Save your energy! New tool shows algorithms’ environmental impact

Data science and artificial intelligence are transforming UK healthcare – but at an environmental cost.

The data centres housing the supercomputers that run the algorithms account for 100 megatonnes of CO2 emissions every year – roughly the same as US commercial aviation. It takes more and more energy to run increasingly complex algorithms – and even a best-case scenario predicts a three-fold increase in the sector’s energy needs by 2030.

Now Cambridge scientists supported by the NIHR Cambridge BRC have developed a freely available tool which allows anyone to estimate the carbon footprint of their computations.

Dr Michael Inouye from the University of Cambridge, who supervised the development of Green Algorithms, said: “We’ve been using computers, supercomputers and cloud computation for many years now, yet there hasn’t been an easy way to work out how much greenhouse gases our computations emit.

“High-performance and large-scale computing have led to many scientific breakthroughs; for example, in astrophysics we now know what black holes 55 million light-years away look like, and in genomics, we now know of thousands of genetic variants for common diseases. We didn’t know the environmental impact of using data science to uncover these discoveries, nor did we have the tools to estimate what the next-generation of breakthroughs would take in terms of carbon footprint.

“So our team set about developing a free and easy-to-use online tool, Green Algorithms, for users to estimate the carbon footprint of any computational task.”

Know your computation’s carbon footprint

Want to know what the weather will be like tomorrow in your home town? A supercomputer in Reading will do that for you – at an environmental cost.

Using Green Algorithms, Dr Inouye’s team calculated that the computations it runs for just one day’s forecasts are equivalent in terms of greenhouse gas (GHG) emissions to driving 1,708 km or taking three return flights between Paris and London. It would take a mature tree over 27 years to sequester this amount of carbon.

Dr Inouye said: “Green Algorithms takes into account what’s ‘under the hood’ of a computer, the length of time it’s used and the location of the resources it utilises to estimate the energy used and the kilograms of CO2 emitted.

“It then shows the equivalent footprint in car and plane journeys, and ‘tree months’, or the number of months a mature tree needs to absorb a given quantity of carbon.

“Green Algorithms also makes specific recommendations for reducing computing’s carbon footprint. For example do you really want to continue using data centres which are heavily reliant on coal for power, even if they have faster processors? What would be the carbon savings or costs if you moved them elsewhere?

“Considerations like these better capture the true costs of computation, taking it beyond the purely financial.”

The carbon footprint of an algorithm depends on two factors: energy needed to run it and the GHG emissions released per unit of energy needed. This depends on the computing resources needed (including how long it takes to run, the number of cores and memory used and how efficient the data centre is) and the data centre’s location and what powers it (e.g. nuclear, gas or coal). Switching from an average data centre to a more efficient one can reduce carbon footprint by a third.

Computations are rarely performed only once. Algorithms are run multiple times, sometimes hundreds, and many are for good reasons but frequently they are unnecessary. This also increases GHG emissions, sometimes substantially. Limiting the number of times an algorithm runs is perhaps the easiest way to reduce unnecessary carbon footprint.

Director of the NIHR Cambridge BRC Professor Miles Parkes said: “We are delighted to have supported such timely and vital research, which has created an open tool for quantifying the carbon footprint of virtually any computation.

“The NIHR is committed to combating climate change and helping the UK meet the goals set forth in the Climate Change Act 2008.

“NIHR both promotes green approaches to health research and actively designs new tools that expand opportunities for green research that can be translated into policy and action.

“This tool empowers researchers, patients and the public to understand and minimise the greenhouse gas emissions of both their work and leisure, whether using home laptops, a high-performance computing cluster or the cloud.”

Dr Inouye added: “We hope our study will help raise awareness of the environmental impacts of day-to-day computer use and the computations underlying data science as well as promote more sustainable practices within the data science community.

“We want to make green computing a cornerstone of carbon reduction within the NHS, ensuring that the artificial intelligence revolution supports both a healthier society and planet.”

1. The research paper Green Algorithms: Quantifying the carbon footprint of computation by lead authors Loïc Lannelongue and Jason Grealey, and Michael Inouye, is available to view on the open access journal Advanced Science.
2. Find out more about this research and the hidden costs of computations in Advanced Science’s feature article on Green Algorithms: Quantifying the carbon footprint of computation.
3. The NIHR Carbon Reduction Guidelines have been published to help researchers explore how they can apply the principles of good carbon management and sensible study design to reduce carbon footprint.
4. Three days of action to highlight urgency of climate redress took place from 20-22 April, culminating in Earth Day 2021 on 22 April.

Differing immune responses discovered in asymptomatic cases and those with severe COVID-19

A UK-wide study part-funded by the NIHR has identified differences in people’s immune responses to COVID-19, depending on whether they have no symptoms or more serious reactions to the virus.

In the study “Single-cell multi-omics analysis of the immune response in COVID-19”, published this month in Nature Medicine, researchers and their collaborators in the Human Cell Atlas initiative analysed blood from 130 people with COVID-19. These patients came from three different UK centres in Newcastle, Cambridge and London and ranged from asymptomatic to critically severe.

The researchers found raised levels of specific immune cells in asymptomatic people to help fight infection – but that patients with more serious symptoms had lost these protective cell types and instead gained inflammatory cells. In severe cases this led to lung inflammation, blood clotting difficulties and hospitalisation.

