Post on 06-Jun-2020
MRes Medical Research Directory
2020/21
Research Directory | Norwich Medical School | University of East Anglia Page 2 of 60
CONTENTS
GASTROENTEROLOGY, GUT BIOLOGY AND MICROBIOLOGY PAGE 3
NUTRITION PAGE 18
DIABETES AND ENDOCRINOLOGY PAGE 24
MUSCULOSKELETAL BIOLOGY AND SURGICAL ANATOMY PAGE 28
ONCOLOGY AND HAEMATOLOGY PAGE 34
CARDIOVASCULAR RESEARCH PAGE 41
RESPIRATORY MEDICINE, RHINOLOGY AND EAR, NOSE AND THROAT PAGE 45
MENTAL HEALTH AND DEMENTIA PAGE 49
POPULATION HEALTH, PRIMARY CARE AND HEALTH CARE DELIVERY PAGE 53
Research Directory | Norwich Medical School | University of East Anglia Page 3 of 60
Gastroenterology, Gut Biology & Microbiology
Research Directory | Norwich Medical School | University of East Anglia Page 4 of 60
Gastroenterology, Gut Biology & Microbiology
RESEARCH AREA OVERVIEW
Gastroenterology research in Norwich offers a broad portfolio of research covering clinical research with
patients, laboratory and epidemiological research. Norwich Medical School is one of the UK’s major centres
for gastrointestinal research; senior academics in the School and the consultants at NNUH work in close
collaboration with other Institutes based at Norwich Research Park, including the Genome Analysis Centre,
the John Innes Centre and the recently established Quadram Institute (QI). Clinical gastroenterology
research is concentrated at the Quadram, which houses the NNUH Endoscopy Facility and provides research
facilities for academic scientists working on the biology of the gastrointestinal tract, alongside clinicians and
clinician-scientists in NNUH Gastroenterology. We also have strong contacts with major epidemiological
databases in the UK and USA to study dietary risk factors for gastrointestinal disease. This gives an excellent
teaching environment for research training.
Relevant Links http://www.uea.ac.uk/medicine/research/research-areas/gastroenterology-and-gut-biology
https://quadram.ac.uk/research_areas/gut-microbes-health/ Current Research Opportunities
Dietary risk factors for gastrointestinal disease – Prof Andrew Hart
Cardiovascular and gut health – Prof Alastair Forbes
Primary sclerosing cholangitis of the liver – Dr Simon Rushbrook
Gastrointestinal pharmacology, therapeutics and education – Dr Ian Beales
Gut microbes in health and disease – Prof Simon Carding
Gut microbes and disease (NHS primary and community care) – Prof Simon Carding
Autophagy and Crohn’s disease – Prof Tom Wileman and Prof Ulrike Mayer
Gut immunology and the microbiota early in life – Dr
Lindsay Hall
Maintaining intestinal barrier function – Prof Alastair Watson
Generation of organoids from stem cells to study innate immune responses in the GI tract – Dr Penny Powell
Unravelling pathogen-host-microbiota interactions in the human gut – Dr Stephanie Schuller
Mucus-associated gut microbiota in health and disease – Prof. Nathalie Juge (Quadram Institute)
Discovering novel antibiotics to combat resistance – Prof Arasu Ganesan
Upper gastrointestinal surgery – Mr Bhaskar Kumar
Medical Microbiology
Molecular diagnosis of infectious disease – Dr Justin O’Grady
Antimicrobial resistance – Dr Mark Webber
Antibiotic resistance – Prof David Livermore
Genomic Microbiology – Prof John Wain
Evolution and spread of antibiotics resistance – Dr Benjamin Evans
Emerging infectious disease – Prof Paul Hunter
Tropical Medicine
Parasite virulence – Dr Kevin Tyler
Antimicrobials – Prof Dietmar Steverding
Research Directory | Norwich Medical School | University of East Anglia Page 5 of 60
Dietary risk factors for gastrointestinal disease
The aim of my work is to firstly conduct epidemiological aetiological studies in to the causes of inflammatory bowel
diseases and cancers of the oesophagus and pancreas, to allow the development of public health interventions to
prevent these diseases.
Translational studies will be conducted, invariably clinical trials, to develop novel treatments for patients with these
conditions.
We work with large observational databases including the EPIC Study (European Prospective Investigation in to
Cancer) and The Clinical Practice Research Database (CPRD).
Inflammation is a valuable defence against infection but chronic inflammation resulting from the sustained
production of inflammatory cytokines can contribute too many acute and chronic human diseases. Interestingly,
long-chain n-3 polyunsaturated fatty acids (also called PUFAs or omega 3s) found in oily fish can decrease the
production of inflammatory cytokines, and are therefore potential anti-inflammatory compounds. In Crohn’s
disease and ulcerative colitis we have shown inverse associations between higher intakes of dietary n-3
polyunsaturated fatty acids and the development of both Crohn’s disease and ulcerative colitis. Diets high in these
nutrients will be assessed in relation to increasing the proportion of such patients responding to biological
therapies. In oesophageal cancer we have reported people prescribed a statin are at a reduced risk of
oesophageal adenocarcinoma and feasibility work is now progressing on their role as an adjunctive treatment in
cancer patients. In pancreatic cancer, we are using detailed dietary information from food diaries assessing dietary
antioxidants, meat and saturated fatty acids in its aetiology. We are investigating the potential role of metformin
as a treatment for patients with this invariably fatal malignancy. Members of the research team include junior
doctors (clinical lecturer and academic clinical fellow grades) and medical students.
Contact: a.hart@uea.ac.uk
Cardiovascular and Gut Health The research of Prof Forbes’ group has a strong clinical bias focussed mainly on intestinal and nutritional
problems, particularly in inflammatory bowel disease and intestinal failure. We are interested in the interface
between nutrition and intestinal inflammation, and exploring this has been a key task for recent PhD and MD(Res)
students. A role of lipids in Crohn's disease is widely accepted, but the nature of the relationship and its
mechanisms remain controversial. Three related phenomena are under investigation: the almost pathognomonic
“creeping fat” seen around inflamed segments of the intestine, the epidemiological association of some forms of
fat with disease incidence, and the differential impact of nutritional therapies of varying fat composition. The group
is performing original work on markers of intestinal integrity and of nutritional manipulation with particular interests
in citrulline and glucagon-like factor 2 analogues, as well as contributing to major national and international
collaborations. An important new direction comes with the foundation of the Nutrition Group of the UEA Health
and Care Partners which takes nutritional assessment and intervention into the wider community outside hospital
practice with an increasing engagement with non-medical researchers.
Contact: alastair.forbes@uea.ac.uk
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Primary sclerosing cholangitis of the liver Primary sclerosing cholangitis (PSC) is one of the archetypal
autoimmune liver diseases characterised by biliary
inflammation and fibrosis that can lead to both cirrhosis and
cholangiocarcinoma. A major focus of our work is to develop a
greater understanding of how these genetic loci are associated
with the development of PSC by studying the immune system
in both the liver and bowel of patients with PSC.
At present PSC is the 5th commonest indication for liver
transplantation in the UK. Although the exact pathogenesis
remains unclear, PSC is thought to have both environmental
and genetic causes, with 16 genetic
loci currently identified and further genetic loci undergoing
evaluation in an international GWAS meta-analysis of which I am a collaborator. Current projects include studies of the role played by genetic variation in PSC and analysis of dendritic cell and T-cell subsets in the pathogenesis of the disease. Contact: simon.rushbrook@nnuh.nhs.uk
Gastrointestinal pharmacology, therapeutics and education Dr Beales has a wide portfolio of research interests
spanning clinical gastroenterology to education and
training. In general this focuses on mechanisms of
disease processes and in particular the interactions of
drugs on the luminal gastrointestinal tract. The current
research portfolio includes participation in several
international multicentre trials of novel biological and
small-molecule inhibitor agents as well as locally
delivered hypothesis-driven studies examining the
mechanisms of drug and hormone effects particularly
in Barrett’s oeosphagus and inflammatory bowel disease.
A variety of experimental approaches have been utilised included laboratory cell line studies,
immunohistochemistry (collaborating with colleagues in histopathology), case-control methodology, systematic
literature review and metaanalysis and interventional studies.
Recent important work has included the seminal original paper describing the mechanisms of the anti-cancer
effects of statins in oesophageal adenocarcinoma, subsequently followed with several case-control studies and a
systematic review confirming the clinical benefits. A detailed series of studies have illustrated the mechanisms
linking acid-reflux, obesity and oesophageal cancer: showing how leptin combined with acid to promote
oesophageal adenocarcinoma and how adiponectin may have inhibitor actions. Further studies to unravel these
effects are ongoing.
Other studies have explored the safety of cyclo-oxygenase inhibitors in patients with inflammatory bowel disease,
in particular showing the safety and efficacy of COX-2 inhibitors as well as the use of novel therapies to treat iron
Study or Subgroup
Nguyen 2010
Nguyen 2009
Kastelein 2011
Kantor 2012
Beales 2012a
Total (95% CI)
Heterogeneity: Chi² = 1.20, df = 4 (P = 0.88); I² = 0%
Test for overall effect: Z = 4.04 (P < 0.0001)
Weight
43.9%
9.5%
15.9%
11.5%
19.2%
100.0%
IV, Fixed, 95% CI
0.58 [0.38, 0.88]
0.73 [0.30, 1.78]
0.52 [0.26, 1.03]
0.71 [0.32, 1.59]
0.45 [0.24, 0.84]
0.57 [0.43, 0.75]
Odds Ratio Odds Ratio
IV, Fixed, 95% CI
0.2 0.5 1 2 5
Statins beneficial Statins hamful
Research Directory | Norwich Medical School | University of East Anglia Page 7 of 60
deficiency anaemia and microscopic colitis. Educational projects have examined timing of endoscopy during the
day on colonoscopy performance, predictors of publication of abstracts presented at conferences and attitudes to
the use of probiotics.
Contact: i.beales@uea.ac.uk
Gut microbes in health and disease A major research focus of the group is to understand how microbes (bacteria and viruses) resident in the lower
human GI-tract (the microbiome) interact with their host to maintain lifelong health, and how microbial dysbiosis
can lead to chronic diseases affecting not only the GI-tract but elsewhere in the body, including the brain. Current
projects in the group include:
The Gut-Brain axis: Identify factors produced by gut microbes that impact on specialised intestinal epithelial cells of the enteric endocrine and nervous systems that can alter signalling in the CNS.
