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Author: Louise Stanley

Pancreatic cancer cell ‘atlas’ uncovers why many promising treatments fail

Written by Louise Stanley on . Posted in Cancer outcomes.

The most detailed atlas of tumour cells from the deadliest form of pancreatic cancer has been developed by an international team of researchers, highlighting how tumour cells change their behaviour depending on their surroundings – and how this leads many promising treatments to fail in standard lab tests.

The research was a collaborative effort led by the BHP founders-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, working with pharmaceutical company Bristol Myers Squibb. Published in Cell Reports, their findings describe the most detailed spatial map to date of pancreatic ductal adenocarcinoma (PDAC).

In the study, tumour samples from 39 untreated pancreatic cancer patients were analysed using cutting-edge spatial transcriptomics technologies, allowing researchers to see which genes are active in cells and exactly where those cells are located in the tumour. This approach generated a massive dataset – comprising hundreds of thousands of spatial measurements and more than half a million individual cells – creating a comprehensive ‘atlas’ of pancreatic cancer tissue.

Pancreatic cancer remains one of the hardest cancers to treat, with few effective therapies and a five-year survival rate in the single digits. A major reason is the disease’s complexity: cancer cells are embedded in a dense, hostile tissue environment filled with scar-like material, low oxygen, and supportive cells that help tumours survive. 

Dr Shivan Sivakumar, co-senior author from the University of Birmingham and consultant medical oncologist at University Hospitals Birmingham said: “This spatial atlas is expected to serve as a foundational resource for the research community, and may accelerate the development of treatments for a disease that has long resisted progress.

“By integrating spatial biology with functional genetic screening, we have created a roadmap for discovering therapies that target pancreatic cancer more effectively – especially combination treatments designed to disrupt both cancer cells and the environments that protect them.

“The findings suggest that environmental factors play a much greater role in tumour cell development in the pancreas, and identifies new intermediate tumour subtypes and highly proliferative cancer cells which together provide a more vivid picture of this deadly cancer.”

Dr. Konstantinos Mavrakis, Executive Director and Head of Discovery Biosciences Oncology at Bristol Myers Squibb and co-senior author of the publication emphasised the importance of scientific collaborations: “This study underscores how important it is to use real-world patient data to better understand the underlying causal human biology of a specific cancer type such as pancreatic cancer.”

Key findings:

  • Cancer cell identity depends on location. The study confirmed known pancreatic cancer subtypes, commonly called classical and basal-like, but showed that these identities are strongly shaped by the tumour’s local environment. In particular, aggressive basal-like cancer cells were consistently found in regions with low oxygen and dense fibrotic tissue.
  • A hidden cancer state comes into focus. Researchers discovered that an ‘intermediate’ tumour subtype is not just a mix of known states, but a distinct cancer cell identity. This finding clarifies long-standing confusion in pancreatic cancer classification.
  • Tumours contain a small but powerful growth engine. A previously underappreciated group of highly proliferative cancer cells was identified, marked by intense cell-division activity. Although relatively rare, these cells may disproportionately drive tumour growth.
  • Context hides critical vulnerabilities. The team used CRISPR gene-editing screens in cancer cells grown under realistic conditions such as low oxygen or inside living tumours. This revealed genetic weaknesses that are invisible in standard laboratory cultures, and may explain why many drug targets that look promising in the lab fail in patients.
  • Common lab models miss key disease features. Widely used mouse and cell-line models captured some aspects of human pancreatic cancer but often failed to reproduce the most aggressive tumour states and their surrounding environments. This highlights the need for better preclinical testing strategies.

Trial to investigate weight loss drugs for treating blinding headache condition

Written by Louise Stanley on . Posted in Clinical trials, Experimental medicine, Inflammation and chronic disease.

Patients with Idiopathic Intracranial Hypertension (IIH), which causes headaches and potential sight loss, are being invited to take part in new research investigating the impact of weight loss drugs on their condition and eye health.

The IIH Advance trial, coordinated by clinical academics at BHP founder-member the University of Birmingham, aims to recruit 86 people with IIH from around the UK to take part in the trial lasting over a year, which will be delivered in partnership with Specsavers.