While it is not yet understood how the infection stimulates these immune responses, the study gives a molecular explanation for how COVID-19 could cause an increased risk of blood clotting and inflammation in the lungs, which can lead to the patient needing a ventilator.

This also uncovers potential new therapeutic targets to help protect patients against inflammation and severe disease.

Professor Menna Clatworthy, senior co-author of the study and Capacity Building Theme Lead, said: “This is one of the most detailed studies of immune responses in COVID-19 to date, and begins to help us understand why some people get really sick while others fight off the virus without even knowing they have it.

“This new knowledge will help identify specific targets for therapy for patients who get sick with COVID-19.”

In the future, research may identify those who are more likely to experience moderate to severe disease by looking at levels of these immune cells in their blood.

Addenbrooke’s specialist endocrinology services ranked best in UK

In their annual specialist hospital rankings, Newsweek has rated the specialist diabetes and endocrinology services at Addenbrooke’s Hospital as the best in the UK, and 20^th internationally. Patients attending clinics through this service benefit not only from the expertise of leading clinicians, but also from the state-of-the-art research programme supported by clinical academics and research partners through the NIHR Cambridge Biomedical Research Centre (NIHR Cambridge BRC).

Dr Tony Coll, Service Lead at the Wolfson Diabetes and Endocrine Clinic (WDEC) at Addenbrooke’s said: “This recognition is a testament to many decades of focused effort to meaningfully link academic efforts with high quality patient care.”

WDEC is at the forefront in using new technologies such as insulin pumps and glucose sensors to improve the lives of people with diabetes.  WDEC is contained within the Wellcome-MRC Institute of Metabolic Science (IMS), a purpose-built centre dedicated to research and clinical care in the areas of diabetes, endocrinology and related diseases. Close collaboration between researchers and clinicians through the NIHR Cambridge BRC, IMS and other research partners has enabled translation of advances in research of the genetic basis, diagnosis and treatment of disorders of insulin and thyroid hormone action into clinical practice.

For children up to 15 years, the Weston Children’s Diabetes and Endocrine Service provides excellent clinical care both during childhood and transition whilst benefitting from the most recent advances in translational research. Major advances pioneered in collaboration between research partners and the services include closed loop insulin delivery (the ‘artificial pancreas’) and strategies to detect and prevent early complications through the AdDIT trial. 

The ‘artificial pancreas’ works by combining an insulin pump with constant glucose monitoring via a sensor fitted on the skin.  The sensor sends information about the level of glucose in the blood to an app that directs the insulin pump to maintain the correct dosage of insulin.  Together, these technologies significantly simplify life for people with type 1 diabetes, particularly during night and for very young patients. 

Cambridge is also a lead in a major EU consortium (INNODIA) which supports research with people newly diagnosed with type 1 diabetes and their relatives, including access to clinical studies and trials designed to prevent further progression following diagnosis. 

Professor Sir Stephen O’Rahilly MD FRS FMedSci, Co-Director of the Wellcome-MRC Institute of Metabolic Science and Scientific Director, NIHR Cambridge Biomedical Research Centre said of the ranking: “The Wellcome-MRC Institute of Metabolic Science was created with the vision of linking basic and applied research in endocrine and metabolic diseases with excellent clinical care. The Newsweek ranking provides evidence that the Institute is being recognised by colleagues around the world for the quality and inventiveness of its work at the interface between research and patient care.”

Prof Miles Parkes, Director of the NIHR Cambridge BRC, congratulated the team, saying: “This recognition clearly reflects the hard work of the endocrinology theme and partners, leading innovative discovery science and integrating it into world-leading clinical care.  The vital importance of translational research and its clinical implementation is sometimes less heralded, but the diabetes and endocrine team have demonstrated how critical it is to improving patient outcomes and supporting the NHS. They are truly deserving of the recognition they have received for their work.”

POPStar study launches to investigate how pregnancy data can predict future health

A new study from the Departments of Obstetrics & Gynaecology and Paediatrics at the University of Cambridge is investigating how conditions in the womb can predict the future health of mothers and their children.

The POPstar study will look at the anonymised data of over 4,000 mother-child pairs who participated in the NIHR-funded Pregnancy Outcome Prediction Study (POPS) and link it to data from the NHS, Department of Education and other agencies to see if growth patterns are associated with high risk of health or developmental problems.

POPS recruited pregnant women at the Rosie from 2008-12 and using interviews, blood samples and extra scans, collected very detailed information on pregnancy outcomes, and growth and development in the womb.

Dr Catherine Aiken from the research team said: “This information is a unique resource and has already been used to draw important conclusions about the immediate health of mothers and babies.

“We now want to see if we can use this data to help predict the likelihood of health problems for both mum and child, including long-term maternal health and developmental delay and neurodisability for the child.

“This is a really exciting opportunity to find new ways of identifying problems early, for example children at risk of developmental delay.

“If we know who is high-risk, then we have measures that can help, such as early learning support.”

Contribution

The POPS children are now aged between six and ten years, and have already contributed a huge amount to clinical care teams’ understanding of birth complications. Professor Gordon Smith, chief investigator for both POPS and POPstar and co-lead for our Women’s health and paediatrics theme, said: “This is a really good example of making the most of the information that is routinely collected to go further in improving the future health of mothers and their children.”

