Cambridge Clinical Vision Laboratory (CCVL) – test
The CCVL is a dedicated facility for vision research embedded within the NIHR Cambridge Clinical Research Facility in a strategic location next to the Early Phase Trials Unit.
The CCVL is part of a major drive by the NIHR Cambridge BRC to fast-track advanced gene therapy and cell-based therapies for ocular and neurodegenerative diseases. We also support early-phase experimental trials exploring novel chemotherapeutic and immunomodulatory agents for cancer and various autoimmune diseases.
The CCVL is available to assist and support your studies, including grant applications. Please contact us to discuss your ideas and requirements further.
CYNAPSE: Supporting new health data research in Cambridge
However, to gain maximum benefit for patients and society from each dataset, researchers sometimes apply to use information from previous studies to support their own investigations.
When data is stored and accessed in different ways, and not listed as an available resource, important research can be limited.
CYNAPSE is a project that aims to support the development of new systems to ensure consistent, safe and accessible storage of health data in Cambridge.
- Find out more about CYNAPSE, and partner project DARE UK, in our Q&A sections.
- Image by Gerd Altmann @Pixabay
The NIHR and Open Access
The NIHR supports the principle of open access to the outputs of research, which can offer both social and economic benefits as well as aiding the development of new research and stimulating wider economic growth of the UK economy.
The NIHR is also committed to adding value in research, which ensures publishing research results in full in an accessible and unbiased report.
Read more on the NIHR open access policy (updated 11/11/2021).
Cancer Research Patient Group
Hear from a group of women who have been been involved in cancer research.
Aartificial pancreas is helping protect very young children with type 1 diabetes
Management of type 1 diabetes is challenging in very young children, because of a number of factors including the high variability in levels of insulin required and in how individual children respond to treatment, and their unpredictable eating and activity patterns.
To manage children’s glucose levels, doctors increasingly turn to devices that continuously monitor glucose levels and deliver insulin via a pump, which administers insulin through a cannula inserted into the skin. These devices have proved successful to an extent in older children, but not in very young children.
Professor Roman Hovorka, developed an app – CamAPS FX – which, combined with a glucose monitor and insulin pump, acts as an artificial pancreas, automatically adjusting the amount of insulin it delivers based on predicted or real-time glucose levels. It is a ‘hybrid closed loop system’, meaning that the child’s carer will have to administer insulin at mealtimes, but at all other times the algorithm works by itself.
The research team found the device performed better than current methods and parents found using this device life-changing. Read the full story from January 2022.
NICE prostate guidelines updated based on Cambridge research
Patients with a raised blood level of Prostate Specific Antigen (PSA) or other worrying symptoms have tests to determine any presence of cancer. If they are diagnosed with the disease, they were normally categorised in one of three groups, low, intermediate or high-risk, depending on the severity of the cancer, and start treatment.
However, research supported by the NIHR Cambridge BRC, demonstrated that some patients did not fit neatly into any of the categories and so did not require the same monitoring and treatments compared to others in the respective groups.
They developed a new risk model – the Cambridge Prognostic Groups (CPG), which re-categorised these groups into five categories.
After years of collecting detailed health information and testing, the team found having five categories was a better method to inform the best treatment choice and also likelihood of the disease responding to treatment.
NICE recognised all newly diagnosed men in the UK should be risk-categorised by the new five category model developed in the CPG’s criteria which will now improve care and tailor appropriate treatment to patients.
Using air filters on hospital wards remove almost all airborne Covid virus
Researchers investigated whether portable air filtration/UV sterilisation devices could reduce airborne SARS- CoV-2 in general wards that had been repurposed as a COVID ward and a COVID Intensive Care Unit (ICU) or ‘surge wards’.
The team installed a High Efficiency Particulate Air (HEPA) air filter/UV steriliser in two repurposed COVID-19 units. HEPA filters are made up of thousands of fibres knitted together to form a material that filters out particles above a certain size.
One ward managed patients who required simple oxygen treatment or no respiratory support; the second was a ICU managing patients who required ventilation either through non-invasive mask ventilation or invasive respiratory support, such as involving the use of an invasive tube and tracheostomy.
In the surge ward, during the first week prior to the air filter being activated, the researchers were able to detect SARS-CoV-2 on all sampling days. Once the air filter was switched on and run continuously, the team were unable to detect SARS-CoV-2 on any of the five testing days. They then switched off the machine and repeated the sampling – once again, they were able to detect SARS-CoV-2 on three of the five sampling days.