IIH is currently considered a rare disease with, affecting approximately 5,000 patients in the UK. It predominantly affects women of childbearing age, and 90% of those living with it also experience obesity. Previous studies at the University have established a direct link between IIH, metabolic dysregulation and obesity, so researchers anticipate that IIH prevalence is set to increase significantly as obesity levels continue to rise.

During the trial, participants will receive the weight loss drug Tirzepatide (commonly known as Mounjaro) and will have Optical Coherence Tomography (OCT) eye scans at a participating branches of Specsavers to monitor swelling of the optic nerves, called papilloedema, which is caused by intracranial pressure.

The study is delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC).

Dr Maria Lange from the University of Birmingham and co-investigator on the trial said: “IIH is a debilitating condition, and after years of research to better understand the condition, this innovative trial will see whether weight loss, achieved by using the drug Mounjaro could have a significant positive impact for patients.”

“As GLP-1 medicines such as Mounjaro have become available for weight management through the NHS, we hope that the IIH Advance trial will establish a link between losing weight using these drugs and reducing the symptoms of IIH.”

Welcoming the trial, Specsavers’ director of professional advancement Paul Morris said: “IIH is a serious condition that can lead to blindness, and the role that community optometrists and their skilled teams can play in harnessing technology to detect serious eye conditions is pivotal. That’s why regular sight tests are so important. We welcome this innovative trial and are looking forward to collaborating with participants in it as well as the team at the University of Birmingham.”

People with a diagnosis of IIH who have papilloedema and live in the UK will be eligible to take part and are invited to self-nominate themselves to the trial. No doctor’s referral is required, and patients will not need to visit hospital or the trial centre in Birmingham.

Each participant will receive regular deliveries of Mounjaro to their home and will have regular calls with a research team member. They will also undergo eye scans at a participating Specsavers practice at the start of the trial, at six and 12 months, and at the conclusion of the trial.

Dr Jessie Gew, from the University of Birmingham and co-investigator adds: “IIH patients can now directly contact the trial team to self-refer. Once contact is made, our team will work closely with each participant to review relevant medical documentation and confirm eligibility for the study.”

Professor Alex Sinclair, Consultant Neurologist and Professor of Neurology at University of Birmingham, who leads the  Idiopathic Intracranial Hypertension Clinical Service at University Hospitals Birmingham NHS Foundation Trust, said : “This trial is an example of the type of pioneering research that could ease pressure on the NHS through innovative community-focused collaboration with industry. We believe that this vision for a trial that streamlines care and empowers patients to participate and receive treatment from the comfort of their own homes is exactly the type of research that the NHS 10-year plan is calling for.”

IIH Advance is now open for participants to self-refer online.

Birmingham researchers lead novel review of heart disease in chronic kidney disease

Written by Louise Stanley on . Posted in Inflammation and chronic disease.

Researchers at BHP member organisations have carried out a state-of-the-art commissioned review on heart disease in chronic kidney disease (CKD), recently published in leading cardiovascular journal Nature Reviews Cardiology. Bringing together decades of clinical, imaging and experimental evidence the review provides a robust and authoritative overview of heart disease in patients with CKD.

Based on existing research, conducted at the University of Birmingham and elsewhere, the review highlights that structural and functional abnormalities of the heart often begin early in CKD, long before patients reach kidney failure, and that heart disease in CKD is not primarily driven by blocked coronary arteries, but by a combination of long-term stresses on the heart. Such stresses include high blood pressure, fluid overload, metabolic and hormonal disturbances, inflammation, anaemia, and abnormalities in calcium and phosphate metabolism – which, together, can lead to heart muscle thickening, stiffness and scarring, increasing patients’ risk of heart failure, arrhythmias and sudden cardiac death.

Birmingham researchers also propose that the term “chronic kidney disease-associated cardiomyopathy”, should be used in place of the traditionally used “uraemic cardiomyopathy”, to more accurately reflect current evidence.

Professor Jonathan Townend, Director of Clinical Research and honorary Professor of Cardiology at the University of Birmingham, said: “Being invited to write this review recognises the strength of cardiovascular and cardio-renal research at Birmingham. The evidence shows clearly that heart damage in chronic kidney disease starts early, progresses silently, and needs to be identified and addressed well before patients reach kidney failure.”