The role extracellular (outer membrane) microvesicles produced by gut bacteria play in mediating crosstalk between the intestinal microbiota and host cells.
The role of the intestinal virome and prokaryotic and eukaryotic viruses play in regulating bacterial populations and in promoting dysbiosis and chronic inflammation.
Development of novel bacteria-based therapies (e.g. probiotics, bacterial products and microbiota transplants) to treat and prevent intestinal inflammation.
Role of the microbiota in the pathogenesis of myalgic encephalomyelitis/chronic fatigue syndrome.
Contact: s.carding@uea.ac.uk
Gut microbes and disease (NHS primary and community care)
Evidence is emerging that disturbances in the human gut microbiota can influence a number
of diseases including obesity, inflammatory bowel disease (IBD), myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CSF), multiple sclerosis (MS), autism
spectrum disorder (ASD), Type 1 Diabetes, rheumatoid arthritis, food allergies and
gastrointestinal cancers and liver disease. This is an incredibly exciting time in science, when
technological advances in DNA sequencing, transcriptomics, proteomics and metabolomics
provide an unprecedented opportunity to explore not only the composition, but also the
function of the microbial communities that live in the intestinal tract of patients with these
diseases. The knowledge gained should provide new and important insights into disease
pathogenesis and innovative therapeutic modalities.
We are developing gut-related projects through collaboration with Norfolk and Suffolk primary
and community care, with contributions from secondary (NNUH) care, that are suitable for
students enrolled in UEA postgraduate degree clinical research masters courses (MSc
Clinical Research, MSc Clinical Research (CAT), MRes Clinical Science, MSc Health
Research, MSc Advanced Practitioner).
Obesity. Student research projects we are developing include the identification of the best and safest follow-
up care following discharge after bariatric surgery. Development of new dietary interventions for early
intervention in obesity, and analysis of behavioural and environmental factors that predispose to obesity.
Research Directory | Norwich Medical School | University of East Anglia Page 8 of 60
Food allergy in children. Food protein-induced enterocolitis syndrome (FPIES) and food protein-induced
proctocolitis are non-IgE-mediated gastrointestinal allergies. FPIES causes changes in the intestinal
architecture in response to chronic exposure to a trigger such as milk. Avoiding milk results in normalization,
and its reintroduction results in a recurrence of partial villous atrophy. While this is similar to coeliac disease,
the two conditions differ in pathophysiology. Student projects will focus on literature reviews of the incidence,
presentation, likely mechanisms, diagnosis and management of FPIES accompanied by case histories of
patients in primary care diagnosed with FPIES and discussions with their families. A greater understanding
of the mechanisms may lead to development of diagnostic tests and management strategies for non-IgE-
mediated gastrointestinal allergies.
Gastrointestinal Symptoms in Adult Eczema Patients. Food allergy is a multisystem disease. Infants
present with a combination of symptoms predominantly in the skin, the gut and the respiratory system. Some
adult patients with food related atopic eczema and may also have gastrointestinal symptoms suggestive of
both IgE or non IgE mediated food allergy which can go unrecognised. Student projects will to look further
into the links between eczema and gastrointestinal symptoms in a cohort of adult patients. They will conduct
a literature review of bowel symptoms associated with adult eczema and non IgE mediated gastrointestinal
disease, and develop questionnaires for use in the dermatology clinic to identify gastrointestinal symptoms in
patients with atopic eczema. Students may also search the primary care database for adults with eczema
that have been referred with GI symptoms.
Gut microbes and mental health (neurodegenerative disease). By 2025 it has been estimated that there
will be more than 1 million patients in the UK suffering from dementia, more than 10% of which will be
attributed to East Anglia cases. Age-associated decline in mental health is associated with striking changes
in the make-up and activity of the intestinal microbiota with animal studies suggesting a direct causal link
between the production of toxic metabolites in the gut and brain pathology. The implications of altered host-
microbiome interactions in neurological disease would be far-reaching as they may underpin the development
of more effective therapeutic management of neurological diseases. Student projects will be to look further
into evidence for intestinal microbial dysbiosis contributing to chronic degenerative diseases such as dementia
and Alzheimer’s Disease through literature reviews and discussions with gut microbiologists at IFR and
dementia diagnosis and care experts within the NNUH and practitioners in primary and community care.
Contact: s.carding@uea.ac.uk
Autophagy and Crohn’s disease
Autophagy is a membrane trafficking pathway that generates
autophagosomes which deliver cytosol to lysosomes for
degradation. Autophagy provides a powerful means of removing
intracellular pathogens and is an important arm of innate
immunity to infection. Recent genome wide association screens
have identified autophagy gene Atg16L1 as a risk allele for
Crohn’s disease, an inflammatory disease of the bowel.
Susceptibility to Crohn’s disease is also linked to mutations in NOD2, a microbial sensor that activates autophagy
during infections. We are using mouse models to investigate whether the inflammation seen in Crohn’s disease is
caused by defects in the control of microorganisms by autophagy in gut epithelial cells.
Contact: t.wileman@uea.ac.uk
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Gut immunology and the microbiota early in life
Complex microbial communities (microbiota) colonise the body after birth. These beneficial bacteria shape immune defence, limiting infection by gut pathogens through a process of colonisation resistance. However, disturbances such as preterm delivery, caesarean sections and antibiotic exposure in early colonisation events can lead to increased susceptibility to pathogens, as well as allergic and chronic inflammatory diseases in later life. The Hall group work on building our knowledge of the contribution of specific bacterial species during early-life development, and how microbiota disturbances increase susceptibility to gut infection, focusing on Bifidobacterium. Current goals are:
To understand the effects of Bifidobacterium on critical colonisation resistance
Determine the short- and long-term impact of early life antibiotic-induced disturbances
Characterise and develop strategies for restoring a disturbed early-life microbiota to control gut infection, for use in infectious-disease settings.
Determine how a probiotic treatment strategy in at-risk preterm neonates alters the microbiota.
Contact: lindsay.hall@uea.ac.uk
Maintaining intestinal barrier function
The Watson group have a long-standing interest in the regulation of cell death in
intestinal epithelial cells. Specifically, intestinal epithelial cell shedding, a special
form of cell death which leaves a “gap” in the epithelial barrier. Under normal
conditions the “gap” is short lived and barrier function is maintained at sites of cell
shedding. However, during inflammation cell shedding is increased, resulting in
loss of barrier integrity and creating sites for the potential entry of microorganisms
and luminal antigens. Importantly, increasing evidence predicts that certain
species within the gut microbiota (probiotics) can reduce intestinal inflammation.
On-going studies are focused on determining how the microbiota and probiotics
can regulate epithelial integrity and thus critical barrier function. Current projects
in the lab include:
Determining to what extent the microbiota plays in modulating the intestinal barrier
Characterise the host cell molecules involved in microbiota signalling and epithelial barrier integrity
Identification and development of probiotic therapies that would protection against chronic inflammation
The role of mucins in prevention of intestinal inflammation
Contact: alastair.watson@uea.ac.uk
Research Directory | Norwich Medical School | University of East Anglia Page 10 of 60
Generation of organoids from stem cells to study innate immune responses in the GI tract
We are interested in the innate immune response in gut following viral infection which may explain the pathogenesis of human diseases. Innate immune responses to infection include apoptosis, autophagy and inflammation. When cells are infected with viruses these pathways are activated, the major pathway being production of interferon and interferon-stimulated genes (ISGs) triggered by dsRNA produced during viral replication. We are investigating this in primary cell cultures and gut organoids developed from small intestinal stem cells. In addition, we have used viruses to deliver exogenous genes to organoids to study innate immune pathways. The project will mainly involve bioimaging with confocal microscopy. Contact: p.powell@uea.ac.uk
Unravelling pathogen-host-microbiota interactions in the human gut
Research in our group is focussed on E. coli infections of the human gut leading to persistent diarrhoea (EAEC, EPEC), acute kidney failure (EHEC) and Crohn’s disease (AIEC). As bacterial pathogenesis in the intestine is largely influenced by host factors and the resident gut microbiota, it is important to apply biologically relevant model systems to decipher these interactions. To this aim, we are using advanced human cell- and tissue-based models (in vitro organ culture, stem cell-derived organoids, microaerobic diffusion chamber) which mimic the environment in the human gut. A better understanding of E. coli-host-microbiota interactions will contribute to the development of efficient antimicrobial- and probiotic-based therapies and facilitate identification of susceptible individuals.
Contact: s.schuller@uea.ac.uk
Research Directory | Norwich Medical School | University of East Anglia Page 11 of 60
Mucus-associated gut microbiota in health and
disease
The mucus-associated microbiota plays a predominant role in human health. We are studying how bacteria interact
with mucins and their associated glycans at the mucosal surface, how mucus-associated bacteria communicate
with the host and respond to changes in the physiological status of the host. Importantly, several conditions, such
as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), colorectal cancer (CRC) or infections are
associated with alterations in mucus-associated bacteria and mucin glycosylation, so the mechanistic knowledge
we are gaining from our research can be of use for designing new biomarkers of disease and developing microbial
and nutritional strategies to restore health. The Juge Group is based at the Quadram Institute Bioscience (QIB)
within the Gut Microbes and Health (GMH) Institute strategic programme (ISP).
Current projects in the Juge group investigate:
The changes in mucin glycosylation and mucus-associated bacteria in health (across lifetime) and disease
(IBS, IBD and CRC)
The molecular mechanisms of adaptation of gut bacteria to the mucus niche
The modulation of gut barrier function by mucus-colonising bacteria using gut organoid-on-chip systems
The role of mucus-colonising bacteria in protecting from pathogen infection at the mucosal interface
The mechanisms underpinning the communication between mucus-colonising bacteria and the host immune
system
The role of mucin glycosylation and mucus associated bacteria in the gut-brain axis.
The development of novel biomarkers of disease and of glycan-based approaches targeted to the mucus-
associated bacteria to restore human health.
https://quadram.ac.uk/nathalie-juge/
Contact: nathalie.juge@quadram.ac.uk
.
