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Funding boost for Birmingham rare disease research

BHP founder-member the University of Birmingham has been awarded a £500k Pathfinder Award from the medical research charity LifeArc which will support early-stage projects with a focus on translational development in rare diseases.

The successful projects have now been announced following an internal selection process. Research, conducted by the University of Birmingham and working across Birmingham Health Partners, will begin this spring.

Professor Timothy Barrett, Director of the Centre for Rare Disease Studies (CRDS) Birmingham, commented: “I am thrilled that our Centre for Rare Disease Studies at the University of Birmingham has been successful in securing a LifeArc Pathfinder Award. We are working closely with other organisations from Birmingham Health Partners; Birmingham Children’s and Women’s Hospital and University Hospitals Birmingham; to fund a number of impactful translational research projects through the fund. Our uniquely diverse patient population, and strength in partnership ensures that we are in the best possible position to drive forward research in rare diseases to accelerate progress and ultimately improve patients’ lives.”

Around the world, approximately 300 million people are living with a rare disease. A disease is considered rare if it affects less than 1 in 2000 people. Around 80% of rare diseases have a genetic component. They are often chronic, progressive, degenerative and frequently life-threatening with no existing cure.

Owing to the nature of rare disease, small patient populations make research challenging. Lack of scientific knowledge and quality of information on rare diseases can mean that misdiagnosis is common and treatment options may be limited.

The Centre for Rare Disease Studies supports basic and applied research, in order to build a pipeline of translational research from gene discovery to improving the diagnosis, clinical management and treatment of these disorders.

Research projects that will benefit from the Pathfinder Award include:

      • The NEEDED Study (NanoporE Enhances Diagnosis in rarE Disease), led by Dr Hannah Titheradge, which will investigate the effectiveness of a new type of genome sequencing to identify rare diseases.
      • A proof-of concept study, led by Dr Nekisa Zakeri, which aims to develop a novel ‘off-the-shelf’ T cell immunotherapy capable of providing more effective treatment for patients with a rare liver cancer.
      • The CATCH Study (CArbalivefor the Treatment of CHoleastic Disease), led by Dr Palak Trivedi, looks into whether a new medical device can absorb toxins from the gut to reduce inflammation and scarring in primary sclerosing cholangitis; a rare progressive liver disorder for which no medical treatment has been shown to slow disease progression.
      • Dr Richard Tuxworth and Professor Zubair Ahmed, whose research in DNA damage in nerve cells has already resulted in patent applications covering pathways and mechanisms that could provide new therapies for neurological conditions and spinal cord injury, will now work with Professor Andrew Beggs and Dr Chiara Bardella to investigate the potential for one of these pathways (the ATM-Chk-2 pathway) as a basis for therapies to tackle rare neurological conditions that appear early in childhood.
      • Dr Sovan Sarkar’s study aims to improve the health of patients with rare childhood-onset forms of neurodegeneration by correcting the process of autophagy that normally removes undesirable cellular materials which is detrimental to brain cells called neurons.

Dr Hannah Titheradge, a Consultant in Clinical Genetics at Birmingham Women’s and Children’s NHS Foundation Trust, will investigate the effectiveness of nanopore sequencing – a new type of real time genome sequencing – on a larger group of patients. Previously tested on a very small sample, this new technology showed promise for improving our capability to diagnose rare diseases.

Nanopore sequencing reads more letters in an individual’s genome than the standard sequencing method used to diagnose rare genetic disorders. The NEEDED Study (NanoporE Enhances Diagnosis in rarE Disease) will explore a more detailed approach that could improve the percentage of patients who receive an important genetic diagnosis, which can help those patients and their families face their challenges feeling better informed.

Dr Hannah Titheradge commented: “Receiving a diagnosis can be an uphill challenge for patients with rare diseases and their families. These individuals often wait years for a final diagnosis, having undergone multiple tests and procedures. Having a diagnosis is very important because it helps these individuals better understand their health problems and plan for the future. Some genetic conditions are treatable, and a diagnosis is the first step towards accessing these treatments. We can also understand whether any other family members’ health may be affected. For these reasons, any advance that can be made in improving rare disease diagnostics is invaluable.”

Samira Fakire, Business Manager at LifeArc, added: “We hope that the Pathfinder Award will encourage more researchers to move into the rare disease space and promote the development of a translational culture – pushing more discoveries from the lab into meaningful real-world benefits for patients.”