The review concludes that a shift in clinical focus is needed, away from treating heart disease only at the stage of kidney failure, and towards earlier detection and prevention of cardiac damage in people with chronic kidney disease.

Birmingham’s leadership in clinical cardio-renal research

The review draws heavily on evidence generated by the Birmingham cardiovascular and cardio-renal research community, which has delivered multiple influential clinical studies and trials over the past two decades. This body of work has been central to defining how CKD affects heart structure, function and clinical outcomes, and Birmingham-led and associated studies have helped demonstrate that cardiac abnormalities are present in early-stage CKD, often before overt symptoms develop.

Professor Charles Ferro, Consultant Nephrologist at University Hospitals Birmingham and Honorary Professor of Cardiovascular Sciences at the University of Birmingham said: “For years the Birmingham Cardio-Renal Research Group has been advocating that the excess cardiovascular disease observed in patients with kidney disease has much more to do with structural changes to the heart rather than coronary artery disease. It is really gratifying that our ideas are getting increasing recognition, becoming more accepted, influencing research strategies worldwide, and most importantly, benefitting patients.”

Collectively, these trials and cohort studies have shaped international understanding of cardiovascular risk in CKD and directly underpin many of the concepts brought together in the review.

Birmingham researchers are now leading a programme of well-funded mechanistic research, supported by the British Heart Foundation, aimed at increasing our understanding of the cellular and molecular drivers of heart disease in early CKD.

Dr Davor Pavlovic, Associate Professor in Cardiovascular Sciences at the University of Birmingham, said: “Heart damage in chronic kidney disease starts early. Our focus at Birmingham is to understand the mechanisms behind these early changes and use that knowledge to prevent disease progression.”

By consolidating existing evidence and setting out future research priorities, the review highlights the importance of a focus on earlier detection and prevention of cardiac damage for CKD patients in the future.

National childhood type 1 diabetes screening could prevent thousands of emergency diagnoses, Birmingham study shows

Written by Louise Stanley on . Posted in Birmingham Health Partners, Early diagnosis and detection, Inflammation and chronic disease.

A landmark UK study led by researchers at BHP founder members the University of Birmingham – which involved tens of thousands of families – has shown that childhood screening for type 1 diabetes is effective, laying the groundwork for a UK-wide childhood screening programme.

Results from the first phase of the ELSA (EarLy Surveillance for Autoimmune diabetes) study, co-funded by charities Diabetes UK and Breakthrough T1D, are published today in The Lancet. 

The findings mark a major step towards a future in which type 1 diabetes can be detected in children before symptoms appear. Currently, over a quarter of children with type 1 diabetes don’t receive a diagnosis until they are already in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment. Early detection can dramatically reduce emergency diagnoses and could give children access to new immunotherapy treatments that can delay the need for insulin for years.

Launched in 2022, ELSA is the first UK study of its kind, and tested childrens’ blood samples for autoantibodies – markers of type 1 diabetes that can appear years before symptoms.  

We know that risk rises sharply with the number of autoantibodies. Children without autoantibodies are unlikely to develop type 1 diabetes, while those with one autoantibody have a 15% chance of developing the condition within 10 years. Having two or more autoantibodies indicates the immune system has already started attacking the insulin-producing cells in the pancreas and it is therefore almost certain these children will eventually need insulin therapy. This is known as early-stage type 1 diabetes.

Among the 17,283 children aged 3-13 years who were screened for type 1 diabetes risk at the time of analysis: 

  • 75 had one autoantibody, signalling increased future risk. 
  • 160 had two or more autoantibodies but did not yet require insulin therapy, indicating early-stage type 1 diabetes. 
  • 7 were found to have undiagnosed type 1 diabetes with all needing to start insulin immediately.  

Families of children found to have early-stage type 1 diabetes received tailored education and ongoing support to prepare for the eventual onset of type 1 diabetes symptoms and to ensure insulin therapy can begin promptly when needed, reducing the chances of needing emergency treatment. Those with one autoantibody also received ongoing support and monitoring.