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Discovering novel antibiotics to combat resistance
Due to the alarming increase in antimicrobial resistance, new antibiotics with novel mechanisms of action are desperately needed. Historically, the major source of antibiotics are soil microorganisms but in recent years the pipeline of such drugs has dried up. Does this mean that there are no new antibiotics left to be discovered? The answer is definitely not! Whole genome sequencing of microorganisms, including common ones that are intensively studied, has identified a vast number of biosynthetic gene clusters (BGCs) that encode for secondary metabolite production. However, the majority are silent, or are expressed at very low levels, under laboratory culture conditions. Our group is interested in unlocking these gene clusters, isolating novel natural products and testing them as antibiotics. An example of our research can be found in this recent publication: Epigenetic modulation of secondary metabolite profiles in Aspergillus calidoustus and Aspergillus westerdijkiae through histone deacetylase (HDAC) inhibition by vorinostat, https://doi.org/10.1038/s41429-020-0286-5. Our projects are multidisciplinary and involve a combination of bioinformatics, genomics, microbiology, epigenetics, natural products chemistry and biology. We use a variety of approaches to the discovery of novel metabolites ranging from the isolation of new species to optimisation of nutritional components in fermentation media to the use of human anticancer drugs in fungi and you will develop these skills as part of your research project.
Contact: a.ganesan@uea.ac.uk
Figure: Fermentation of an Aspergillus species in the presence of the histone deacetylase (HDAC) inhibitor vorinostat, clinically approved for the treatment of T-cell lymphoma, induces production of the anticancer compound phenylahistin.
Research Directory | Norwich Medical School | University of East Anglia Page 13 of 60
Upper gastrointestinal Surgery
General Surgery research in Norwich covers a broad range of areas from cancer research, perioperative care,
epidemiology, microbiology and robotic surgery. We work in close collaboration with the Norwich Medical School,
clinical researchers and scientists at the Bob Champion Research and Education Building and the Quadram
Institute.
Preoperative cardiopulmonary fitness may protect against the risk of postoperative complications after major
surgery. We are currently running a multi-centred observational study across 15 UK hospitals investigating the
association between preoperative cardiopulmonary fitness and the risk of postoperative mortality after
oesophagectomy.
Poor preoperative glycaemic control has been shown to be independently associated with adverse postoperative
outcomes. In the largest study of its kind, we are using both genetic and blood biochemistry information from the
UK Biobank to investigate the association between hyperglycaemia and postoperative complications.
There is increasing evidence that the biliary microbiome may play a role in gallstone formation. Advances in
sequencing and bioinformatics have made shotgun metagenomics the most detailed approach to understanding
the microbiome of the biliary tract. In collaboration with the Quadram Institute of Bioscience we are using shotgun
metagenomics sequencing, phylogenetic profiling and microbial genome analyses to elucidate the role of the
biliary microbiome in gallstone formation and disease.
Peritoneal metastasis develops in more than 50 % of gastric cancer patients. Median survival without treatment is
3-7 months. Delivering chemotherapy directly into the peritoneum is an approach with improved tissue
concentrations and reduced toxicity compared to systemic treatment. Pressurised Intraperitoneal Aerosol
Chemotherapy (PIPAC) has been shown to be an effective mode for intraperitoneal drug delivery. We are
generating data to justify and inform a large definitive trial to determine if PIPAC should be offered as a treatment
option for patients with an otherwise dismal prognosis.
Contact: bhaskar.kumar@nnuh.nhs.uk
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Medical Microbiology
Molecular diagnosis of infectious disease Current research interests are in the molecular diagnosis of infectious diseases with a particular focus on the utility of next generation sequencing (NGS) for the diagnosis of complex clinical syndromes such as sepsis and respiratory tract infections. Currently, NGS is being used in centralised national reference laboratories to type referred bacteria but is not yet
available for routine diagnostic laboratories. Technologies under development will radically change this landscape,
reducing cost and removing the need for expert operators. Oxford Nanopore are developing one NGS technology,
the MinION device, which is expected to be available in 2014 and will work through the USB port of a computer.
Such technological advancements will move NGS from being a research and reference laboratory technology to
being something that can be used for the rapid, routine profiling of pathogens in clinical samples, possibly at the
point of care. The challenges to implementation are
sample preparation and data analysis. NGS
platforms are not optimised for the enrichment of tiny
amounts of pathogen nucleic acid from a vast excess
of human nucleic acid, as applies, for example, in the
investigation of bloodstream infection. We intend to
facilitate this leap in technology by developing
methods for preparing routine biologicals.
Contact: justin.ogrady@uea.ac.uk
Antimicrobial resistance
Bacterial resistance to antimicrobials is becoming a global crisis with
pathogens now commonly being isolated that are resistant to the first
choice antibiotics we use to treat infections. Antibiotics are crucial to
treat infections but are also needed to provide prophylaxis allowing
invasive surgeries and immunocompromising therapies such as
common cancer treatments. Loss of the utility of antibiotics affects
almost all medicine. We investigate how bacteria are able to become
resistant to antibiotics (and antiseptics and disinfectants used in
infection control) and under which conditions exposure to antibiotics
does and does not result in resistance emerging. We study both real
world populations of isolates and mutants selected in controlled
laboratory experiments to understand resistance. We aim to develop
improved strategies to use current drugs in a way that won’t select
resistant mutants and to help design new treatments to treat
resistant bacteria.
Contact: mark.webber@quadram.ac.uk
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Antibiotic resistance The main research focus of the Livermore lab is antibiotics and pathogen resistance. Research is centred on β-lactamases, their activity and bacterial resistance strategies including studies on hyper-resistant β-lactamase-hyper-producing mutants of Enterobacter. Other research relates to resistance epidemiology; leading teams investigating the molecular biology behind rises in MRSA, ciprofloxacin-resistant gonococci, carbapenemase-resistant Acinetobacter spp., cephalosporin-resistant E. coli and, latterly, carbapenemase-producing Enterobacteriaceae. Other current interests centre on the rapid detection of resistant bacteria in clinical samples and how this information can be used to improve patient treatment and antibiotic stewardship. Contact: d.livermore@uea.ac.uk
Genomic microbiology
Our research is centred on the use of bacterial genomic data in clinical and public health microbiology; in particular the development of sequence based tools for the diagnosis and molecular epidemiology of infectious disease. We are establishing an evidence base for the association of a bacterial species (or sub-species) with any given infection. Our current Norwich based research projects include the linking of Staphylococcus to prosthetic joint infection, Clostridium to outbreaks of antibiotic associated diarrhoea and specific strains of Pseudomonas aeruginosa to antibiotic resistant biofilm associated respiratory infection.
We have a very active collaboration with Public Health England to develop the use of metagenomic DNA sequencing for pathogen discovery and outbreak detection, as well as with the Jos University, Nigeria to look at Salmonella epidemiology and antibiotic resistance. For MRes students we offer specific experimental plans within each project that can be carried out to completion within the one year time frame; the work adds incremental information towards publication. We also encourage undergraduates to be part of our research effort and MRes students are expected to help with their supervision. Contact: j.wain@uea.ac.uk or e.manners@uea.ac.uk
Phylogenetic tree of Staphylococcus coloured by species
Dark Blue, is Staph. Epidermidis
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The evolution and spread of antibiotic resistance
Bacteria can become resistant to antibiotics through a number of different mechanisms. These include intrinsic
mechanism that all members of the bacterial species possess and that they switch on or ‘ramp up’ when exposed
to antibiotics, and mechanisms that the bacteria acquire from external sources that can then be exchanged
between bacteria.
My work centres on understanding which mechanisms bacteria are using to become resistant to antibiotics, and
how these are evolving and being transferred in bacterial populations. An example of current work is investigating
the effect of non-antibiotic drugs, such as cancer
chemotherapies, on promoting antibiotic resistance. Many
drugs used in healthcare coincidently have antibacterial
properties, and therefore bacteria develop resistance
against these. However, in doing so, some bacteria can
become more resistant to antibiotics at the same time, even
without having been exposed to any antibiotics. This ‘cross-
resistance’, where exposure to one drug (e.g. a cancer
chemotherapy) causes resistance to a different drug (e.g.
an antibiotic) is not well understood despite its potential to
have a major impact on the evolution and spread of
antibiotic resistance. By understanding how different drugs
cause cross-resistance to antibiotics we will gain a more
holistic view of antibiotic resistance that can be exploited in
the design and development of new drugs, and in the
management and use of existing drugs.
Contact: benjamin.evans@uea.ac.uk
Emerging infectious disease The epidemiology of emerging infectious disease especially regarding outbreaks and epidemics linked to environmental factors. Research in the Hunter group has been focussed in the spread of infection by drinking water and insect vectors, the role of recreational water contact and food, climate conflict and other causes of rapid change. But a broader interest in zoonotic diseases, disease reservoirs and transmission pathways has developed during recent years working with SGOs like WHO and NGOs including MSF. Currently conducting case-control and other epidemiological studies in the UK, Europe and the developing world. Particular interest in risk assessment and risk communication Contact: paul.hunter@uea.ac.uk
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Tropical Medicine
Parasite virulence
Infectious disease remains the major cause of illness and mortality especially of infants worldwide but disproportionately affect those in tropical regions the developing world. At UEA we are particularly interested in interventions to diagnose and prevent waterborne and vector borne diseases which are often most prevalent in the tropical areas but which continue to represent a threat to the UK population. Protozoan parasites cause many of the most widespread infections; most are benign, but many are deadly. Virulence factors determine what makes one infection deadly, while another is asymptomatic, as well as the extent and type of symptoms and pathology observed. We are interested in determining which parasite proteins are virulence factors and how we can exploit their identification for diagnosis of virulent strains, therapy and prevention. Current projects are directed towards understanding which virulence factors are associated with host range for cryptosporidiosis and trichomoniasis, with cell invasion for leishmaniasis and with enteric pathology for giardiasis. Opportunities exist for students to identify virulence factors from genomic analyses, to culture and transfect
parasites and host cells and to evaluate the function of the proteins they identify and their role in pathogenesis.