On the ICU, the team found limited evidence of airborne SARS-CoV-2 in the weeks when the machine was switched off and traces of the virus on one sampling day when the machine was active. Additionally, the air filters significantly reduced levels of bacterial, fungal and other viral bioaerosols on the both the surge ward and the ICU, highlighting an added benefit of the system.
This discovery could have implications for improving the safety of repurposed ‘surge wards’, the researchers say it also opens up the possibility of being able to set standards for cleaner air to reduce the risk of airborne transmission of infections.
This research was supported by the NIHR Cambridge BRC and led by doctors, scientists and engineers at Addenbrooke’s and the University of Cambridge in January 2021, at the height of the second wave of the pandemic.
Could irritable bowel syndrome (IBS) and and mental health disorders such as anxiety be linked?
IBS affects around 1 in 10 people and causing symptoms such as abdominal pain, bloating and bowel dysfunction that can significantly affect people’s lives. Causes of IBS are not well understood but researchers have now identified several genes that provide clues into the origins of IBS.
In a large international study of more than 50,000 people with IBS, research teams from more than 40 institutions looked at genetic data from people who suffer with IBS and compared them to people without IBS (controls). The findings were repeated with de-identified data from people who have consented to research, again, people with IBS to those without.
The results showed that overall, heritability of IBS (how much your genes influence the likelihood of developing a particular condition) is quite low, indicating the importance of environmental factors such as diet, stress and patterns of behaviour that may also be shared in the family environment.
However, 6 genetic differences were more common in people with IBS than in controls. Researchers found most of the altered genes appear to have more clear-cut roles in the brain and possibly the nerves which supply the gut, rather than the gut itself.
The team also looked for overlap between susceptibility to IBS and other physical and mental health conditions. They found that the same genetic make-up that puts people at increased risk of IBS also increases the risk for common mood and anxiety disorders such as anxiety, depression, and neuroticism, as well as insomnia. However, this doesn’t mean that anxiety causes IBS symptoms or vice versa.
Read the full press release from November 2021.
Brain receptor uses nutritional state to control growth and age at puberty
It was previously thought growing taller and reaching sexual maturity may have been related to access to food for pregnant women and children, but researchers have now found it might be related to a receptor in the brain.
It is already known that signals reach the brain to indicate the body’s nutritional state. In a part of the brain called hypothalamus, hormones act on a small group of neurons that produce signals called melanocortins.
The melanocortins act on a variety of receptors, two of which are present in the brain. One of these, the melanocortin 4 receptor (MC4R) has previously been shown to regulate appetite and lack of MC4R results in obesity, but the MC4R system does not control the effect of nutrition on growth and timing of puberty.
Researchers found that in response to nutritional signals the MC3R system controls the release of key hormones regulating growth and sexual maturation, showing the brain can sense nutrients. This study could help people with the management in growth and puberty disorders.
Read the full press release from November 21
New study to test personalised breast cancer screening
MyPeBS trial is taking place in 6 European countries and plans to involve 85,000 volunteers aged between 50 and 70 who have never had breast cancer before.
Currently those between the ages of 50-70 are invited for a routine NHS breast cancer screening by having a mammogram every three years. However, not everyone has the same breast cancer risk, other factors such as genetics, hormones, family history and breast density can put some in a higher risk category.
The MyPeBS study randomly assigns trial volunteers to follow either the standard NHS screening schedule or a personalised screening schedule according to their risk of breast cancer.
Professor Fiona Gilbert, professor of radiology at University of Cambridge and imaging theme lead for the NIHR Cambridge Biomedical Research Centre is leading the UK study. “This is an opportunity to take part in one of the largest studies so far into how we find early stage breast cancer. By taking a saliva sample and history from those selected on the trial, we can identify whether they are at higher or lower risk of developing breast cancer. Once we know this, we can tailor screening to their own personal needs.”
Cambridge University Hospitals NHS Foundation Trust (CUH), the Leeds Teaching Hospitals NHS Trust and Manchester University NHS Foundation Trust (MFT) will be supporting the UK arm of the study and plans to recruit 10,000 volunteers which will last for 4 years. The Cambridge site will be supported by the NIHR Cambridge BRC.
For more information about the trail, go to: www.mypebs.eu
ITV News reported on the trial in October 2021 or read the full news article.
Identifying the cause of Alzheimer’s progression in the brain
An international research team, led by the University of Cambridge and supported by the NIHR Cambridge BRC, investigated how Alzheimer’s disease progresses in the brain.