Some families were also offered teplizumab, the first ever immunotherapy for type 1 diabetes, which can delay the need for insulin by around three years  in people with early-stage type 1 diabetes. The first patient was treated at Birmingham Children’s Hospital, demonstrating the hive of cutting-edge diabetes activity in and around Birmingham Health Partners and the Birmingham health and life sciences district. Teplizumab was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK in August 2025, and is currently being assessed by the National Institute for Health and Care Excellence (NICE) to determine whether it should be available through the NHS.

As of November 2025, more than 37,000 families had signed up to the ELSA programme and, building on this strong foundation, the second phase of the research launches today. ELSA 2 will expand screening to all children in the UK aged 2-17 years, with a focus on younger children (2-3 years) and older teenagers (14-17 years). The research team aims to recruit 30,000 additional children across these new age groups.

ELSA 2 will also establish new NHS Early-Stage Type 1 Diabetes Clinics, providing families taking part in the study with clinical and psychological support and creating a clear pathway from screening to diagnosis, monitoring and treatment.

Amy Norman, 44, from the West Midlands, was diagnosed with type 1 diabetes at the age of 13. She recently discovered via the ELSA study that her 11-year-old daughter, Imogen, is in the early stages of type 1 diabetes but has been able to slow its progression as the second child in the UK to access a breakthrough immunotherapy drug – teplizumab. She said: “Being part of the ELSA study has helped us as a family to prepare for the future in a way we never expected. Knowing what’s coming – rather than being taken by surprise – has made an enormous difference to our confidence and peace of mind.

“When I was diagnosed, I had no warning and ended up quite poorly in hospital with diabetic ketoacidosis (DKA). When Imogen’s diagnosis arrives, we hope that having this awareness will reduce her chances of experiencing DKA and the added trauma that comes from a sudden illness.

“Imogen took part in the study to further research and help others, but it has helped her too – being forewarned is being forearmed. She was always going to develop type 1 diabetes, but through ELSA we’ve been able to slow down the process and prepare – we know what is coming, but we’re not scared.” 

Lead researcher, Parth Narendran, Professor of Diabetes Medicine at the University of Birmingham, said: “We are extremely grateful to all the families who have participated in the study and generously given their time to help understand how a UK-wide screening programme could be developed. Together with Diabetes UK, Breakthrough T1D and NICE, we are working towards a future where type 1 diabetes can be detected in a timely manner, and families appropriately supported and treated with medicines to delay the need for insulin.

“We are also grateful to partners across the Birmingham health and life sciences district and beyond as well as the NIHR for the support they have provided in getting us to where we are.”

Dr Elizabeth Robertson, Director of Research and Clinical at Diabetes UK, said: “For too many families, a child’s type 1 diabetes diagnosis still comes as a frightening emergency. But that doesn’t have to be the case. Thanks to scientific breakthroughs, we now have the tools to identify children in the very earliest stages of type 1 diabetes – giving families precious time to prepare, avoid emergency hospital admissions, and access treatments that can delay the need for insulin for years.

“The ELSA study, co-funded by Diabetes UK, is generating the evidence needed to make type 1 diabetes screening a reality for every family in the UK. We’re incredibly grateful to the 37,000 families who’ve already signed up and urge others to get involved. Together, we can transform type 1 diabetes care for future generations.”

Rachel Connor, Director of Research Partnerships at Breakthrough T1D, said: “This is about rewriting the story of type 1 diabetes for thousands of families. Instead of a devastating emergency, we can offer time, choices, and hope. By finding children in the earliest stages, we’re not just preparing families, we’re opening the door to treatments that can delay the need for insulin by years. That extra time means childhoods with fewer injections, fewer hospital visits and more normality. Thanks to research like ELSA, what once struck as an unexpected crisis can become an actively managed healthcare process, changing the course of T1D for the better.”

The Research FIRST team at Birmingham Health Partners has played a pivotal role in the successful delivery of the ELSA study. Drawing on extensive specialist expertise, the team developed and implemented a robust, resilient database to support high-quality data capture and long-term study integrity.