Contact: k.tyler@uea.ac.uk
Antimicrobials
My research aims to identify synthetic and natural compounds with anti-microbial activity against neglected tropical diseases (e.g. human African trypanosomiasis or sleeping sickness) and fungal infections (e.g. candidiasis). My work focusses on the anti-microbial activity of compounds that inhibit cysteine proteases, proteasomes or topoisomerase. We test antimicrobial activity using bloodstream forms of Trypanosoma brucei, the causative agent of human African sleeping sickness, and Candida albicans, a causative agent of superficial fungal infection of the mucosa and skin. Compounds are tested in cell culture and the effect of the compounds on parasite and fungal cells are monitored by cell counting and/or spectrophotometrically by measuring absorbance. The effect of inhibitors on the targeted enzyme is determined by activity assays using substrate specific for the enzyme. Contact: d.steverding@uea.ac.uk
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Nutrition
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Nutrition
RESEARCH AREA OVERVIEW Our mission is to conduct world-leading nutrition research which spans from fundamental mechanistic studies to large pragmatic trials in healthy participants and ‘at risk’ groups. Our research will help deliver the government Ageing Grand Challenge goal of increasing healthy life expectancy by five years by 2035.
We investigate the impact of key dietary components and dietary
patterns on health and risk of major age-related chronic diseases, in
particular cardio-metabolic health, musculoskeletal health, cognitive
health and dementia, micronutrient status and prostate cancer.
Key Research Interests include:
Flavonoids and their metabolites, and cardio-metabolic and
cognitive health
n-3 fatty acids, metabolism and cognition
Gut-liver-brain axis and the role of the microbiota
Micronutrient status, health and malnutrition e.g. iron and
vitamin D
Dietary fibres and glucose metabolism
Nutrient-gene interactions and personalised nutrition
Relevant Links: https://www.uea.ac.uk/medicine/research/cardiometabolic/nutrition-and-preventive-
medicine
Contact: a.minihane@uea.ac.uk
Current Research Opportunities
Anti-cancer effect of isothiocyanates – Dr Yongping Bao
The impact of n-3 fatty acids and APOE genotype on cardiovascular and cognitive health – Prof Anne Marie Minihane
Musculoskeletal & nutrition research – Dr Inez Schoenmakers, PhD
Molecular Nutrition of the gut-liver-brain-axis – Prof Michael Muller
Public Health Nutrition
Nutritional epidemiology – Prof Ailsa Welch
Dehydration in older adults – Dr Lee Hooper
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Anti-cancer effect of isothiocyanates (ITCs) The main focus of Dr Bao’s team is to determine doses of Isothiocyanates (ITCs) that are optimal for health, and
to investigate interactions with other nutrients in the modulation of key genes that affect cell proliferation, migration
and invasion. The work will contribute to the advancement of knowledge regarding the benefits and risks of dietary
bioactives.
ITCs derived from glucosinolates from cruciferous vegetables, possess chemo-preventive properties. ITCs have
been shown to exert antioxidant effects by the induction of the NF-E2-related factor-2 (Nrf2) transcription factor,
which activates the transcription of various antioxidant genes upon binding to the antioxidant response element
(ARE) in their promoters. The Nrf2-ARE
pathway is typically induced in response to
oxidative stress, against which it initiates a
major cellular defence mechanism. This
protection is very important in preventing
cancer. However, the overexpression of
Nrf2 in cells that are already cancerous has
the potential to promote their chemo
resistance.
Contact: y.bao@uea.ac.uk
The impact of n-3 fatty acids and APOE genotype on cardiovascular and cognitive health The research group’s primary focus is investigating the independent and
interactive impact of dietary/components (in particular marine n-3 fatty
acids and plant based Mediterranean style diets) and common genotypes
on cardiovascular and brain health (Alzheimer’s Disease risk).
The majority of the work uses randomised controlled trials (RCTs) with the
‘human’ interventions complemented by cell and rodent studies and
molecular biology approaches to inform the RCTs and investigate the
mechanisms underlying gene*diet*health associations. It is hoped our work
will contribute to the future personalisation/stratification of nutrition
recommendations and therapeutics based on an individual’s genetic profile.
Contact: a.minihane@uea.ac.uk
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Musculoskeletal & nutrition research
Inez Schoenmakers’s research is focussed on the investigation of calcium, phosphate and vitamin D metabolism,
particularly in relation to bone health. This research aims to investigate the metabolic processes that underpin the
development and maintenance of a healthy bone phenotype and how these are modulated by pregnancy, ageing,
kidney function, nutrition and ethnicity.
A major part of my current research investigates the renal-bone axis in the ageing population and how this relates
to the development of frailty. We investigate how this relates to micro-nutrient deficiencies.
My research offers opportunities to engage with pre-clinical research, lab-based projects and data analyses.
Contact: i.schoenmakers@uea.ac.uk
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Molecular nutrition of the Gut-Liver-Brain axis
Research in the Müller group is directed towards getting an in-depth understanding of the mechanisms
underpinning the role of nutrition in controlling health. We will use the knowledge we acquire to develop efficient
strategies to prevent diet-related conditions, which include liver disease, cancer and cardiovascular disease.
These strategies may include probiotics, food bioactives, specific bile acids or drugs that target specifically the
small intestine to improve health and prevent systemic diseases.
We are currently facing significant human health and societal challenges that are linked to our unhealthy food
patterns and lifestyles. One of the organs playing a vital role in health maintenance is the intestine. In the small
intestine, food is processed, further digested and selected components are efficiently absorbed. The largely
indigestible remnants that pass the SI and enter the colon are partly fermented by the resident microbiota.
Compromised functionality of the intestine has been linked to several metabolic complications.
The important role of nutrition for the intestine, the gut microbiota and the gut liver axis is increasingly recognised.
However, to our knowledge, the exact mechanisms underlying the complex interaction of the food-microbiome-
host system in the different highly specialized regions of the small and large intestine remain largely unknown.
Our research aims to define the specific role of the microbiota in the differential responses of the small intestine
to diets with different dietary fibre content.
We are studying how diet-related changes in the small intestinal bile acid metabolism impact enterohepatic
functions and the functionality of the liver. We will also define the role of small intestinal metabolism for the aging
phenotype of the gut-liver-brain axis.
By targeting the small intestinal microbiota and its metabolism, we will characterise the reversibility of detrimental
age-related changes in the gut-liver-brain axis.
Interdisciplinary expertise allows us to apply our molecular nutrition research to molecular biology techniques and
in vivo studies using various mouse models a broad range of different methodologies like NGS, metabolomics
(with a focus on bile acids), miRNA, Transcriptome, 16S microbiome analysis and the related systems biology-
based data integration.
Contact: michael.muller@uea.ac.uk
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Public Health Nutrition
Nutritional epidemiology
Ailsa’s research focuses on nutritional epidemiology to
understand the relationship between diet and ageing, with a
particular focus on nutrition, muscle loss, osteoporosis and
fracture risk; this research feeds into prevention for public
health.
Ailsa also researches the impact of and developing nutritional
public health interventions. The research will be based on using
datasets with detailed information on diet and disease risk
factors (for instance the EPIC-Norfolk cohort study). It could also
involve evaluating local public health interventions with the
Norfolk County Council, with some contact with participants.
Contact: a.welch@uea.ac.uk
Dehydration in older adults .Lee Hooper carries out innovative research on low-intake dehydration in older adults living in the community
and in residential care homes. Student research projects may include:
data collection for and/or analysis of primary research with older adults assessing the diagnostic accuracy of signs of early dehydration,
carrying out systematic reviews in the area of low-intake dehydration in older adults, or
analysis of systematic review data on dietary fats and health outcomes
Research with Lee’s team offers an introduction to low-intake dehydration in the elderly, a chance to experience
research in a care home setting, and training in systematic review and/or diagnostic accuracy methodology.
Students may choose to participate in an on-going systematic review or secondary data analysis.
To access the Hydrate group go to: https://www.uea.ac.uk/medicine/research/publichealth/health-services-and-
primary-care/DrinKit
For further information on our dehydration research: http://driestudy.appspot.com/index.html, and for recent
publications see: https://people.uea.ac.uk/l_hooper/publications.
Contact: l.hooper@uea.ac.uk
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Diabetes and Endocrinology
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Diabetes and Endocrinology
RESEARCH AREA OVERVIEW
Diabetes and endocrinology research opportunities include diabetes related foot disease and the experience,
and management of, patients with diabetes within hospitals. Other researchers have developed in vitro model
systems and three-dimensional models to understand the role played by inflammation in the development of
a number of pathological conditions.
Current Research Opportunities
Diabetic foot - Dr Ketan Datariya
Inflammation and disease – Prof Jelena Gavrilovic
Epigenetic Control of Development of Diabetes – Dr Zoe Waller
Diabetic foot Dr Dhatariya leads one of the largest diabetic foot clinics in the East of England seeing over 6000 patients per year. Over the last 5 years he and his podiatry team supervised over a dozen student projects on several aspects of diabetes related foot disease. Diabetes related foot disease remains the most frequent ‘diabetes specific’ reason for an acute hospital admission, and £1 in every £150 spent in the NHS in the UK is spent on the ‘diabetic foot’. His second major interest is hospital in patients with
diabetes. Across the UK, over 20% of all inpatient
beds are occupied by someone with diabetes. They
are not in hospital because of their diabetes, they just
happen to have it in addition to whatever else is
wrong with them. Having diabetes as an inpatient is
associated with an increased length of hospital stay,
lots more complications of their underlying condition,
and eventually a greater expense to the NHS. Dr
Dhatariya has been an author on many of the
national guidelines on the management of inpatients
with diabetes, and led the recently published world’s
largest survey on the management of diabetic
ketoacidosis.
He also has a special focus on patients with diabetes
undergoing surgery.
Contact: ketan.dhatariya@nnuh.nhs.uk
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Inflammation and disease
We are interested in understanding the role played by inflammation in the development of a number of pathological conditions. We have developed complex in vitro model systems that allow us to mimic the in vivo environment as closely as possible. Some examples include the use of 3-dimensional systems to study the invasion of monocytes, macrophages, adipocytes, endothelial cells and tumour cells through complex 3-D collagen matrices and micro-mass cultures made from cartilage and chondrocytes. We assess inflammatory responses by exploring cell migration and the expression of metalloproteinases (MMPs, ADAMs and ADAMTS enzymes), as well as the connective tissue (CCN) family of growth factors implicated in osteoarthritis and fibrosis. We interact closely with several clinicians including Dr Jeremy Turner, Dr Martin Lee and Professor Simon Donell. Contact: j.gavrilovic@uea.ac.uk
Epigenetic control of development of diabetes
There is the need for a better understanding of epigenetic control of development of diabetes. The insulin
minisatellite or insulin-linked polymorphic region (ILPR) resides in the promoter region of the gene coding for
insulin (INS). The region consists of a 14 base pair tandem repeat DNA sequence of 5'-ACAGGGGTGTGGGG-
3'/3'-TGTCCCCACACCCC-5' and is located 363 bp upstream of the transcription start site of INS. Mutations or
shortening in the length within the sequence of the ILPR has been linked to the development of both insulin-
dependent (type 1) and type 2 diabetes. The ILPR can form alternative DNA secondary structures such as G-
quadruplexes and i-motifs. This project would aim to learn more about how DNA structure affects the ILPR and
expression of INS.