• POPStar is funded jointly by the NIHR Cambridge BRC and the children’s charity Action Medical Research.
• To find out more visit the study website or contact the research team at popstarstudy@medschl.cam.ac.uk.

Prestigious fellowship election for NIHR Cambridge BRC researchers

The NIHR Cambridge BRC is delighted that three of our researchers have been elected as Fellows of the Academy of Medical Sciences.

Theme leads Professor Menna Clatworthy and Professor Ludovic Vallier, together with Professor Ziad Mallat, who is one of our researchers in the Cardiovascular and respiratory disease theme, are among 50 world-leading UK researchers who have been elected to the prestigious Fellowship.

To be elected to the Academy, Fellows must have made exceptional contributions to advancing biomedical science.

In the current coronavirus global health crisis, the value of medical science has never been more apparent and like many Academy Fellows, Professors Vallier, Mallat and Clatworthy have redirected their research efforts to tackle the effects of the pandemic.

Professor Vallier’s team has developed a technology to grow a type of cell in the bile duct known as cholangiocytes in vitro (in test-tubes), so that they can study the effects of coronavirus on the liver. Professor Vallier said: “These liver cells express high levels of the SARS-CoV2 receptors and can be infected by the virus.

“We are using this model to study how the virus can enter cells and also to identify drugs which could limit this process.”

Professor Mallat’s team is studying how SARS-CoV2 infection can lead to heart attacks, and examining whether and how medications that alter the way the immune system works can modify cardiovascular outcomes.

Professor Mallat said: “This work is in close collaboration with investigators of the TACTIC trial and with many investigators in the Department of Medicine, and is also supported through BHF-CRE funding.”

Professor Clatworthy’s team is helping to study blood samples taken as part of the TACTIC-R trial, applying cutting-edge technologies to white blood cells (the body’s defence cells) to understand why some people experience an over-active immune response to the virus, and to look at the effect of the trial drugs on this response.

• Professors Clatworthy, Vallier and Mallat join Dr Helen Firth, Professor Tamsin Ford and Dr Nitzan Rosenfeld from the University of Cambridge who were also elected Fellows. Read more about the announcement on the University of Cambridge website.

Fast-track HRA review of COVID-19 studies

The Health Research Authority (HRA) is working with the rest of the research system to provide a coordinated process so that COVID-19 research can progress quickly, using a fast-track review process with bespoke advice and support for researchers.

The average review timeline is 5 days, with many completed within 24 to 72 hours.

HRA have updated the information on their website about the fast-track review process, guidance for researchers, sites and sponsors, guidance about using confidential patient data without consent and information about how it is handling other types of research.

This review takes place in parallel with the Chief Medical Officer’s prioritisation process for COVID studies.

To ensure that information about COVID-19 related research is made public as quickly as possible, summary information about each COVID-19 research project is available on the HRA website.

New National guidance for prioritising funding and support for COVID-19 research across the UK

Published by NIHR 26 March 2020:

Working with partners across the health and care system, NIHR is leading, enabling and delivering world-class COVID-19 research, a key element of the Government’s overall response to the pandemic. Given the extraordinary pressures currently being faced by the health and care system, we must also ensure that we are making best use of the limited resources and capacity available to support research.

We will do this by establishing and implementing a single, national process that will allow the Chief Medical Officer (CMO) / Deputy Chief Medical Officer (DCMO) for England to draw on expert advice to prioritise the COVID-19 studies which hold the most potential for tackling the challenges we face.

This process will cover all funded studies, irrespective of whether they are funded by the public sector, industry or charities and also, in partnership with UKRI, studies that require funding. It aims to prevent duplication of effort and to ensure that the capacity of the health and care system to support research is not exceeded.

Details of the process and the new single point of entry for prioritising COVID-19 studies can be found here.

With regard to HRA approvals, researchers should make an application through the national prioritisation process first and will be signposted for expedited regulatory approvals so that approval review can progress in parallel to the system of assessment leading to a view from CMO/DCMO on prioritisation.

All NHS Trusts, health and care providers and universities will need to prioritise support for studies which have been nationally prioritised. A live list of these studies is being collated. Organisations may support COVID-19 research activity only when this does not impact on the system’s ability to recruit participants and/or provide the resources (including staff, samples and data) needed to support nationally prioritised research. Organisations will be expected to pause any local studies that impede their ability to contribute to national research efforts.

• Government support for research related to COVID-19: Find out how to get your study nationally supported or funded as high priority COVID-19 Urgent Public Health Research.
• COVID-19 and Clinical Research Oversight Group CUH: This has been established under the governance of the NIHR Cambridge BRC and will review nationally prioritised studies to consider which can be supported locally with the available resources.
• NIHR response to COVID-19 pandemic: All NIHR updates on one page.
• Covid-19 response from the NIHR Cambridge BRC: Information for researchers, academics and clinicians on clinical research taking place on the Cambridge Biomedical Campus during the COVID-19 outbreak.

COVID-19 research studies at CUH

In response to the COVID-19 pandemic Cambridge University Hospitals has put in place measures to help researchers and research infrastructure deliver COVID-19 studies, whilst also supporting the care of patients with COVID-19 by redeployment of resources where necessary.