Funding renewal allows experimental cancer therapy research to continue in Birmingham

New and innovative ways to detect and treat cancer being trialled at the University of Birmingham are to receive renewed funding from Cancer Research UK and the NIHR.

The Birmingham Experimental Cancer Medicine Centre (ECMC), jointly funded by Cancer Research UK and the National Institute for Health and Care Research in England, provides world-leading expertise in the development of innovative cancer trials. New funding will enable the Birmingham ECMC to continue to conduct the highest quality trials into experimental treatments for cancer over the next five years.

The centre aims to be an integrated translational hub for cancer research in Birmingham and brings together the University of Birmingham’s global expertise in cancer research and strength in clinical trials to deliver accelerated patient benefit regionally, across the ECMC network and globally.

The centre is part of world-leading cancer research infrastructure in Birmingham alongside the Birmingham Cancer Research Clinical Trials Unit (CRCTU) and the NIHR Biomedical Research Centre. The funding enables the University of Birmingham, working closely together with organisations across the Birmingham Health Partners network, to focus on three themes in experimental cancer medicine: Precision Medicine, Cancer Immunotherapy and Biomarker-driven patient stratification.

Gary Middleton, Professor of Medical Oncology and Centre Director for the Birmingham Experimental Cancer Medicine Centre said:

“Thanks to the funding from Cancer Research UK and the National Institute for Health and Care Research we will be able to continue to design and deliver trials that have the power to make a huge difference to the lives of cancer patients.

“Over the past five years we have already made significant advances in precision medicine for cancer including through the National Lung Matrix trial. With renewed funding we will be able to drive forward the next generation of these studies, offering access to personalised therapies to cancer patients in the West Midlands and across the national ECMC network.”

Case study: Lung Matrix Trial

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said:

“We are proud to be supporting an expansion of our successful ECMC network, bringing together vast medical and scientific expertise to translate the latest scientific discoveries from the lab into the clinic.

“The ECMC network is delivering the cancer treatments of the future, bringing new hope to people affected by cancer. The trials taking place today will give the next generation the best possible chance of beating cancer.

Chief Executive of the NIHR, Professor Lucy Chappell, said:

“The ECMC Network is a vital strategic investment in the UK’s cancer research community, bringing together top scientists and clinicians to tackle some of the biggest scientific challenges in cancer and improve outcomes for patients.

“Through this route, we enable more people to join trials that could help them. The ECMC Network will give access to brand new experimental treatments for patients, including children and young people, paving the way for these treatments to be used in the clinic one day. This is a crucial part of NIHR’s work, and enables more people to join trials that might help them. We are proud to be partnering with Cancer Research UK and the Little Princess Trust in funding this network.”

Building on success

Birmingham is part of a network of 17 ECMCs across the UK, funded by Cancer Research UK and the NIHR, which deliver clinical trials of promising new treatments. Since 2007, when the network was first established, around 30,000 patients have taken part in 2,100 trials.

The funding will allow new, experimental treatments – including immunotherapies – for a wide variety of cancers to be developed, as well as improve existing treatments.

ECMCs work in conjunction with local NHS facilities to provide access to cutting-edge cancer treatments. Testing these treatments helps to establish new ways of detecting and monitoring the disease and to evaluate how it responds to the treatment.

DETERMINE

The University of Birmingham is part of a newly announced partnership which is running a multi-drug, precision medicine platform trial for adults and children with rare cancers who have run out of other treatment options.

The DETERMINE trial is one of the largest precision medicine platform trials targeting these populations and it will enrol patients who have an identifiable genetic alteration in their cancer that can be targeted by treatments that are already approved for use in other cancer types.

The trial is aiming to recruit patients with rare adult and paediatric cancers, as well as more common cancers with rare genetic alterations that could be targeted by the drugs being studied in the trial.

Researchers make mini ‘bone-marrow-in-a-dish’ to test cancer treatments

Scientists from BHP and Oxford University have made the first bone marrow ‘organoids’ that capture the key features of human bone marrow. The technology, for which University of Birmingham Enterprise has filed a patent application, will allow for the screening of multiple anti-cancer drugs at the same time, as well as testing personalised treatments for individual cancer patients.

A study, published in the journal Cancer Discovery, describes the new method; a process resulting in the production of an organoid that faithfully models the cellular, molecular and architectural features of myelopoietic (blood cell producing) bone marrow.

The research also showed that the organoids provide a micro-environment that can enable the survival of cells from patients with blood malignancies, including multiple myeloma cells, which are notoriously difficult to maintain outside the human body.