Contact: z.waller@uea.ac.uk
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Musculoskeletal Biology and Surgical Anatomy
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Musculoskeletal Biology and Surgical Anatomy
RESEARCH AREA OVERVIEW In this area, there are opportunities to access the state of the art technologies of the Bio-Analytical facility at BCRE, devoted to the study of bone disease. Other research groups apply biochemistry and molecular biology to understand skeletal muscle regeneration, and the fabrication of synthetic biomaterials to enhance surgical treatment of tendon injury. Current Research Opportunities
Metabolic bone disease and calcium disorders – Prof William Fraser
Stem cells for skeletal muscle repair – Prof Ulrike Mayer and Prof Ernst Poschl
Osteoarthritis drug development – Dr Linda Troeberg
3D modelling of joints using clinical imaging data – Dr James Mackay and Dr Tom Turmezei
Autoimmunity and inflammatory bone loss disorders – Prof. Nicole Horwood
Metabolic bone disease and calcium disorders Research opportunities exist exploring the clinical diseases of Osteoporosis, Paget’s Disease of Bone,
Osteomalacia (vitamin D deficiency) and hyper/hypoparathyroidism. Both diagnostic and therapeutic projects are
available.
The Bio-Analytical facility at BCRE is equipped with state of the art technology able to measure all molecules of
interest in the regulation of bone and calcium metabolism. We have recently developed technology for the
measurement of vitamin D metabolites and several projects are available looking at the role of these metabolites
in health and disease. In particular the relevance of
these measurements in predicting outcome of vitamin
D supplementation in sportsmen, army recruits,
patients with osteoporosis, osteomalacia and FGF23
related disorders such as hypophosphataemic rickets.
Development and clinical application of FGF23,
AntiOPG, Sclerostin and PTHrP assays are ongoing
projects. Recent developments in miRNA technology
as applied to bone disease and bone/cartilage
tumours are becoming more important and an
expanding area of interest of the unit.
https://www.uea.ac.uk/bioanalytical-facility Contact: w.fraser@uea.ac.uk
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Stem cells for skeletal muscle repair
We are using genetically modified mice in combination with histology,
fluorescence activated cell sorting (FACS), molecular biology methods
and biochemical techniques as research tool to address our research
question. We aim at understanding the function of these two types of
stem cells by defining the differences of their specific phenotypes,
expression patterns and differentiation capacities. These results will
help to understand the regenerative processes in muscle in more detail
during normal repair as well as in various muscle diseases.
Skeletal muscle is a terminally differentiated tissue, but has the remarkable capability of continuous and accurate
repair after injury due to exercise, trauma or disease. Muscle regeneration is mainly dependent on highly
specialised muscle stem cells called satellite cells. These stem cells are specified during development and are
crucial for us to gain muscle mass in postnatal life. Satellite cells become dormant later in life until muscle damage
occurs and regeneration is needed. More recently, blood vessel-associated stem cells, called pericytes, have been
proposed to represent another source of stem cells for skeletal muscle regeneration. Our research aims to
determine the signals that are required for differentiation of these stems cells into muscle cells. This knowledge
will be important for developing strategies to combat muscle wasting diseases, such as during Duchenne muscular
dystrophy, or muscle loss associated with ageing.
Contact: u.mayer@uea.ac.uk or e.poschl@uea.ac.uk
Osteoarthritis drug development Osteoarthritis is a chronic degenerative joint disease that affects 1 in 5 people over the age of 50. Despite this high prevalence, treatment options for osteoarthritis are limited. This group, led by Linda Troeberg, aims to develop novel therapies for the disease by defining the molecular events that lead to joint damage. Understanding the molecular mechanisms that drive inflammation and extracellular matrix remodelling may also help us treat other chronic conditions, including rheumatoid arthritis and age-related macular degeneration. Our research is of relevance in the fields of orthopaedics, rheumatology, ophthalmology, endocrinology and gerontology. Research opportunities include:
Investigating what molecular changes in the joint increase risk of osteoarthritis as we age
Testing whether dietary supplements and chemical inhibitors can block cartilage damage
Evaluating chemical inhibitors for treatment of age-related macular degeneration Contact: i.troeberg@uea.ac.uk
Research Directory | Norwich Medical School | University of East Anglia Page 31 of 60
3D modelling of joints using clinical imaging data
We use novel 3D surface modelling and image
analysis techniques to analyse clinical computed
tomography (CT) and magnetic resonance (MR)
imaging in patients with osteoarthritis (OA). Our
approach has been developed in collaboration
with the University of Cambridge Department of
Engineering
These methods provide improved insight into the
pathogenesis of OA as well as better
assessment of disease progression and
response to treatment.
OA is a very common condition with a huge
unmet need, so this work has the potential to
make significant impact.
Projects are available working with both CT and
MR imaging data, including from the large
prospective multicentre APPROACH (EU) and
MOST (US) studies.
Projects would involve using advanced imaging
analysis software. Full training will be given, the
software is user-friendly and support will always
be available. However, a degree of pre-existing
computer literacy would be helpful.
The project could include training in basic programming in R and MATLAB for image data processing if this
was an area of interest for the candidate.
Current Research opportunities:
We will be interested in an MRes research student for the 2020/21 year.
Contact: james.w.mackay@uea.ac.uk or tom.turmezei@nnuh.nhs.uk
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Autoimmunity and inflammatory bone loss disorders
Prof Nikki Horwood has recently joined UEA Medical School as a research supervisor for the MRes course. Prof
Horwood is a molecular and cellular biologist who specializes in the loss or gain of bone mass during disease.
She studies the prevalence of immune cells and their soluble mediators, as major regulatory factors in skeletal
biology which has become increasingly evident in the last 20 years. Osteoimmunology seeks to define the roles
and interactions of immune cells with skeletal cells to understand their relative contributions to musculoskeletal
diseases. She has recently been appointed at UEA after nearly two decades at the Kennedy Institute of
Rheumatology (Imperial College London and University of Oxford). Bone loss is a problem in many inflammatory
diseases and there are limited therapeutic options to replace bone once it has been lost. Her research focuses on
the underlying cellular causes of bone loss and identification of potential therapeutic options.
Current Research Questions
1. Determining the role of natural killer cells in the initiation of autoimmunity. 2. How inflammation can cause both bone destruction and bone formation in ankylosing spondylitis? 3. How the tissue repair cycle is initiated and what happens if it fails to switch off? What are the roles
of different macrophage subsets in bone turnover? 4. What factors control bone marrow cell fate and their correlation to disease susceptibility in the aged? 5. Are there ways to reprogram bone forming osteoblasts to produce more bone? 6. Altering the bone microenvironment in bone marrow cancers to reduce disease burden and preserve
bone architecture. 7. How to separate the anti-inflammatory properties of glucocorticoids from their adverse effects on
bone destruction? 8. Ways to speed fracture repair in healthy and osteoporotic bone
These areas will be suitable to all the students interested in pursuing an academic career, especially in
specialities like endocrinology, rheumatology, metabolic medicine and orthopaedics. She is very happy to meet
and discuss specific projects with potential MRes intercalation candidates.
Contact: n.horwood@uea.ac.uk
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Oncology and Haematology
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Oncology and Haematology
Current Research Opportunities
Angiogenesis and solid cancers – Dr Stephen Robinson
Prostate cancer genetics – Prof Colin Cooper and Dr Dan Brewer
Melanoma and neural crest development – Dr Grant Wheeler
Microtubule an epithelial cell differentiation in health and cancer – Dr Mette Mogensen
Proteases and breast cancer metastasis – Prof Dylan Edwards
Chemopreventive agents in the diet – Prof Dylan Edwards and Prof Cathie Martin
I-motif in Nrf-2 – Dr Zoe Waller
Melanoma and pigment cell research – Dr Chris Morris, PHA
Angiogenesis and solid cancers
The recruitment of a blood supply is critical for solid cancers to grow beyond a very small size. Once this
vasculature is established (by a process called angiogenesis) tumours become much more aggressive, they begin
to invade nearby tissues, and they may eventually spread to distal sites throughout the body (metastasise). Thus,
angiogenesis presents itself as a key target for cancer therapeutic delvelopment.
To date, the drugs that have been developed as anti-angiogenic agents are showing only limited effect in the clinic. The Robinson group works on understanding how cells of the blood vasculature respond to angiogenic signals derived from the cancer, in an effort to develop better anti-angiogenic therapies. Current goals are:
To understand how movement of the vasculature toward a growing tumour is orchestrated; who are the essential molecular players that might serve as drug targets?
To determine the short- and long-term impacts of current angiogenic interventions that are designed to ameliorate cancer growth and spread; are they good targets?
To develop better anti-angiogenic strategies.
Contact: stephen.robinson@uea.ac.uk
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Prostate cancer genetics
A critical problem in the management of prostate cancer is that it is not possible to distinguish reliably aggressive
from non-aggressive disease at the time of diagnosis. This results in considerable overtreatment of this disease
such that many men with indolent disease are given radical treatments (surgery, radiotherapy) unnecessarily and
made impotent. The current work of the Cancer Genetics Team, led by Prof. Cooper and Dr. Brewer, are focused
on identifying biomarkers to help solve this problem and exploring the molecular evolution of prostate cancer. We
do this through the generation of large data sets using novel approaches in the lab, mainly in the ‘omics space,
and the application of cutting-edge data analysis techniques. Our work has strong components of both data
generation and bioinformatics analysis. Current projects include:
The collection and analysis of sequencing data (genomic, transcriptomic and epigenomic) from 250 prostectomy samples (ICGC Prostate UK project and PanProstate Cancer Initiative).