Chief and Principal Investigators of studies have been reviewing whether part or all of their studies need to be put on hold. Many existing studies are now suspended, and the NIHR Clinical Research Network is pausing any studies that are not nationally prioritised COVID-19 studies.

The NIHR has emphasised the need to prioritise COVID-related work, and are putting in place mechanisms for fast-tracking nationally prioritised studies through HRA and MHRA. A COVID-19 and Clinical Research Oversight Group has been established under the governance of the NIHR Cambridge BRC and will review nationally prioritised studies to consider which can be supported locally with the available resources.

The group will also consider proposals for studies to be sponsored by Cambridge University Hospitals and / or the University of Cambridge, but these are likely to need to have national reach or build on unique local capability to meet the threshold for fast -tracking through HRA / MHRA approval processes.

Professor Ian Wilkinson, Director of the Cambridge Clinical Trials Unit (CCTU), is also establishing a committee to review proposals for clinical trials related to COVID-19.

If you have questions, research proposals or clinical trials that you wish to be considered please contact Covid19research@addenbrookes.nhs.uk in the first instance.

• The HRA and MHRA have also provided guidance relating to coronavirus that is updated regularly.

Medovate working with CUH team to bring life-saving upper GI therapy device to market

Medical device company Medovate has secured the exclusive rights to bring to market a pioneering endoscopic surgical device.

The new device, ENDOVAC, has the potential to dramatically improve survival of patients with life-threatening infection following a leak from their the upper gastrointestinal (GI) tract whilst significantly enhancing current treatment methods.

Developed by a team led by Mr Andrew Hindmarsh (pictured left in photo), Consultant Oesophagogastric Surgeon at Cambridge University Hospitals, ENDOVAC is also backed by a £1.2m grant from the National Institute for Health Research, which has a number of regional specialist partners including the Hospital, the Cambridge Clinical Trials Unit, Health Enterprise East and Suffolk-based JEB Technologies Ltd. Medovate’s role is to attain regulatory approval and commercialise this technology, with a view to beginning clinical evaluation as early as 2021 and market launch thereafter.

Each year, around 2,800 people in the UK get a hole in their upper GI tract. These holes may occur on their own; arise from problems such as stomach ulcers; or be caused through surgery or other medical interventions. The presence of a hole allows leakage of gastrointestinal contents into the body which quickly leads to infection around vital organs such as the heart and lungs, a serious medical emergency that is fatal if not treated successfully.

In the past, the standard treatment for these holes has been surgery, but this was often unsuccessful. More recently surgeons have developed an alternative treatment strategy for this problem called Endoluminal Vacuum Therapy (EVT). However, this treatment still needs improvement as it requires multiple technically difficult procedures under general anaesthesia in an operating theatre to be successful.

ENDOVAC is a ground-breaking progression of EVT. This novel technology allows easier delivery of treatment without the need for general anaesthesia, meaning the procedure does not need to be performed in an operating theatre. ENDOVAC makes EVT safer, quicker, easier and cheaper, and importantly is far less traumatic for patients. It will also enable patients to be mobile during treatment, unlike standard EVT, where patients are often confined to their hospital beds.

Robert Donald, New Business Manager at Medovate (pictured right in photo), commented: “ENDOVAC offers a deceptively simple solution to a complex problem that has sadly claimed many lives over the years. The team at Cambridge University Hospitals have come up with a straightforward yet effective device [and] we are excited to be working with Mr Hindmarsh and his colleagues to bring such a ground-breaking product to market.”

Update on clinical research during the COVID-19 outbreak

UPDATE 7 APRIL 2020:

Approval process for COVID-19 related research

Locally, trials and studies need first to be reviewed by the Cambridge BRC/Covid-19 oversight committee before being submitted through the national NIHR prioritisation mechanism.

All COVID-19-related research studies are being prioritised at a national level through the NIHR. Studies seeking approval should first apply through the NIHR gateway, with nationally prioritised research being signposted for an expedited regulatory approval with the HRA/MHRA.

Email Covid19research@addenbrookes.nhs.uk for more information about undertaking COVID-19-based research studies at CUH.

Continue reading previous update (dated 19 March 2020):

As part of our response to COVID-19, some of our research activity will need to change.

We are reviewing all of our clinical research with Cambridge University Hospitals (CUH) and the University of Cambridge. Each study is being assessed on a case-by-case basis to minimise risks to participants either from continued participation in or disruption to a trial that forms part of their clinical care.

Some studies will need to pause or wind down to release staff for clinical roles and sample processing infrastructure to support the NHS.

Principal Investigators:

Chief and Principal investigators should review their studies and assess the risk to participants posed by COVID-19. Following risk assessment, please confirm your proposed mitigations or actions with Professor John Bradley, Director of Research, as soon as possible.

Research Participants:

Research participants will be contacted by their study team with updates about any changes to the study they are enrolled in. Please contact your study team if you have any further questions about your study or your participation during these events.  Participants who believe they have COVID-19 symptoms should follow Department of Health and Social Care advice and contact their study team.