In Alzheimer’s disease, tau and another protein called amyloid-beta, build up in clumps known as aggregates, causing brain cells to die and the brain to shrink. This results in memory loss, personality changes and difficulty carrying out daily tasks.
Alzheimer’s disease develops over years and can be hard to study the progression. Researchers looked at post-mortem brain samples from Alzheimer’s patients, as well as brain PET (positron emission tomography) scans from patients who were at different stages of the disease, from mild impairment through to those with late-stage symptoms.
It was thought that Alzheimer’s develops from one part of the brain and then spreads, but researchers found aggregates in multiple regions of the brain and that trying to stop the spread in just one part will do little to slow down the disease.
This is the first time that human data has been used to understand the development of Alzheimer’s disease over time. The findings will give researchers a better understanding of Alzheimer’s and other neurological diseases and will be able to help develop new treatments.
Read the full news story from October 2021
Markers to help newly diagnosed seropositive rheumatoid arthritis patients
Researchers collected clinical and laboratory measures from 28 UK centres every 3 months over a total of 18 months to understand the progression of seropositive rheumatoid arthritis.
It was measured against the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and Simplified Disease Activity Index (SDAI).
Researchers found that collecting biological markers early after diagnosis could help manage the disease.
Read the full paper published in October 2021
Positive phase 3 results reported in trial for new COVID-19 vaccine supported by Cambridge
The trial has been taking place at 22 locations across the UK and recruited a total of 4012 participants aged 18 years and over, and 660 adolescents.
Results showed in October 2021, that the vaccine was successful in producing high levels of neutralising antibodies against the COVID-19.
Developed by the French specialty vaccine company Valneva and manufactured in Scotland, the vaccine is the only inactivated, adjuvanted COVID-19 vaccine in clinical development in Europe. This means, that like flu and polio vaccines, it contains dead versions of the virus that cannot cause disease. Valneva hopes to initially get the jab approved for those aged between 18 and 55.
This national trial was supported at the Cambridge site by the NIHR Cambridge Clinical Research Facility and NIHR Cambridge BRC.
A DNA test that can identify secondary infections in COVID-19 patients.
Patients who are diagnosed with severe COVID-19 may need mechanical ventilation in order for clinicians to help treat the virus. However, some may be susceptible to secondary bacterial infections.
COVID-19 patients are thought to be more at risk of a secondary infection because of the amount of lung damage from the virus and will spend more time on a ventilator than those without COVID-19. Many of these patients also have a poorly-regulated immune system, where the immune cells damage the organs and also have impaired anti-microbial functions, so trying to diagnose these patients early is vital.
Cambridge researchers have developed a DNA test to identify those who may have developed the secondary infection a lot sooner.
The test uses multiple polymerase chain reaction (PCR) to help detect the DNA of the bacteria within a few hours rather than waiting for it to grow in the lab. The test runs multiple PCR reactions and can simultaneously pick up 52 different pathogens (organism that causes disease), which often infect the lungs of patients in intensive care. At the same time, it can also test for the bacteria which may be resistant to antibiotics.
Often patients have already started to receive antobiotics before the bacteria has had time to grow meaning cultures are often negative. However, the PCR test doesn’t need to viable bacteria to be able to detect it, not only making it a more accurate test and are able to speed up the diagnosis.
This is one of the first times that this technology has been used in routine clinical practice and was approved by Addenbrooke’s hospital in Cambridge.
Neuroinflammation predicts disease progression in PSP
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease that can cause problems with balance, movement, vision, speech and swallowing. It occurs when brain cells become damaged from the build-up of protein called tau.
Patients with PSP volunteered for a trial which would involve having their brains scanned with a PET (Positron Emission Tomography) scan. The patients were then followed up for a few years.
Researchers were able to map where the inflammation occurred in the brain and highlight any significant changes. It could mean that using PET scans may be able to help clinicians see how PSP is progressing in their patients.
Read the full paper from March 21
Can looking at the brains communication channels help detect dementia earlier?
These connect to neurons in the brain and to the neurons in the rest of the body. Loss of these synapses is common in early dementia.
By using a PET (positron emission tomography) scan, researchers are now able to measure the amount of synapses in the brain.
Looking at healthy volunteers who are at risk of developing dementia because of a mutation in a gene called C9orf72, they found synapse loss was already present many years before symptoms were expected, especially in a part of the brain called the thalamus.
Spotting these changes early could be vital to help those who are at high risk of dementia. Patients will be able to be monitored and begin treatment sooner.
Studying brain activity in Progressive Supranuclear Palsy
PSP is caused by the cells in the brain becoming damaged as a result of a build-up of a protein called tau.