Identification of biomarkers to predict disease aggressiveness at diagnosis from urine.
Exploring the role of bacteria in prostate cancer.
Identifying and exploring subtypes of disease in prostate cancer through the analysis of large scale expression data sets.
Contact: colin.cooper@uea.ac.uk or d.brewer@uea.ac.uk
A
ERG-C
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D
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Prognostic
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Metastatic
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Cancerous
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Prostate
with
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Normal
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Clonal Expansions
EMT
CAFs
etc.
Exe
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Gene
tics?
Infe
ctio
n?
Die
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Development of multip le cancer lineages
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Melanoma and neural crest development The Wheeler group works on the molecular events that govern the origin and migration of different cell types within
developing embryos. We use tadpoles from Xenopus
laevis (African Clawed Frog) as our model system. To
investigate these processes we are using a combination
of embryological, molecular developmental biology,
imaging and chemical genetic approaches.
We are also interested in developing Xenopus as a potential tool in the drug screening and discovery process. We
are mainly focused on looking at the differentiation and migration of Neural Crest cells especially with respect to
pigment cell development and melanoma growth. Current projects include:
Using chemical genetic screens to determine a role for epigenetic modifiers in neural crest development and migration.
Screening small molecule libraries for inhibitors of pigment cell development to gain insight into neural crest and also to identify inhibitors of melanoma growth.
Developing in vivo toxicity assays for small molecules and nanoparticles. Contact: grant.wheeler@uea.ac.uk
Microtubule an epithelial cell differentiation in health
and cancer
Microtubules are tubular filaments that are vital for cell survival with many critical functions including cell division
and intracellular transport being dependent on them. They are also important for cell differentiation with dramatic
reorganization of the microtubule network driving changes in cell architecture and supporting specialised functions.
For example, the formation and maintenance of polarised transport epithelia such as that lining the gut is
dependent on microtubules. The correct alignment of the microtubules is critical for normal tissue function with
defects in polarisation leading to loss of function, cell invasion and cancer. Microtubules are therefore often targets
of cancer drugs with the stabilising taxanes being classic examples.
Our aim is to identify the molecules and mechanisms involved in microtubule organisation and maintenance. Funding from BigC and Breast Cancer Now is helping us to better understand the mechanisms responsible for loss of epithelial polarity and progression to an invasive cancer state. We use 3D in vitro gut organoids that closely mimic the in vivo gut architecture and organogenesis as well as cancer cell lines in combination with GFP- and RNAi technology and immuno-localisation and confocal, multi-photon and live time-lapse microscopy to pursue these aims.Developing in vivo toxicity assays for small molecules and nanoparticles. Contact: m.mogensen@uea.ac.uk
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Proteases and breast cancer metastasis
Metastasis is the main cause of death for cancer patients. Our group is studying the roles of extracellular proteases
in regulation of the tumor microenvironment, and how these enzymes contribute to tumour growth and metastasis.
It had previously been thought that these enzymes promoted cancer by acting as molecular scissors to cut a path for the invading cells through the extracellular matrix (ECM) but we have found that they work in many different
and subtle ways – essentially, they control the microenvironment within tumours, influencing growth, cellular organization, immune function, angiogenesis (blood vessel formation), invasion and metastasis. Indeed - as we have found - some proteases such as matrix metalloproteinase-8 (MMP8) actually stop cancers from spreading. We have developed a number of tools to evaluate the “degradome” – the repertoire of proteases and related molecules that cells and tissues deploy during normal and pathological tissue remodeling processes. We are interested in how these degradome genes act, how they are controlled, and their development for diagnosis and for novel therapies.
Particular projects underway at present include:
Studies of the interplay between ADAMTS metalloproteinases and Syndecan proteoglycans in signalling and adhesion mechanisms in breast cancer.
Regulation of the innate immune system by the anti-metastatic protease MMP8.
Protease involvement in angiogenesis
Use of nanoparticles for delivery of cancer therapeutic agents. Contact: dylan.edwards@uea.ac.uk
Chemopreventive agents in the diet This work is undertaken in collaboration with Prof Cathie Martin at the John Innes Centre, who has engineered
strains of tomato that are enriched in particular plant polyphenolic compounds. We have demonstrated that
extracts from these plants cause selective apoptosis of cancer cells. We are interested in the mechanisms by
which these dietary polyphenolic compounds influence cancer cell survival and apoptosis
The research would primarily be wet lab-based but there are opportunities for bioinformatics studies related to analysis of cancer gene and gene expression databases. For further details on the work of the lab go to the following links: http://www.uea.ac.uk/biological-sciences/People/Academic/Dylan+Edwards http://www.researcherid.com/rid/B-4734-2009
Contact: dylan.edwards@uea.ac.uk
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I-motif in Nrf-2
Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is a key
regulator of cell detoxification, which maintain homeostasis in
healthy cells and promote chemoresistance in cancer cells.
Controlling the expression of this transcription factor is therefore
of great interest. A cytosine-rich quadruplex-forming sequence
has been identified on the opposing strand downstream of the
Nrf2 promoter, which may play, or be made to play, a role in the
expression of the gene. i-Motifs are non-canonical quadruplex
secondary DNA structures defined as two parallel stranded duplexes held in an antiparallel manner by the
intercalation of hemiprotonated cytosine–cytosine+ base pairing. These alternative structures may play a role in
gene expression (whether genes are switched on or off) and also in the development of genetic diseases such as
cancer. By targeting these alternative DNA structures, this could allow for more specific interventions and
therapeutics compared to traditional chemotherapies. This project will explore targeting the i-motif in Nrf-2.
Contact: z.waller@uea.ac.uk
Melanoma and pigment cell research
Research in my group addresses a number of areas
in skin cancer and skin pigmentation. Melanoma
projects include the identification and validation of
new biomarkers/drug targets in melanoma. We use
phage display screening technology to map the
surface of melanoma cells with the aim of identifying
cell surface proteins that are over-expressed in
melanoma cells. We have recently identified
proteins that are uniquely over-expressed in
melanoma and have shown them to drive a pro-
metastatic phenotype in melanoma cells. These
proteins have the potential to serve as new disease
biomarkers in melanoma.
Skin pigmentation projects in the lab are
collaborations with Prof. Tom Wileman (MED). We
are working with cellular models to better understand how melanin pigment granules are secreted from the
pigment-producing melanocytes and trafficked into epidermal keratinocytes to serve as a barrier to UV radiation
induced DNA damage. The projects involve the isolation and culture of melanocytes and keratinocytes from mouse
models and studying their behaviour using live cell and fixed cell fluorescence microscopy. This project has the
potential to be adapted to pigment cell diseases such as Griscelli Syndrome.
Contact: Christopher.J.Morris@uea.ac.uk
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Cardiovascular Research
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Cardiovascular Research
RESEARCH AREA OVERVIEW
Cardiovascular research is a growing activity at University of East Anglia and Norfolk and Norwich University
Hospital and across the Norwich Research Park. All researchers mentioned in this summary would be
delighted to discuss with students about research in this field and very happy to be contacted about
opportunities. Such opportunities could be for both SSS and importantly for MRes related research.
Current Research Opportunities
Heart function/heart failure – Dr Vass Vassiliou
Acute coronary syndromes – Prof Marcus Flather and Dr Alisdair Ryding
Adult congenital heart disease – Prof Marcus Flather
Interventional Cardiology – Dr Simon Eccleshall and Dr Vass Vassiliou
Valvular Heart Disease- Dr Vass Vassiliou
The impact of n-3 Fatty Acids and APOE Genotype on Cardiovascular and Cognitive Health – Prof Anne-Marie Minahane
Stem Cell Models of Heart Disease - Dr James Smith
Heart function/ heart failure There is ongoing research on understanding the basic
mechanisms of cardiac contractility including energy
requirements and response to exercise are key aspects of this
work leading to an understanding of novel therapies to support
the failing heart.
The group has developed the concept of diastolic ventricular interaction (DVI) where right ventricular overload can impact on left ventricular function and is testing ways to improve this including pacing. Enhancing nitric oxide at a cellular level may lead to improved cardiac energetics and a randomised trial of nitrate supplements in dilated cardiomyopathy is underway to understand the mechanistic response to this therapy and safety.
Contact: v.vassiliou@uea.ac.uk
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Acute coronary syndromes Professor Marcus Flather is undertaking clinical and translational research projects in a wide range of cardiovascular conditions including acute coronary syndromes, heart failure and coronary revascularisation through national and international collaborations. Students can have access to datasets from ongoing and completed clinical trials and observational studies to undertake analyses for their MRes projects and for future publications. Examples of current work include:
1. Arterial Revascularisation Trial (ART). This is a large multi-centre trial of 3200 patients undergoing coronary artery bypass graft surgery comparing single versus bilateral internal mammary artery grafts
2. SENIORS: A study of 2100 elderly patients with heart failure randomised to the vasodilating beta blocker nebivolol or placebo
3. AIMS: A randomised trial of irbesartan in 160 patients Marfan Syndrome 4. Beta blockers in heart failure meta-analysis: individual patient data meta-analysis of all RCTs of beta
blockers versus placebo in heart failure in 18,200 patients 5. CARDia: Randomised trial of percutaneous coronary intervention versus coronary artery bypass grafting
in 510 patients with Diabetes
Adult congenital heart disease Analysis of a longitudinal database of clinical cases of adult congenital heart disease managed at Norfolk and
Norwich University Hospital has been undertaken to describe patient characteristics, treatments and outcomes
(Dr Leisa Freeman) as well as a more detailed analysis of the haemodynamics and cardiac structure and function
in collaboration with Guys and St Thomas’s Hospital. A new study is being set up to investigate early changes in
hepatic structure and function in patients with adult congenital heart disease in collaboration with Dr Simon
Rushbrook (NNUH and Norwich Medical School) using elastography (Dr Cathy Head, Dr Leisa Freeman).
Contact: m.flather@uea.ac.uk
Interventional cardiology Norfolk and Norwich University Hospital (NNUH) is one of the busiest coronary interventional centres in the UK.