Patient and Public Involvement (PPI):

CUH is committed to supporting the research effort against COVID-19, and patients and the public will have a particularly valuable role as we embark on this.  The PPI team are working remotely, but are still available to speak to researchers who need assistance with PPI for their grant applications or documentation reviewed by the CUH PPI panel. Our panel has over 70 people who are willing to review research-related documents and this service is still available, with our panel members very committed to continuing their support for researchers during this period.

Non-essential visits to the campus are not permitted at this time. As such, we have cancelled all in-person meetings and training that were planned through to the summer. This will continue to be reviewed as the situation changes. All filming and work experience in our research buildings have been suspended/ cancelled due to the current restrictions in place.

The PPI and communications team are also investigating options to run their training sessions and other PPI activities online.

If you need any assistance contact the PPI team: cuh.ppi@nhs.net

It’s your data – so have your say in how it should be used

How do you think health data should be shared and used – and who should share it?

Now’s your chance to tell Cambridge researchers what you think about accessing, sharing and using YOUR health data – in an online survey from the CLIMB research project.

The survey should only take you about 20 minutes and will ask you questions about your views on sharing your health data for both clinical and research purposes. The information you provide will be anonymous.

You can find out more about CLIMB and what the survey is aiming to achieve on their website.

Who can take part?

• Anyone who lives in the UK – this is a national survey
• Anyone who is over 16 – children under 16 can also take part, as long as they have their parent’s/guardian’s permission

I use local services in Cambridge – what options do I choose for questions about where I heard about the survey?

• NIHR Cambridge BRC is not an option, simply choose where applicable “Hospital” and then “Addenbrooke’s”

Please feel free to forward to family and friends, far and wide! You can do it for or on behalf of children and remember, it only takes about 20 minutes.

Begin the survey.

New NIHR Cambridge BRC director appointed

The NIHR Cambridge Biomedical Research Centre (BRC) has announced Dr Miles Parkes will be the new director of the centre, based at Cambridge University Hospitals (CUH).

Dr Miles Parkes is currently a consultant gastroenterologist and researcher at CUH.

His research focuses on understanding the causes of Crohn’s disease and ulcerative colitis, and the factors that affect the course and outcomes of treatment for these conditions – by focusing on their genetics and the gut microbiota. In addition he researches new ways of managing and treating Crohn’s disease and ulcerative colitis.

Miles already leads the UK IBD genetics consortium and is also the clinical and academic lead for the recently established Health Data Research Hub for IBD, known as Gut Reaction.

Miles will take over the role from Professor John Bradley, who announced in late 2019 he would be stepping down from his director role at the NIHR Cambridge BRC. John will still play an integral part in the development of research on the Cambridge Biomedical Campus as he continues to be joint director of the NIHR BioResource and Research and Development Director at CUH.

Research in Cambridge

The NIHR Cambridge BRC is a partnership between Cambridge University Hospitals and the University of Cambridge which is located at the Cambridge Biomedical Campus and funded by the NIHR. Biomedical Research Centres aim to bring academics and the hospital together to speed up research in order to create new treatments and medicines for the benefit of patients and the NHS.

The NIHR Cambridge BRC is one of the largest BRCs in England and has significant expertise in the major health challenges we face today such as antimicrobial resistance, cancer, dementia, diabetes, mental health and obesity.

Since its creation in 2007, the centre has already delivered medical breakthroughs including a new screening device to detect Barrett’s oesophagus and the use of genomic testing for rapid diagnosis of critically ill babies.

Miles will begin his new role on 01 April 2020. He will work with clinicians and industry partners on the campus to deliver ground-breaking research in Cambridge. Miles said: “I’m delighted to have been appointed as the new director of the NIHR Cambridge BRC. It’s a big remit, and John Bradley has given me a tough act to follow. However, the opportunities for translational research in Cambridge are enormous.

“By working with colleagues across the whole biomedical campus, I hope we can all push to accelerate the clinical translation of the many medical and scientific advances being made each week in Cambridge. We will strive to continue the success of the NIHR Cambridge BRC and bring forward improved patient care.”

Professor Patrick Maxwell, Regius Professor of Physic and Head of the School of Clinical Medicine said: “I am absolutely delighted with the appointment of Dr Parkes to lead the NIHR Cambridge Biomedical Research Centre.

“Miles is an excellent gastroenterologist and has a fantastic track-record in developing important insights into inflammatory bowel disease. John Bradley, the founding Director of the BRC, is a really hard act to follow but I have complete confidence that Miles will be an outstanding leader of our translational research partnership.”

NIHR Cambridge BRC research highlights over 2019

From breath tests for cancer to finding the root of childhood kidney cancer, what are the research stories that NIHR Cambridge BRC supported or funded which hit the news over 2019?  Click on the picture below to bring up our highlights, then select a picture to find out more about each news story.

We’ve picked a story for every month of 2019 – but we’ve also funded and supported much more. Go to our theme or publications pages to find out more.

Winning research poster at our Open Evening unveiled – as voted for by you!

Is DNA your destiny?

Not necessarily, according to Cambridge postdoctoral researcher Dr Kousik Kundu – whose poster was voted the public’s favourite at the NIHR Cambridge BRC Open Evening which took place last November.

