-term improvements in patients with severe depression.

“Our analyses show that nitrous oxide could form part of a new generation of rapid-acting treatments for depression. Importantly, it provides a foundation for future trials to investigate repeated and carefully managed dosing strategies that can further determine how best to use this treatment in clinical practice for patients who don’t respond to conventional interventions.”

Further research required

The meta-analysis of studies found strong evidence for short-term improvements in mood following nitrous oxide administration. Due to the limited number of existing trials, there was notable variability in how depressive symptoms were measured and reported, as well as in the timing of these assessments. Further studies are needed to determine the optimal dose, nitrous oxide’s long-term safety, and the best way to integrate it into existing treatment pathways.

The team also examined the safety and potential side effects of nitrous oxide. Some patients experienced side effects such as nausea, dizziness and headaches, all of which passed quickly and resolved without medical intervention. While higher dosing (at 50% concentration) increased the likelihood of these side effects, none of the studies reported any short-term safety concerns. The researchers emphasised that longer-term safety must be assessed through future studies with extended follow-up periods.

The study was conducted by researchers at the Mental Health Mission Midlands Translational Centre, led by the University of Birmingham and funded by the National Institute for Health and Care Research through the NIHR Oxford Biomedical Research Centre. The team are working on improving treatment options for treatment-resistant depression in superdiverse and deprived populations. The Centre aims to accelerate the development and delivery of innovative, evidence-based interventions to improve outcomes and reduce disparities in mental health care.

This work also aligns with ongoing efforts within the Birmingham Clinic for Advanced Mood Disorder Management (CALM), where innovative, evidence-based treatments such as ketamine and neuromodulation are being delivered to people with severe or treatment-resistant depression.

Building on this translational pathway from discovery to clinical practice, the team is now preparing the first NHS trial in the UK to assess whether nitrous oxide can be delivered safely and acceptably as a treatment for major depression. The findings will help determine how nitrous oxide could be integrated into NHS care and may expand the range of innovative options available for patients who have not benefited from standard approaches.

Birmingham researchers lead world-first treatment trial for rare liver disease

The first participant has been treated in an early-phase clinical trial investigating whether a new medical device, Carbalive, can slow disease progression and improve outcomes for patients with a rare liver disease called primary sclerosing cholangitis (PSC). The trial, known as the CATCH trial, marks the first time this device will be studied in humans with PSC-IBD.

The new clinical trial involves several BHP partners – it’s being coordinated by researchers from the University of Birmingham and the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, and clinicians at University Hospitals Birmingham (UHB) NHS Foundation Trust. 

PSC affects around 3500-4000 people in the UK, including both adults and children. In PSC, the body’s immune system attacks itself, causing inflammation and scarring of the bile ducts – the small tubes that carry bile (a digestive fluid produced by the liver) to the gallbladder and small intestine. This leads to reduced or blocked bile flow, and over time, liver damage.

In around 80% of people with PSC, the body also attacks the bowel, which can lead to inflammatory bowel disease (IBD), a devastating disease that affects the lining of the gut, leading to severe gut inflammation, bleeding and diarrhoea.

There is currently no cure or medication to improve survival, and liver transplantation remains the only life-saving option for PSC.

The exact cause of PSC is not known, but research has shown that gut inflammation, that is also a key component of IBD, is a key trigger for the disease. Removing harmful substances and restoring the disturbed gut microbiome reduces gut inflammation, which may help slow its progression.

Carbalive (also called YAQ001) is a medical device created by Yaqrit – a company that develops life-saving treatments for patients with advanced liver disease. This device is made up of tiny carbon beads with lots of different sized pores to absorb toxins that would otherwise return to the liver.

In pre-clinical studies, animals with cholestatic disease (a condition where bile flow from the liver is impaired) showed improvements in liver function and signs of disease activity after treatment with Carbalive. Early studies in people with cirrhosis have also shown the device to be safe and effective in restoring the gut microbiome and reducing inflammation.

Palak Trivedi, Principal Investigator of the study, Consultant Hepatologist and Clinician Scientist at UHB, and Professor of Cholestatic and Immune-mediated Liver Disease at the University of Birmingham, said: “PSC-IBD is a progressive condition, and with no approved treatments, it can ultimately lead to liver failure.

“This trial is an important step in exploring the potential of Carbalive to slow the progression of this disease and improve patient outcomes. By funding this trial, and this innovation, LifeArc offers hope to patients and their families through a promising new approach.”

First participant in the trial

Nick Haynes, from Nottingham, is the first participant to take part in the trial and began his treatment this week.