First author Dr Abdullah Khan, a Sir Henry Wellcome Fellow at BHP founder-member the University of Birmingham, said: “Remarkably, we found that the cells in their bone marrow organoids resemble real bone marrow cells not just in terms of their activity and function, but also in their architectural relationships – the cell types ‘self-organise’ and arrange themselves within the organoids just like they do in human bone marrow in the body.”

A cross section of a mini bone marrow organoid, showing cells that produce blood platelets, in a network of blood vessels. Credit: Dr A Khan, University of Birmingham

This lifelike architecture enabled the team to study how the cells in the bone marrow interact to support normal blood cell production, and how this is disturbed in bone marrow fibrosis (myelofibrosis), where scar tissue builds up in the bone marrow, causing bone marrow failure. Bone marrow fibrosis can develop in patients with certain types of blood cancers and remains incurable.

Senior study author Professor Bethan Psaila, a haematology medical doctor as well as a research Group Leader at the Radcliffe Department of Medicine, University of Oxford, said: “To properly understand how and why blood cancers develop, we need to use experimental systems that closely resemble how real human bone marrow works, which we haven’t really had before. It’s really exciting to now have this terrific system, as finally, we are able to study cancer directly using cells from our patients, rather than relying on animal models or other simpler systems that do not properly show us how the cancer is developing in the bone marrow in actual patients.”

Dr Khan also added: “This is a huge step forward, enabling insights into the growth patterns of cancer cells and potentially a more personalised approach to treatment. We now have a platform that we can use to test drugs on a ‘personalised medicine’ basis.

“Having developed and validated the model is the first crucial step, and in our ongoing collaborative work we will be working with others to better understand how the bone marrow works in healthy people, and what goes wrong when they have blood diseases.”

Dr Psaila added: “We hope that this new technique will help accelerate the discovery and testing of new blood cancer treatments, getting improved drugs for our patients to clinical trials faster.”

Birmingham BRC receives £30m boost to improve treatment of inflammatory diseases

Increased funding for the renewed NIHR Birmingham Biomedical Research Centre will enable continuation of major developments around inflammatory diseases and new technologies and systems

The NIHR Birmingham Biomedical Research Centre (BRC) has been awarded more than £30 million in funding from the National Institute for Health and Care Research, a major funder of global health research and training, to support world-leading research into inflammation – including the development of new diagnostic tools and treatments for those with cancer, liver and heart disease, and many more illnesses.

The centre brings together multiple BHP members – including leading NHS providers led by the University Hospitals Birmingham NHS Foundation Trust and academic institutions led by the University of Birmingham – as well as other organisations working closely with charities and businesses. Its aim is to support research into inflammation which causes or worsens many common long-term illnesses including arthritis, liver disease and cancer.

This new investment represents an almost threefold increase in funding for the NIHR Birmingham BRC and will enable researchers to focus on eight areas of illness including heart disease, women’s health, and common complications from inflammation. Researchers will also be empowered to consider new tests and biomarkers for disease, health technologies including stem cells and gene therapy, patient experiences and data science.

Professor Phil Newsome, Director of the NIHR Birmingham BRC, said: “Inflammation plays a central role in many health conditions, with millions of people in the UK alone experiencing inflammatory diseases such as arthritis and bronchitis. This significant increase in funding will enable us to provide an outstanding environment for world-leading clinical research and allow us to make a step-change in our work tackling different forms of cancer, trialling new drugs for liver disease, and dealing with antimicrobial resistance.”

Patients will benefit from the increased funding thanks to the BRC’s collaborative research that has seen nearly 1,000 clinical trials and informed UK clinical guidelines.

Researchers will look at eight themes to continue to understand and help patients manage inflammation-based diseases including cancer, arthritis, and liver disease. The investment of the NIHR funding in biomedical research will enable clinicians, researchers, patients and supporters to find new treatments such as the development of new immunotherapies, which are types of cancer treatments to support the body to fight cancer.

Professor David Adams, Director of BHP, commented: “The investment from NIHR is hugely important for researchers working across the BRC partner institutions, to continue to tackle some of the critical health themes that affect our region. The funding will allow us to deliver new therapies and diagnostic tests for a range of chronic inflammatory diseases for which we currently have few effective treatments.”

Professor Lucy Chappell, Chief Executive of the NIHR, said: “Research by NIHR Biomedical Research Centres has led to a number of ground-breaking new treatments, such as new gene therapies for haemophilia and motor neurone disease, the world-first treatment for Creutzfeldt–Jakob disease, a nose-drop vaccine for whooping cough, and the first UK-wide study into the long-term impact of COVID-19.