Beyond technical delivery, the team also provided dedicated data management support throughout the project, ensuring rigorous standards, regulatory compliance and operational efficiency. They also offered oversight across key project activities, working closely with participating sites to support recruitment and ensure timely follow-up.

The team’s co-ordination and proactive problem-solving were instrumental in keeping the study on track. A further major achievement was the end-to-end management of dry blood spot testing kit dispatch, enabling sites to begin screening as quickly as possible after families signed up. This comprehensive project management has been critical in maintaining momentum and supporting the continued success of the study, enabling researchers to continue their work with confidence.

The findings from ELSA’s first phase signal a major step towards a future in which type 1 diabetes can be detected early, managed proactively, and potentially delayed through immunotherapy. ELSA demonstrates that childhood screening in the UK is feasible, acceptable to families, and capable of preventing emergency diagnoses. Continued research through ELSA 2 will assess how screening can be scaled across the NHS and evaluate its cost-effectiveness.

Type 1 diabetes is a serious and lifelong autoimmune condition affecting up to 400,000 people in the UK. It is caused by an immune system attack on the insulin-producing cells in the pancreas, meaning they can no longer make enough insulin. Rapid diagnosis of type 1 diabetes is essential to avoid life-threatening complications. 

For more information about ELSA or ELSA 2, visit elsadiabetes.nhs.uk/taking-part/. 

Simple tool predicts mental health and treatment needs for new inflammatory bowel disease patients

Written by Louise Stanley on . Posted in Early diagnosis and detection, Inflammation and chronic disease, Mental health.

Researchers at BHP founding-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), have shown how early use of the IBD Disk questionnaire can help forecast which patients are likely to experience more severe physical and mental health outcomes over the following year.

More than half a million patients in the UK have inflammatory bowel disease (IBD), and research suggests that up to 30% experience mental ill health as a result. Now, a new study outlines how many of the 25,000 new patients diagnosed each year could receive more tailored mental health support thanks to a simple tool that identifies psychological distress and predicts disease severity.

The paper published in Frontiers in Gastroenterology shows how a patient-reported questionnaire called IBD Disk – currently used to track impact of disease on daily life – can also be powerful prediction tool, detecting anxiety and depression symptoms from the outset of a patient’s diagnosis for the inflammatory condition.

The Birmingham study is the first to show that the tool can be used at the point of diagnosis to identify patients at risk of mental health challenges and predict who may need more intensive treatment.

This dual-purpose use – both as a mental health screener and a predictor of disease trajectory – could help clinicians intervene earlier and personalise care for patients more effectively.

Dr Peter Rimmer, lead author of the study, researcher at the University of Birmingham and Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust said: “This is the first time we’ve shown that the IBD Disk can act as both a mental health screener and a predictive tool for clinical outcomes at the very start of a patient’s journey.

“The findings support the use of the IBD Disk not only as a disability tracker, but as a proactive tool to guide early treatment decisions and mental health support. It’s a simple intervention that could help personalise care and reduce long-term burden on the NHS.”

Mental health conditions more common for IBD patients

Mental health conditions including anxiety and depression are more common in people with established IBD than in the general population, with some studies suggesting that 20-30% of patients are affected by mood disorders.

However, very few studies have been undertaken among patients when they are first diagnosed – at a time when their new IBD symptoms and uncertainty around diagnosis can contribute to psychological distress.

This study found that patients with higher levels of disease-associated physical disability and psychological distress at diagnosis were more likely to need escalating treatments such as stronger medication or surgical interventions, or require an emergency admission to hospital later on – adding to growing evidence that early identification of these symptoms could play a key role in improving long-term outcomes for people with IBD.

The study followed 188 patients attending a rapid-access clinic for suspected IBD who were subsequently diagnosed with either Crohn’s Disease or Ulcerative Colitis. At their first visit – before diagnosis – patients completed the IBD Disk, and a subgroup also completed the Hospital Anxiety and Depression Scale (HADS) to assess mental health. After diagnosis, patients were treated according to standard clinical guidelines and followed for 12 months.