Nick said: “I was diagnosed with PSC a couple of years ago, and as there aren’t many treatment options available currently, that really attracted me to taking part in this trial. I think it comes with many benefits – you hope the medicine will lead to some kind of improvement, but it’s also very reassuring to be part of enhanced screening. It’s about looking to the future too, and being part of something that could advance medicine and treatment options for people with PSC feels really positive. I really hope it becomes a viable treatment for patients in the future.”

Twelve patients with PSC-IBD will receive Carbalive orally for twelve weeks, and the data collected will assess whether the treatment improves bile flow and reduces inflammation.

The trial has been made possible through funding from LifeArc, a not-for-profit organisation supporting research into rare diseases.

Troels Jordansen, Yaqrit’s Chief Executive Officer said: “This is a great opportunity for Yaqrit to help patients with PSC-IBD while remaining highly focused on the treatment of late-stage liver disease.

“In YAQ001, the company has developed a treatment that addresses toxicities and inflammation that are common in advanced liver disease but also apparent in a broader spectrum of conditions.”

Sam Barrell, CEO of LifeArc, said: “For the 3.5 million people in the UK living with rare diseases, access to treatment is a huge challenge – 95% of conditions have none. That must change. World-first trials, like the CATCH Trial, are part of the solution, which is why LifeArc funded it through our Pathfinder Programme. We have an opportunity to make the UK the go-to place for innovative trials like this, but to realise this ambition we need to transform how we support rare disease research, making a difference for rare disease patients much faster.”

CATCH is the latest clinical trial delivered through the NIHR Birmingham Biomedical Research Centre, a partnership between the University of Birmingham and University Hospitals Birmingham NHS Trust, which focuses on inflammatory disease research. Collaborative research from the NIHR Birmingham BRC has already seen nearly 1,000 clinical trials initiated and has informed UK clinical guidelines.

Lifesaving programme to prevent post-birth bleeding wins Times Higher Education STEM Award

A cost-effective intervention for postpartum haemorrhage, which has reduced maternal deaths worldwide by 60%, has won a major award in UK Higher Education.

The E-MOTIVE programme led by BHP founder-member the University of Birmingham and the World Health Organisation (WHO), with partners around the world, has been awarded Times Higher Education’s 2025 STEM award for best research in science, technology, engineering or mathematics.

Members of the E-MOTIVE team collect their award

The award was given to the low-cost set of interventions, which are being used to reduce deaths from childbirth-related bleeding – the leading cause of maternal mortality worldwide. It affects an estimated 24 million women each year and results in around 70,000 deaths – mostly in low and middle-income countries – equivalent to one death every seven minutes.

Professor Adam Devall from the University of Birmingham and an author of the study said: “We are delighted that E-MOTIVE has received recognition from the Times Higher Education awards, demonstrating the high calibre of research undertaken at the University of Birmingham.

“Childbirth-related bleeding is a major risk to life for women around the world, affecting an estimated 24 million women each year. E-MOTIVE is a powerful toolkit that is already being employed globally to dramatically reduce the numbers of women dying from excessive bleeding during childbirth.

“Continued international collaboration could see EMOTIVE prevent up to 20,000 maternal deaths a year, marking a revolution in maternal care.”

Following a landmark study published in the New England Journal of Medicine, the WHO has convened a group to draft its first official guidelines on bundled PPH care. It stated that bundled treatments could be provided for less than $1 per package – making them cheap enough to scale in low-income countries.

Four countries have now incorporated E-MOTIVE into their national clinical guidelines, with WHO updating its road map for addressing PPH. The Gates Foundation, which funded the trial, has pledged to invest a further $500 million (£375 million) into the treatments and further research as a result of its success.

Professor Arri Coomarasamy, Honorary Professor at the University of Birmingham who led the E-MOTIVE trial said: “E-MOTIVE has the power to radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it.

“Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be gamechangers for maternal health.”

The award-winning research programme is part of the University of Birmingham’s work to end preventable death and illness in mothers affected by postpartum haemorrhage, miscarriage and other pregnancy-related conditions around the globe.

The University is leading the way in women’s health research by championing the need to test safe and effect medicine use during pregnancy and breastfeeding, including jointly leading Europe’s largest miscarriage research centre – the Tommy’s National Centre for Miscarriage Research.

The breadth of research expertise extends to other women’s health priorities, including ovarian cancer, where research has been instrumental in changing National Institute of Clinical Excellence guidelines regarding surgical approach.