The poster was one of 13 on display highlighting individual research projects which the NIHR Cambridge BRC and local colleagues have supported and funded, and which were chosen for their readability and accessibility to a lay audience. It was then up to members of the public to select their favourite!

Dr Kundu’s winning poster, which was a collaboration with Professor Nicole Soranzo and fellow researchers at the Wellcome Sanger Institute, summed up his team’s research in the genetic factors underlying individuals’ disposition to life-changing diseases.

Dr Kundu said: “While we share 99.9% of our genomes with other people, it is that 0.1% that can affect our susceptibility to any disease and our response to medicines.

“By understanding these genomic differences we can work out the best possible way to treat a patient for a range of diseases – from diabetes and heart disease to cancer.

“But our research showed that environmental factors, such as our lifestyle and diets, also play an important role on how we respond to a drug – and that it could be possible to develop better therapeutic approaches to personalised healthcare.”

In designing the poster Dr Kundu said: “I learnt a lot about how to make a very complex scientific work simple and attractive, while providing a very important message which can be easily understood by a lay audience.

“I think because of its simplicity, many people found my poster interesting and stopped to ask many questions.”

Communications and PPI Strategy Lead Amanda Stranks said: “The standard of entries for our Open Evening was incredibly high, but Kousik’s colourful use of graphics and non-technical language ensured that his poster neatly got across why the research was necessary and its impact.”

Dr Kundu’s current research focuses on the genetic factors of several immune-mediated diseases, such as Crohn’s disease, rheumatoid arthritis and multiple sclerosis. He is also working to generate whole genome sequence data from UK Biobank samples and to analyse data from the NIHR-funded INTERVAL study, which showed that blood donors could safely give blood more frequently than is allowed at present without having a major impact on their health.

He said: “We are possibly not far away from when doctors will prescribe the right combination of medicines at the right time that is most suitable for an individual.”

• Dr Kundu’s current research focuses on the genetic factors of several immune-mediated diseases, such as Crohn’s disease, rheumatoid arthritis and multiple sclerosis
• Click to view “Genomics and Personalised Medicine” poster.

Public Open Evening highlights research expansion plans for campus

It is already a world-leader in clinical care and research – and now there are plans for the Cambridge Biomedical campus to literally build on this reputation, as more than 150 people found out when they attended the NIHR Cambridge Biomedical Research Centre Open Evening.

Called simply “Growing the Cambridge Biomedical campus”, the evening featured presentations from Cambridge University Hospitals CEO Roland Sinker, who talked about the importance of research in healthcare, and from leading researchers involved in the new infrastructure.

Cambridge BRC Director Professor John Bradley opened the evening, together with patient representative Valerie Berkson.

Valerie sits on the Cambridge University Hospitals Patient & Public Involvement Panel and she talked about its vital role in research – “Most individuals do want to help” – and, with her husband and co-panel member Michael, spent time talking with people interested in getting involved in research after the event.

Presentations from consultants and researchers who are leading the new developments described how the new buildings will help to accelerate important research into heart and lung conditions, paediatrics, cancer and inflammation, infection and immunotherapeutics.

One audience member said: “It’s hugely exciting to find out direct from the researchers how these developments are helping to drive research – and listening to a patient representative [Valerie] right at the start brought all that science alive and relevant to me.”

Another member of the public, who had travelled with his wife from nearby village Meldreth, said: “We enjoyed the event very much and felt that it gave us a good ‘overview’ of all the exciting things which are going on at the site.”

The evening featured a lay-friendly poster exhibition, where the audience was asked to vote for their favourite research poster, and information stands from organisations including ACTIVE, the children’s group based at Addenbrooke’s, Cambridge Children’s, NIHR BioResource and the Patient-Led Research Hub.

• The NIHR Cambridge BRC Public Open Evening took place on 20 November 2019
• Find out more about our Patient and Public Involvement Panel at Cambridge University Hospitals

Scientists discover root of childhood kidney cancer

A fundamental change in our understanding of the childhood kidney cancer Wilms’ tumour is on the horizon, after the discovery of its earliest genetic root by scientists at the Wellcome Sanger Institute and their collaborators.

By comparing genome sequences from normal kidney tissue and tumours, the team identified patches of normal-looking kidney tissue that in fact carried DNA changes that cause Wilms’ tumour.

The study, which was part-funded by NIHR, uncovers a novel route by which cancers can form in the first few weeks of life, whereby an early cell gains the DNA modification associated with cancer and proliferates while the kidney is developing.

Understanding the root of the cancer promises to improve treatment and help prevent recurrence of Wilms’ tumour. This discovery also raises the possibility of one day being able to screen for cancers like this before tumours develop.

Wilms’ tumour is a form of kidney cancer mainly affecting children under five years of age. Though kidney cancers in children are rare, Wilms’ tumour is the most common type with around 80 cases per year diagnosed in the UK. Nine out of ten cases are curable by surgery to remove the affected kidney together with chemotherapy and sometimes radiotherapy. Usually the cancer only affects one kidney, but in around 10 per cent of cases both kidneys are affected*. It has been assumed that the cause of Wilms’ tumour is one cell ‘going wrong’ as the kidney develops in the first few weeks of life.