Norwich has pioneered the introduction of Drug Coated Balloon (DCB) technology in which coronary stenosis are
dilated with DEB without the placement of a stent. NNUH has one of the largest case series of DCB treatment and
these cases are being analysed for a report that can inform future research (Dr Simon Eccleshall, Dr Vass
Vassiliou). Projects in acute coronary syndromes interventional programme are being carried out by Dr Alisdair
Ryding.
Valvular heart disease With an ageing population, valve disease is becoming a significant burden to the NHS services. Dr Vassiliou leads the work in identifying adverse predictors in patients with valve disease and mortality. This work is undertaken in collaboration with the Royal Brompton Hospital and specifically looks at the role of cardiac MRI and the presence of scarring in associating with mortality. Contact: v.vassiliou@uea.ac.uk
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The Impact of n-3 fatty acids and APOE genotype on cardiovascular and cognitive health
The research group’s primary focus is investigating the independent and
interactive impact of dietary/components (in particular marine n-3 fatty
acids and plant based Mediterranean style diets) and common genotypes
on cardiovascular and brain health (Alzheimer’s Disease risk).
The majority of the work uses randomised controlled trials (RCTs) with the
‘human’ interventions complemented by cell and rodent studies and
molecular biology approaches to inform the RCTs and investigate the
mechanisms underlying gene*diet*health associations. It is hoped our
work will contribute to the future personalisation/stratification of nutrition
recommendations and therapeutics based on an individual’s genetic
profile.
Contact: a.minihane@uea.ac.uk
Stem cell models of heart disease
Fibrosis is a prevalent and hard-to-treat condition. Of all deaths in the developed world, 45% are associated with
chronic fibro-proliferative disease. Cardiac fibrosis disrupts the mechanical and electrical activity of the heart,
which can lead to sudden cardiac death. Many heart diseases,
such as hypertrophic cardiomyopathy (HCM), are associated
with a fibrotic phenotype.
This group led by Dr James Smith, uses human induced
pluripotent stem cells (hiPSCs) and CRISPR-Cas9 gene editing
technology, to create new human in vitro models of cardiac
disease. Gene edited hiPSCs can be differentiated to produce
force-generating cardiomyocytes, and secretory active cardiac
fibroblasts. We investigate the interplay between these cell
types, creating models that recapitulate the impact of cardiac
fibroblasts on cardiomyocyte function. The role of disease
causing mutations (including HCM mutations) can be
investigate in such models to gain better insights into these
diseases and identify new potential therapeutic targets.
Contact: j.g.smith@uea.ac.uk
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Respiratory Medicine, Rhinology and Ear, Nose and
Throat
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Respiratory Medicine RESEARCH AREA OVERVIEW This group has a programme of work investigating self-efficacy in patients with chronic disease such as bronchiectasis and other respiratory diseases. Researchers are exploring and evaluating options for improving self-efficacy and health related quality of life, through patient education and patient self-management plans (PSMP). Current Research Opportunities
Self –efficacy in respiratory disease – Prof Andrew Wilson
Rhinology and ENT – Prof Carl Philpott
Self-efficacy in respiratory disease
Living with chronic disease results in considerable financial and emotional burden for patients. Innovative methods are required to increase the quality of patient care, improve patient choice and provide care closer to home, in an expedient and productive manner. Modern healthcare approach encourages a change in the doctor:patient relationship from paternalistic to shared decision making. Self-efficacy is the confidence patients have in their ability to successfully deal with their condition and make decisions that affect their care.We have a programme of work investigating self-efficacy in patients with chronic disease and exploring options of improving self-efficacy though patient education and patient self management plans (PSMP). We have designed a PSMP for bronchiectasis called BET (see figure) and are currently evaluating its utility. Other workstreams investigate the influence of self-efficacy on health related quality of life. Opportunities are available to evaluate self-efficacy further in different contexts in patients with different respiratory diseases. Contact: a.m.wilson@uea.ac.uk
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Rhinology and ENT
The Rhinology and ENT Research Group led by Professor Carl Philpott has a portfolio of research ranging from
lab based to clinical and engagement projects. Currently active research includes chronic rhinosinusitis olfactory
disorders and cholesteatoma as subject areas with opportunities to develop research skills in collection and
processing of tissue samples, cytokine analysis, data interpretation, genetics, health economics, qualitative
analysis, recruitment to clinical trials, observational studies and public engagement and education. MRes students
will be supported in undertaking primary research activities as well as presenting their findings to national and
international meetings and contributing to the publication of research papers. The group receives funding from
various sources including NIHR which funds the £3.2 million MACRO programme grant for chronic rhinosinusitis.
Anyone interested in exploring an MRes should contact Kay Tate to arrange an appointment to see Professor
Philpott.
Contact: c.phlipott@uea.ac.uk
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Mental Health and Dementia
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Mental Health and Dementia RESEARCH AREA OVERVIEW Dementia is becoming one of the biggest burdens of our society with the aging population. There is an urgent
need to improve our clinical and research understanding of the underlying disease in dementia. Dementia
research topics at UEA take therefore a multi-disciplinary approach, linking bedside to bench research
approaches.
Current Research Opportunities
Mental health in the elderly – Prof Chris Fox
Underlying Genetics and Epigenetics – Dr Zoe Waller
Brain changes in dementia – Prof Michael Hornberger
Nutrition and dementia – Prof Anne-Marie Minihane
Mental health in the elderly Our research focuses on 3 strands: cause, care and interventions in dementia in primary, secondary, tertiary and social care. Current projects include (1) ‘Perfected’ which is developing an enhanced recovery pathway (care), (2) the use of large data sets allows us to extract causative factors in dementia (cause) and (3) develop prevention interventions trials such as use of minocycline and use of assistive technology (intervention). We have literature reviews to develop a new comorbidity tool for use as an App or tech platform-skills opportunity-
which advances students skills on literature analysis. We have qualitative projects in the PERFECTED study of
care in hospital in dementia and can provide data analysis from 3 projects funded by NIHR and Alzheimers society
looking at the harms and benefits of commonly prescribed medications and screening for dementia. These use
CPRD and CFAS datasets. Our website provides more detail.
https://www.uea.ac.uk/medicine/research/dementia.
Contact: chris.fox@uea.ac.uk
Underlying Genetics and Epigenetics There is the need for better understanding of the underlying genetics and epigenetics (altered gene expression and activation) surrounding Alzheimer’s Disease to inform cutting-edge diagnostic and treatment options available for development. i-Motifs are quadruplex secondary structures formed from DNA sequences rich in cytosine, composed of parallel-stranded duplexes and held together by intercalated, hemi-protonated cytosine-cytosine base pairs. This project would aim to establish the function of a rare type of DNA i-motif forming sequence (C6) which are implicated in the progression and development of Alzheimer’s disease.
Contact: z.waller@uea.ac.uk
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Brain changes in dementia
Clinical symptomology and underlying brain changes are closely linked in dementia. Our research investigates the interactions of these clinical symptoms and their neural correlates, with a particular focus on behaviour, memory and eating changes via state-of-the-art neuroimaging methods. In particular we are interested in identifying the shared and unique clinical and imaging features across the most common dementias: Alzheimer’s disease, vascular dementia, frontotemporal dementia and Dementia with Lewy bodies. We have strong clinical links with neurological and old-age psychiatry clinical services in the region. Our research findings inform primary to tertiary clinical services and is particularly targeted towards better differential diagnosis and improved symptom prediction and management.
Contact: m.hornberger@uea.ac.uk
Nutrition and dementia Nutrition is a significant determinant of cognitive development and decline throughout the life-course. A number of dietary components, including marine n-3 fatty acids (and in particular DHA) and select plant bioactives, have emerged as having the potential to improve cognitive performance and reduce the risk and prevalence of dementia. In the Department of Nutrition and Preventive Medicine, a main area of research focus is investigating the independent and interactive impact of these dietary components and APOE genotype on cognition, brain volumes and blood flow, and circulating markers of cognitive health. An APOE4 genotype status, which occurs in 25% of the population, is the most prevalent genetic risk factors for Alzheimer’s Disease. The majority of the work uses human randomised controlled trials (RCTs), which are complemented by cell and
rodent studies and molecular biology approaches to inform the RCTs and investigate the mechanisms underlying
gene*diet*health associations. It is hoped our work will contribute to the identification of strategies to promote
’healthy’ brain ageing, and in particular in at-risk APOE4 individuals’.
Contact: a.minihane@uea.ac.uk
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Population Health, Primary
Care and Health Care Delivery
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Population Health, Primary Care and Health Care Delivery
RESEARCH AREA OVERVIEW The focus of population health research is to improve health and quality of life through prevention and
treatment of disease and other physical and mental health conditions. Our work combines state-of-the art
research in several clinical, public health and health service fields: health economics, clinical trials,
epidemiology, health geography, and medical statistics and our research addresses a wide range of clinical,
health service and public health problems. We have particular strengths in research on: the organisation and
delivery of primary health care; diabetes; cardiovascular risk factors; obesity; smoking; musculoskeletal
disease; HIV; tuberculosis; respiratory disease; mental health; diagnostic screening; and environmental
influences on health.
MRes students can get good hands-on research experience and can produce original publishable papers
themselves, with expert guidance. For example, statistical analysis of pre-existing survey data already held
by academic staff, but yet not fully exploited, can answer interesting research questions in new ways.
Students can collect their own data using questionnaire surveys or by going through medical records. In
depth-interviews with individual patients, health professionals or groups of people can provide deeper insights
into issues and problems that are not captured by numerical evidence. It is quite feasible for students to
collect and to analyses these qualitative data themselves. Systematic reviews and meta-analyses (statistical
summaries) of previously published research are also feasible for students to do by themselves, often
producing high impact publications. With any of these methods, the process of identifying problems, asking
questions, defining hypotheses and analysing data provides transferable skills which can be used in many
different areas of medical research.