Researchers analysed whether scores on the IBD Disk, particularly in the “Emotions” domain, could identify patients with moderate to severe anxiety or depression symptoms, and whether those scores predicted the need for advanced therapies, hospitalisation, and persistent disease activity.

Statistical analysis showed that an “Emotions” score of 7 or higher was highly correlated with moderate to severe depression symptoms. Patients with higher IBD Disk scores at diagnosis were significantly more likely to experience poor clinical outcomes, especially those with ulcerative colitis. Where medical treatments were not effective and their IBD remained active, patients were more likely to experience ongoing symptoms of psychological distress.

The study involved collaborators from Hoffmann-La Roche, Beaumont Hospital Dublin, and Royal Wolverhampton NHS Trust. Hoffmann-La Roche provided funding for the study and the Roche author participated in manuscript writing, review and editing.

West Midlands Living Lab: connecting healthcare through technology

Written by Louise Stanley on . Posted in Health inequalities.

A new initiative will see researchers work with digital technology leaders and industry to meaningfully impact healthcare services and improve patient outcomes in the Midlands.

The West Midlands Living Lab will explore the use of digital technology to improve patient communication, enable community care, avoid unnecessary hospital admissions, and support a more prevention-based health service.

Working with worldwide technology giant Cisco, BHP founder-member the University of Birmingham will lead the latest of the Lister Alliance Living Labs in the country’s richly diverse second city. With approximately 6.2 million people, and more than 100 languages spoken, the diverse West Midlands population truly reflects the global community. Research conducted in the region will be widely applicable, meaning it provides the ideal test bed.

University Hospitals Birmingham’s Professor Simon Ball, who is also Senior Responsible Officer for the West Midlands Secure Data Environment and co-lead for the living lab said: “The West Midlands is the perfect place to do this innovative work, with our leading researchers bringing together key stakeholders to connect state-of-the-art NHS facilities and uniquely diverse local communities. Working with an industry partner with the capability and reach of Cisco working alongside us is a testament to the scale of our ambition and drive to improve health outcomes using innovative technology and analytics.”

Professor Neil Hanley, Pro Vice Chancellor and Head of College of Medicine and Health, said: “We’re delighted that the University of Birmingham, led by Professor Kotecha, is at the forefront of this collaboration. It was great to attend the recent launch event and inspiring to feel the cross-sector work- the genuine triple helix of universities, public sector and industry – all focussed on stopping readmission to hospital and, in particular, addressing the health inequalities associated with this. Aligning all this with skills, innovation, entrepreneurship and commercialisation really excites me. And of course, with the make-up of Birmingham and the West Midlands being the demographic of the world, lessons learned and experiences gained will be rapidly translatable across the UK and internationally.”

The West Midlands Living Lab, funded by Cisco’s Country Digital Acceleration programme, will take advantage of considerable and unique health data resources, including the West Midlands Secure Data Environment which is connecting health systems across the region, and DaRe2THINK, which provides a national digital clinical trial platform for NHS Primary Care.

Pilot studies are planned to run through community hubs, NHS Primary Care and hospital trusts, looking at how best to break down siloes between existing services and orchestrate better, connected health and social care. Partnerships with community organisations will help address the needs of diverse neighbourhoods and be a blueprint for global benefit.

Professor Dipak Kotecha, School of Medical Sciences, University of Birmingham, said: “Our new living lab focused on health technology will allow us to bring together health data and industry partners to innovate towards better healthcare for all. This includes exploring technologies for remote monitoring, developing AI tools for prediction, improving how people get discharged from hospital, and integrating health data to keep people informed and well in their own homes.

“For example, our previous research, now adopted into the NHS 10-year plan, has shown that wearable devices for health monitoring can provide information similar to that recorded at hospital visits. These early indications show promise for a less hospital-centric and more personalised approach to care, delivered in the community by using new healthtech.”

Declan Hadley, Healthcare Lead, Cisco UKI, said: “We are looking forward to harnessing the creativity, experience and collective capabilities in the West Midlands to improve routine NHS care through technology but also need to be mindful that we don’t exacerbate existing heath inequalities. Living labs are just as much about finding out what does work as what doesn’t, and we plan to achieve this through co-production with local community leaders.”