This study is the first to compare healthy kidney tissue with Wilms’ tumour tissue, using comparative genome analysis to investigate the cause of the disease. 66 tumour and 163 normal kidney tissue samples were collected by researchers at Addenbrooke’s Hospital in Cambridge and Great Ormond Street Hospital in London. Scientists at the Wellcome Sanger Institute sequenced DNA from the samples to create 229 whole genome sequences, which were analysed to identify genetic changes between tumours and normal tissue.

In two thirds of children with Wilms’ tumour, DNA changes associated with the disease were found to be shared by both normal kidney tissue and tumour tissue. This allowed the researchers to hone in on patches of genetically abnormal cells which, when looked at down a microscope, appeared to be normal.

These patches were found to have developed from a single rogue cell with a DNA change suppressing the H19 gene. Normally, the function of H19 is to ensure that cells grow in an orderly manner. This particular DNA change is what is known as an epigenetic change, where part of the DNA code becomes ‘invisible’ to the cells, rather than a physical alteration of the person’s DNA. This epigenetic change ‘turns off’ H19 and enables cells to grow rapidly into pre-cancerous patches of kidney tissue from which Wilms’ tumour can arise.

Tim Coorens, first author of the study from the Wellcome Sanger Institute, said: “A good analogy for what we found is that Wilms’ tumour is not just an isolated weed on an otherwise well maintained field. We discovered that the weed has an extensive root underneath the soil. Now we know we need to look for the patch of soil where the root has taken hold. If we remove that patch, the weed isn’t going to return.”

Due to the likelihood of recurrence, Wilms’ tumour is usually treated by removing the whole kidney. Most people can live a relatively normal life with one kidney, but in the 10 per cent of Wilms’ tumour cases that affect both kidneys, removing them entirely will have life-changing consequences for the patient.

As well as changing how we treat Wilms’ tumour, these findings open up the possibility of one day screening for this and similar cancers.

Dr Sam Behjati, lead author of the study from the Wellcome Sanger Institute and Addenbrooke’s Hospital, said: “The discovery of the genetic root of Wilms’ tumour signals a shift in our understanding of this particular cancer and childhood cancer more generally. Our findings represent a radical departure from how we think about Wilms’ tumour because we never expected to find the root of cancer in normal-looking tissue. It may even pave the way for us to begin to think about preventing childhood cancer.”

Wellcome Sanger Institute

World Health Organisation CVD risk charts updated using Cambridge-led research

Research revising the World Health Organisation (WHO) cardiovascular disease (CVD) risk prediction charts to aid efforts to reduce the burden of CVD, especially in low- and middle-income countries, has been published by The Lancet Global Health.

The research – carried out by the WHO CVD Risk Chart Working Group* and led by researchers at the University of Cambridge – was funded by the National Institute for Health Research Cambridge Biomedical Research Centre, WHO, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence and UK Medical Research Council.

It analysed data from more than 375,000 mainly middle-aged participants in 85 prospective cohort studies to develop simplified risk prediction models and revised risk charts tailored for implementation in low- and middle- income countries. The participants did not have previous history of CVD at the outset and 19,000 had a CVD event (heart attack or stroke) during the first 10 years of follow up.

This risk models were then statistically adapted or ‘recalibrated’ to more accurately estimate CVD risk for contemporary populations in 21 global regions, using available estimates of population-specific CVD incidence rates and risk factor values, including low- and middle-income countries.

The revised risk models will help support these countries – which along with other WHO member states have committed to provide counselling and drug treatments for at least half of their populations known to be at high risk of CVD – in their efforts to prevent and control the disease.

Prof Emanuele Di Angelantonio, from the University of Cambridge, senior author of the study said: “Three-quarters of all premature deaths from CVD globally are in low- and middle-income countries and while there are many risk-prediction tools to help countries prevent and control CVD, they only apply to specific populations, usually in high-income countries.

“Our research ensures that the revised models are applicable to the circumstances of many different global regions, with a particular focus on low- and middle-income countries, where individual risk for CVD can vary hugely from region to region and resources may be limited.”

Dr Cherian Varghese, from WHO, which coordinated the study, said: “CVDs are the number 1 cause of death globally and more people die annually from CVDs than from any other cause. The use of updated CVD risk charts should enhance global efforts to prevent CVD worldwide and help to reduce premature mortality from non communicable diseases.”

*The WHO CVD Risk Chart Working Group is a global collaboration of academics, policy makers and end users and was convened to help develop tools for predicting CVD risk which could be used by low- and middle-income countries.

• “World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions” was published by The Lancet Global Health on 1 September 2019.
• CVD is one of the most common non-communicable diseases world-wide, responsible for an estimated 17.8 million deaths in 2017. It is a United Nations goal to cut premature deaths from non-communicable diseases (including CVD) by a third by 2030.

No microbiome in human placenta: Cambridge researchers’ paper published in Nature

World-leading science journal Nature has published a paper from the Department of Obstetrics and Gynaecology at the University of Cambridge. Entitled “Human placenta has no microbiome but can contain potential pathogens”, the paper presents three key messages: (1) the placenta does not have a microbiome; (2) bacterial infection of the placenta is not a common cause of adverse pregnancy outcome; and (3) the placenta is however a potential site of perinatal acquisition of Streptococcus agalactiae, a major cause of neonatal sepsis.