Relevant Links https://www.uea.ac.uk/medicine/research/publichealth
https://www.uea.ac.uk/medicine/research/publichealth/health-services-and-primary-care
https://www.uea.ac.uk/medicine/research/publichealth/epidemiology-and-public-health https://www.uea.ac.uk/medicine/health-economics-group/our-research Current Research Opportunities
Effectiveness, cost effectiveness and epidemiology
of health care – Prof Max Bachmann
Measuring population health – Prof Nick Steel
Musculoskeletal epidemiology - Prof Alex MacGregor (academic rheumatologist), Dr Max Yates (academic rheumatologist), Dr Jack Dainty (statistician), Dr Donnie Cameron (MRI physicist) and Prof Elena Kulinskaya (actuary/statistician in Computer Science)
Economic evaluation/cost effectiveness - Prof Garry Barton
Environmental influences and social on health – Prof Andy Jones
Economics of ageing – Prof Ruth Hancock
Economic evaluation methods – Prof Tracey Sach
Public health and clinical intervention – Prof Fujian Song
Addiction Research – Dr Caitlin Notley
Social gerontology – Dr Charlotte Salter
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Effectiveness, cost effectiveness and epidemiology of health care Max Bachmann is professor of health services research. He is a
public health physician interested quantitative evaluation of the
effectiveness and cost effectiveness of health care, especially of
primary care interventions intended to improve the health of
populations. Disease areas of interest include HIV, tuberculosis,
diabetes, and chronic illness in general. He works with South
African colleagues on a research programme to improve primary
care through training and clinical guidelines, based on a series
of randomised trials and related research. For medical student
research he is able to supervise systematic reviews and
synthesis of evidence about the effectiveness of health care, and
the epidemiology of these conditions. We may be able to extend
this to statistical analysis of epidemiological data.
Contact: m.bachmann@uea.ac.uk
Measuring population health
Professor Nick Steel leads the Health Services and Primary Care Research Group within the Public Health and
Health Services Research Theme in Norwich Medical School. His research interests focus on measuring heath at
population level with a view to improving the health and quality of life of people in need. He is currently working on
two major projects that offer excellent opportunities for quantitative analysis of existing data for MSc and PhD
students: the English Longitudinal Study of Ageing (https://www.elsa-project.ac.uk/), and the Global Burden of
Disease Study in England (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32207-4/fulltext
and http://www.healthdata.org/gbd).
Nick has also been involved with a local evaluation of
primary health care for vulnerable people, including the
homeless and migrants, and there may be
opportunities for further research in this area.
Figure: Global total number of deaths,1950-2017
(www.healthdata.org/gbd)
Contact: n.steel@uea.ac.uk
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Musculoskeletal epidemiology In 2013, the Centre for epidemiology (CfE) Versus Arthritis was jointly awarded to Manchester University and UEA,
recognising the strengths and potential for musculoskeletal epidemiology research across the two institutions. This
has placed UEA and Manchester at the centre of a UK collaborative network in musculoskeletal epidemiology that
includes the universities of Oxford, Southampton, Keele, Nottingham, Aberdeen and Bristol. The UK Research in
Musculoskeletal Epidemiology (UK-RiME) partnership facilitates collaboration and partnership between these
institutions.
Here, at UEA within the centre for epidemiology, we are dynamic group with links to other national and international
centres. We included academic rheumatologists, statisticians, MRI physicists and computer scientists. In addition,
we collaborate with “wet-bench” scientists here at UEA. Our work includes descriptive and aetiological work on
the two large and long-running cohort studies based in Norfolk: The Norfolk Arthritis Register (NOAR) and The
European Prospective Study into Cancer and Nutrition (EPIC-Norfolk). NOAR was set-up in 1989 and represents
one of the longest and best-characterised inception cohorts of patients with inflammatory arthritis in Europe. EPIC-
Norfolk recruited participants between 1993 to 1997 and has an unrivalled rich phenotype.
In addition we have experience of working with other large datasets such as the CPRD, UK Biobank, UK Twins
Registry and National Joint Registry. We are always delighted to have intercalating medical students to work with
us on small, well contained projects which enhance studies of morbidity and disease progression within these data
sources. Other opportunities include pilot studies from translation work up to, and including, clinical interventional
trials.
The range of projects carried out address research questions across the life course of musculoskeletal disease,
and as such, would be suitable to all students interested in pursuing an academic career. Specialities particularly
aligned include: rheumatology, orthopaedics, public health, general practice and radiology. We are very happy to
meet and informally discuss research ideas with potential MRes students.
Contacts:
Prof Alex MacGregor (academic rheumatologist): A.Macgregor@uea.ac.uk
Dr Max Yates (academic rheumatologist): m.yates@uea.ac.uk
Dr Jack Dainty (statistician): jack.dainty@uea.ac.uk
Dr Donnie Cameron (MRI physicist): donnie.cameron@uea.ac.uk
Prof Elena Kulinskaya (actuary/statistician in Computer Science): e.kulinskaya@uea.ac.uk
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Economic evaluation/ cost effectiveness
Professor Garry Barton’s main area of expertise is in the application and development of the methods of economic evaluation. As a health economist, Garry is a co-applicant on a number of pragmatic randomised controlled trials in a variety of clinical areas. His role is generally to assess the costs and benefits associated with different interventions, in order to make judgements about cost-effectiveness. Methodological work which Professor Barton has undertaken includes the comparison of two measures of utility (the EQ-5D and SF-6D) which can be used to measure the benefits of interventions, where the practicality, construct validity, and responsiveness of these two measures were assessed.
Contact: g.barton@uea.ac.uk
Environmental and social influences on health
The research led by Andy Jones and his group focusses on the
environmental and social determinants of health outcomes and
health related behaviours. We undertake research to understand
how the context in which people live, work, and study may affect
their health. We have a focus on physical activity and dietary
behaviours but also holder wider health interests, and we are
involved in several population studies which present opportunities
for students wishing to obtain research experience of non-
laboratory analysis. Studying for an MRes with us also provides
great opportunities for undertaking research in collaboration with a
range of organisations outside the academic and health sectors,
such as local authorities, national bodies such as Sport England
and more local providers including Active Norfolk. We also work closely with members of the Medical Research
Council Epidemiology Unit in Cambridge and I also lead the Health Geography programme of the UK Centre of
Excellence in Physical Activity and Dietary Research (CEDAR – http://www.cedar.iph.cam.ac.uk/), both of which
provide students with the potential for experience of working in an internationally recognised collaborative research
environment.
Current projects include:
• Cohort studies on the influences of the environment on physical activity in children, adolescents, and older adults.
• Research on the best ways to increase the prevalence of walking and cycling behaviours.
• Work on health interventions with under-represented groups including those living in material disadvantage or
with disabilities.
• Use of technologies to track people’s use of the environment for health-related behaviours.
Contact: a.p.jones@uea.ac.uk
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Economics of ageing
My experience and interests centre on the economics of ageing, including long-term care finance, disability benefits for older people, health and disability in later life. My research involves the statistical analysis of large-scale household survey data, particularly through microsimulation/tax-benefit modelling.
Recent research has been aimed at estimating the additional personal costs experienced by older disabled people in order to guide disability benefits policy. Using household survey data on older people’s incomes, material living standards and disability levels, we can infer the extra income than a disabled older person needs to achieve the same standard of living as an otherwise similar non-disabled person. Economists call this extra income (∆ in the graph below) a ‘compensating variation’ – a concept which has a wide range of applications in health economics. Contact: r.hancock@uea.ac.uk
Economic evaluation methods Professor Tracey Sach is a Professor in Health Economics with an interest in developing and applying economic evaluation methods in a number of clinical areas including Dermatology, Falls, and Rehabilitation. For medical student research she can supervise systematic reviews of economic evidence and /or potentially primary data analysis alongside on-going projects of a methodological or applied nature should they be at the right stage at the time.
Contact: t.sach@uea.ac.uk
Public health and clinical intervention
Fujian Song has experience in systematic reviews and simulation modelling for evaluating healthcare interventions, conducted methodological research concerning evidence synthesis, including heterogeneity in meta-analysis, publication and related biases, assessment of non-randomised studies, indirect and mixed treatment comparison for evaluating competing healthcare interventions, and methods for synthesizing evidence for the evaluation of complex healthcare interventions. Current research projects potentially suitable to MBBS students:
Systematic review/meta-analysis of selected public health or clinical interventions and epidemiological studies;
Literature-based methodological research related to clinical trials and research synthesis (e.g., systematic review methods, complex healthcare interventions, indirect comparison, and publication bias);
Evidence based global health.
Contact: fujian.song@uea.ac.uk
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Addiction research
Dr Caitlin Notley leads the Addiction Research Group: The group produces high quality multidisciplinary research
evidence to impact upon people who are affected by addiction, including service users, carers, health professionals
and policy makers. The research approach emphasises responsiveness to social, cultural and pressing health
needs, and supporting high risk or disadvantaged groups. Caitlin is a social scientist, and an expert in qualitative
research methodologies applied across health and social sciences. She has extensive experience of running
qualitative studies as stand-alone projects or alongside clinical trials,
intervention development and systematic reviewing. Caitlin is a Cochrane
author situated within the Cochrane tobacco and alcohol review group.
Her particular areas of research expertise, that she would welcome
students to work with on, are tobacco smoking cessation, relapse
prevention and electronic cigarette use. She could also supervise projects
more broadly in the fields of substance dependency, misuse and
addiction, alcohol misuse, mental health and young people, health needs
assessment and qualitative systematic reviewing.
Currently Caitlin has projects funded by the National Institute for Health Research, focused on smoking cessation
provision within neonatal intensive care units; Cancer Research UK, focused on dual use of e cigarettes and
tobacco smoking; and Public Health England, on young peoples use of e cigarette flavours. Starting in 2020 Caitlin
will be leading a large scale randomised controlled trial funded by the NIHR to test a smoking relapse prevention
intervention developed through previous work
Relevant Links https://www.uea.ac.uk/medicine/research/addiction Contact: c.notley@uea.ac.uk
Social gerontology I am a social gerontologist and expert in qualitative research methods. I am interested in promoting improvements to the quality of life and wellbeing of older people by contributing to knowledge and advances in healthy ageing. My areas of interest include: health and social care, sociology of diagnosis, adherence to osteoporosis medicine, physical activity, health literacy and healthcare communication. I also research empathy in the medical consultation. My work involves users and/or patients and public involvement. Current research projects include:
A trial of older people setting personal goals in general practice
https://www.uea.ac.uk/medicine/research/primary-care-and-
epidemiology/goalplan)
A study with Sports England and Active Norfolk on physical activity
at retirement https://www.sportengland.org/funding/active-ageing/
Figure 1: Older women’s experience of taking bisphosphonate medication by
Alice Edwards MED tudent and Brandon Mattless of Norwich University of the
Arts
Contact: c.salter@uea.ac.uk