Researchers looked at the brain activity patterns and found patients with PSP spend more time than individuals without the disease in certain brain states, meaning their brain activity was less flexible and less efficient than normal. The time spent in these brain states was more noticeable in participants who were more severely affected with PSP.
Researchers noticed that it wasn’t just certain parts of the brain that are most affected but it could affect the whole brain, even where it may appear normal on a scan or have no tau pathology.
Read the full paper published in July 21
Cambridge hosts world-first COVID-19 vaccine booster study
In this Government-funded trial, Cambridge were one of the sites to host the ‘booster’ COVID-19 vaccine trial at the NIHR Cambridge Clinical Research Facility.
With thousands of volunteers taking part in the UK, the study would provide researchers vital data on the impact of a third dose on patients’ immune responses.
The trial looked at seven different COVID-19 vaccines (including the Pfizer/BioNTech, and Valneva vaccines) as potential boosters, given at least 10 to 12 weeks after a second dose as part of the ongoing vaccination programme. One booster will be provided to each participant and could be a different brand to the one they were originally vaccinated with.
All the data was then analysed to help inform decisions by the Joint Committee on Vaccination and Immunisation (JCVI) on any potential booster programme for autumn of 2021.
Researchers in Cambridge saw more than 180 participants from the Cambridgeshire area. Professor Krishna Chatterjee, Director of the NIHR Clinical Research Facility in Cambridge, who led the trial in Cambridge said in June: “We are delighted to support this study here in Cambridge. We have conducted trials of several COVID-19 vaccine studies over the last year. It’s an exciting opportunity to now work on a study to determine the effects of a third ‘booster’ dose of vaccines and I want to thank both the trial participants and our staff who are helping with this important research.”
Read the full story from June 2021
Artificial pancreas trialled for outpatients with type 2 diabetes for first time
Tests led by the University of Cambridge and Inselspital, University Hospital of Bern, Switzerland and supported by the NIHR Cambridge BRC, show that the device can help patients safely and effectively manage their blood sugar levels and reduce the risk of low blood sugar levels.
Diabetes is the most common cause of kidney failure, accounting for just under a third (30%) of cases. Kidney failure increases the risk of hypoglycaemia and hyperglycaemia – abnormally low or high levels of blood sugar respectively – which in turn can cause complications from dizziness to falls and even to coma.
Managing diabetes in patients with kidney failure is challenging for both patients and healthcare professionals. Many aspects of their care are poorly understood, including targets for blood sugar levels and treatments. Most oral diabetes medications are not recommended for these patients, so insulin injections are the most commonly used diabetes therapy – though optimal insulin dosing regimens are difficult to establish.
The researchers showed that the artificial pancreas – developed for patients with type 1 diabetes – can also be used to support patients living with both type 2 diabetes and kidney failure.
Unlike the artificial pancreas being used for type 1 diabetes, this version is a fully closed loop system – which means it can function entirely automatically. without any input from patients.
In the trial patients were split into two groups, one using the control treatment and the other using the artificial pancreas. Those using the artificial pancreas spent on average 53% of their time in the target blood sugar range, compared to 38% when they used the control treatment. The length of time they had potentially low blood sugar levels, or ‘hypos’, was also lower.
Nine out of ten (92%) reported that they spent less time managing their diabetes with the artificial pancreas than during the control period, and similar numbers (87%) were less worried about their blood sugar levels when using it.
This is an abridged version of the press release which was first published on our website on August 5, 2021.
Could a cancer drug be key to helping patients recover from a heart attack?
The NIHR Cambridge Clinical Research Facility supported study has found that a low dose of the cancer drug aldesleukin when injected into acute heart attack patients, increased the activation of immune cells shown to protect the heart.
By targeting the inflammation caused by the body’s immune response to a heart attack the researchers also hope to reduce a person’s chances of having a second heart attack. The Cambridge team are now conducting a Phase 2 clinical trial to test the drug.
Dr Tian Zhao, BHF clinical lecturer in cardiovascular medicine at the University of Cambridge said: “Right now, there is no way to stop the immune system, which gets activated after a heart attack, from mistakenly damaging the heart.
“If our clinical trial shows that aldesleukin works by harnessing the ‘good cops’ of our immune system, we may have found a way to help the heart heal after a heart attack.”
The research is supported by NIHR Cambridge BRC and the Medical Research Council and featured on BBC Look East in October 2021.
This is an abridged version of the press release that was published on our website on October 7, 2021.