“This latest round of funding recognises the strength of expertise underpinning health and care research across the country and gives our nation’s best researchers more opportunities to develop innovative new treatments for patients.”

The Birmingham Biomedical Research Centre is made up of the following BHP member organisations:

  • University Hospitals Birmingham NHS Foundation Trust
  • University of Birmingham
  • Sandwell and West Birmingham NHS Trust
  • Birmingham Women’s and Children’s NHS Foundation Trust
  • Aston University

Working closely with partners:

  • Birmingham Community Healthcare NHS Foundation Trust
  • Keele University
  • University of Oxford

‘Cellular brake’ offers clue to autoimmune response during immunotherapy

A ‘cellular brake’ which could prevent lung cancer patients from developing a dangerous autoimmune response during treatment has been identified by scientists.

The finding, published in Nature Communications, is the first clue to the cause of autoimmune toxicity, in which patients develop dangerous additional conditions during immunotherapy treatment.

Immunotherapy works by enabling the body’s immune cells (T cells) to engage with and kill tumour cells. They do this by suppressing proteins called immune checkpoints. These exist to prevent an immune response from being so strong that it destroys healthy cells in the body.

Autoimmune toxicity, which includes conditions such as pneumonitis, or inflammation of the lungs, can affect lung cancer patients undergoing immunotherapy treatment. Pneumonitis is responsible for around 35 per cent of treatment-related deaths in lung cancer patients.

Given the increasing use of immunotherapy treatment against cancer, the management of these reactions has become a significant healthcare challenge. Most commonly, clinicians will recommend discontinuing the treatment and exploring other options.

Led by Professor Gary Middleton, the team, in the University’s Institute of Immunology and Immunotherapy pinpointed a specific biological response among patients who develop autoimmune toxicity. They found a ‘cellular brake’ – a protein which would normally limit the activity of the T cells – is missing or not functioning properly.

By identifying patients who lack this cellular brake, it may be possible to recognise patients at high risk of developing severe autoimmune complications.

Lead author Dr Akshay Patel said: “Immunotherapy is an extremely important weapon in cancer treatment and so identifying people who are at particular risk of developing these potentially life-threatening autoimmune conditions is key to weighing the risks and benefits of different treatments. It would enable clinicians to closely monitor high-risk patients, develop preventative strategies, or pursue alternative treatments altogether.”

The research was funded by Cancer Research UK and the National Institute for Health and Care Research (NIHR) Biomedical Research Centre.

Identifying DNA repair genes holds promise for improving cancer treatment

A new way in which cancer cells can repair DNA damage has been discovered by researchers at BHP founder-member the University of Birmingham.

These new findings shed new light on how cancer cells react to chemotherapy and radiotherapy, and also uncover a new way in which cancer can become resistant to particular treatments. These insights may enable clinicians to select different cancer treatments that can be more targeted to specific patients.

Repairing damage to DNA is vital for cells to remain healthy, and to prevent diseases like cancer from developing. Understanding how DNA repair works is crucial to better understand how cancer develops, and also how anti-cancer treatments like radiotherapy and chemotherapy can be used effectively to induce DNA damage that kill cancer cells.

In the study, published in Molecular Cell, a team of researchers in the University’s Institute of Cancer and Genomic Sciences pinpointed two proteins that had not previously been identified in the DNA repair process.

Professor Martin Higgs, Associate Professor for Genomics and Rare Disease in the Institute of Cancer and Genomic Sciences, explained: “This research has the potential to change how cancer patients are identified for treatment and also how they become resistant to different drugs, which will improve treatment efficiency as well as patient outcomes.”

Called SETD1A and BOD1L, these proteins modify other proteins called histones which are bound to DNA. Removing these two proteins changes how DNA is repaired, and makes cancer cells more sensitive to radiotherapy. Loss of SETD1A and BOD1L also makes cancer cells resistant to certain anti-cancer drugs called PARP inhibitors.

Lead author Associate Professor Martin Higgs explained: “This is the first time that these genes have been directly linked to DNA repair in cancer. This research has the potential to change how cancer patients are identified for treatment and also how they become resistant to different drugs, which will improve treatment efficiency as well as patient outcomes.”

The team hopes the work could eventually also lead to new inhibitors being developed that would allow clinicians to re-sensitise cancers that have become resistant to certain therapies.

The research was funded by the Medical Research CouncilCancer Research UK, and the Wellcome Trust.