Researchers found that there was no evidence for the presence of bacteria in the large majority of the 537 placental samples that were provided, from both complicated and uncomplicated pregnancies. Complicated pregnancies included pre-eclampsia, spontaneous preterm birth and the delivery of infants who are small for gestational age.

The exception was Streptococcus agalactiae (group B Streptococcus), which was detected in approximately 5% of samples collected before the onset of labour.

The researchers concluded that bacterial infection of the placenta is not a common cause of adverse pregnancy outcome and that the human placenta does not have a microbiome, but it does represent a potential site of perinatal acquisition of S. agalactiae, a major cause of neonatal sepsis.

Further studies will be needed to determine the association between the presence of S. agalactiae in the placenta and fetal or neonatal disease; if such a link is identified, rapid testing of the placenta for the presence of S. agalactiae might allow targeting of neonatal investigation and treatment.

• The Department of Obstetrics and Gynaecology is based at the Rosie Hospital, where it undertakes scientific research in human pregnancy, the placenta and the uterine endometrium.
• This research was supported by the Medical Research Council and the NIHR Cambridge BRC (Women’s Health theme).

Discovery of genetic variants that protect against obesity and type 2 diabetes could lead to new weight loss medicines

Around four million people in the UK carry genetic variants that protect them from obesity, type 2 diabetes and heart disease, suggests new research from the University of Cambridge.

The MRC/Wellcome Trust-funded research, which also received support from the NIHR Cambridge BRC, could lead to the development of new drugs that help people lose weight.

Scientists have known for several years that genes can influence a person’s weight. One of the genes that is known to play a key role in regulating weight is MC4R, which codes for the melanocortin 4 receptor. This receptor acts like a switch in the brain to suppress appetite.

People who have genetic variants that disrupt this receptor gain weight easily. Now, in a study published today in the journal Cell, researchers have shown that other genetic variants in the MC4R gene that increase the activity of this brain receptor can protect people from becoming overweight, a finding that could lead to the development of new medicines that ‘copy’ the protective effect of these genetic variants to achieve or maintain weight-loss.

A team led by Professors Sadaf Farooqi and Nick Wareham and Dr Claudia Langenberg at the Wellcome Trust-MRC Institute of Metabolic Science in Cambridge looked at the MC4R gene in half a million volunteers from the UK population who have taken part in the UK Biobank study, finding 61 distinct naturally-occurring genetic variants.

While some of these genetic variants predisposed people to become obese, other variants provided protection against obesity and some of its major complications, such as type 2 diabetes and heart disease. To investigate the reasons for this mystery, Professor Farooqi’s team, who previously showed that MC4R works in the brain as a ‘switch’ to tell us to stop eating after a meal, studied the function of these genetic variants in a number of laboratory experiments.

They found that MC4R gene variants linked to higher obesity risk stopped the gene from working, whereas variants that offered protection against obesity kept the gene ‘switched on’. Around six per cent of study participants carried genetic variants that caused the receptor to remain ‘switched on’. People with these variants would eat less, which could explain their lower weight. People with two copies of these particular variants (1 in over 1,000 people) were on average 2.5 kg lighter than people without the variants and had a 50% lower risk of type 2 diabetes and heart disease.

“This study drives home the fact that genetics plays a major role in why some people are obese – and that some people are fortunate enough to have genes that protect them from obesity,” said Professor Farooqi of the University of Cambridge Metabolic Research Laboratories. The discovery adds to recent work by the team which showed that some slim people have a genetic advantage when it comes to maintaining their weight.

“It doesn’t mean that we can’t influence our weight by watching what we eat, but it does mean the odds are stacked against some people and in favour of others,” added Professor Farooqi.

When the researchers looked in detail at the genetic variants in laboratory experiments, they found that MC4R can send signals through a pathway – known as the beta-arrestin pathway – that had not previously been linked to weight regulation. Genetic variants that sent signals preferentially through this pathway were the ones driving the association with protection against obesity and its complications and, importantly, were also associated with lower blood pressure.

Designing drugs that mimic the effect of the protective variants in MC4R could provide new, safer weight loss therapies. “A powerful emerging concept is that genetic variants that protect against disease can be used as models for the development of medicines that are more effective and safer,” said Dr Luca Lotta, Senior Clinical Investigator at the Medical Research Council Epidemiology Unit and joint lead author of the study.

“Our findings may pave the way for a new generation of weight loss therapies that activate MC4R preferentially via the beta-arrestin pathway.”

Professor Wareham, Director of the MRC Epidemiology Unit and Co-Director of the Institute, said: “Our work would not have been possible without the unique blend of expertise in large-scale genetic epidemiology analysis and laboratory experiments at the Institute of Metabolic Science.

“Genetic studies of thousands of people and a functional understanding of the mechanisms behind protective genetic variants can really help us inform the development of a new generation of medicines for common diseases like obesity and diabetes that affect millions of people globally.”

Additional routine ultrasounds benefit mothers and babies, and could save costs, study finds

The Pregnancy Outcome Prediction study, which was funded by the National Institute for Health Research and supported by NIHR Cambridge BRC and CRF, found that routine late ultrasounds could spot previously undiagnosed breech presentation (when a baby’s buttocks or feet emerge first at birth, increasing the risk of perinatal morbidity and mortality).