A pioneering study has found tens of thousands of patient beds could be saved by the NHS every year by using a new rapid test. Patients with suspected gastroenteritis were assessed with a rapid molecular test in the trial at Southampton General Hospital. The test can give results in around an hour rather than 1-2 days with conventional testing. This means non-infectious patients can move out of isolation rooms much faster. It also means infectious patients can receive the best care. Results published in The Lancet Infectious Diseases shows that almost a third of single room time was saved using the new test. This would free up around 40,000 isolation rooms per year if rolled out across the UK. Isolation rooms are a limited resource in NHS hospitals with more patients needing them than rooms available. Molecular tests The study was designed and led by Professor Tristan Clark from the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre and University of Southampton. Prof Clark, a Professor of Infectious Diseases, said: “These results show that rapid molecular testing can help patients get their test results faster. This means they can get the care they need earlier." He added: "Hospitals have a limited number of side rooms, so it is vital that patients who do not have transmissible infections are moved out of them as soon as possible. "Our trial found that non-infectious patients could move out of isolation in around half a day, compared to two days if they had the standard test. This led to a 30% reduction in total side room use. "This technology has the potential to become a routine tool to help ease pressures on the NHS." What is gastroenteritis? Gastroenteritis is an infection of your stomach or bowels. The main symptoms include diarrhoea, sickness and stomach pain. The illness accounts for over one million visits to emergency departments and at least 130,000 hospital admissions in England every year. Patients with these symptoms are cared for in isolation rooms, known as side rooms, while they await test results. This helps stop the spread of infection. However, there are a limited number of side rooms on each ward and there are more patients requiring these facilities than are available. Trialling a new test Researchers recruited 278 patients at Southampton General Hospital between 2017 and 2022. They were randomly assigned to either receive the new rapid test or standard laboratory testing. The rapid test can detect a wide range of pathogens in a single test and was performed on a stool sample or a rectal swab. The molecular point-of-care test (mPOCT) delivered much faster results, with an average time to results of 1.7 hours. The standard test took on average 44.7 hours. These faster results directly led to a reduction in side room use. The study also found the giving of inappropriate antibiotics was reduced by almost four days with the new test. The study was supported by the NIHR Southampton Clinical Research Facility. It was funded by University Hospital Southampton NHS Foundation Trust.

Southampton researchers have launched a new project in South Africa. The research will assess young people’s physical and mental health. Many aspects of our mental and physical health are set during our teenage years. Support at this age is vital to ensure future health and wellbeing. Professors Shane Norris and Mary Barker from the University of Southampton are leading the Mind-Food-Space project. They are both researchers in the NIHR Southampton Biomedical Research Centre’s Nutrition, Lifestyle and Metabolism theme. Building on previous research Previous research has shown that we have the largest generation of young people in human history (1.8 billion). 10 to 24-year-olds now form 40 per cent of the world’s population. Southampton researchers published a series of papers in the Lancet on adolescent nutrition in 2021. This explored how nutrition affects young people’s growth and development, and the influence of the food environment on their dietary choices. The series also considered how best to promote healthy behaviours to this age group. International partnerships The researchers have partnered with the University of the Witwatersrand in South Africa. They will apply for further funding to extend the project to Ethiopia. The team will assess depression, stress and anxiety, dietary intake, physical activity, sedentary behaviour and sleep in young people. They will use several research methods. These include monitoring technology, mental health assessments and qualitative interviewing. They will also assess the impact of household and community context. ‘An exciting opportunity’ Researchers hope the data will give valuable insight into the health and nutrition of young people. This can help develop new ways to see this age group thrive in challenging, urban poor settings in the UK and Africa. Prof Barker is a Professor of Psychology and Behavioural Science. She said: “This is an exciting opportunity to work with young people in low-resource settings. It will help us understand how they experience a combination of mental and physical health problems. “On the back of this understanding, our partners and young people in South Africa and Ethiopia will develop new primary care services to address a large and unmet need for more health support.”

Two leading Southampton researchers have signed a letter asking the Prime Minister to tell his colleagues to stop discrediting facts about air pollution. Professor Sir Stephen Holgate and Dr Matt Loxham co-signed the letter. They are both part of the NIHR Southampton Biomedical Research Centre. It said some politicians do not believe in the science and have supported conspiracy theorists. ‘Disassociate from these views’ The letter describes how world-leading UK research has shown that toxic air contributes to the development of asthma, strokes, heart attacks, cancer and dementia. “A collapse in trust in the scientific process would be a disaster. We urge you to disassociate from these views and in no uncertain terms to tell your party colleague to not repeat or endorse them,” the letter said. The group of 36 academics, including Professor Holgate and Dr Loxham, urged the PM “to join us in making the case for urgent action on air pollution”. Both Professor Holgate and Dr Loxham have conducted various research studies into the effects of toxic air on health. ‘Clear misunderstanding’ Professor Holgate has long history of research into the health effects of air pollution. This includes research into associations between airway damage and inflammation. His research has also investigated exposure to diesel combustion and ambient particulate matter. It has led to changes in government legislation, and national and regional policy. He also gave key evidence in the 2020 inquest of nine-year-old Ella Adoo-Kissi-Debrah. She was the first person in the UK to have air pollution listed as a factor in the cause of her death in 2013. Professor Holgate said: “There is a clear misunderstanding of how air pollution damages health. Rarely it is a primary driver of illness and death, as was the case with Ella Adoo Kissi-Debrah. Her asthma was initiated by air pollution, and her asthma attacks and death were driven by this. She was highly unusual in having strong genetic drivers of her disease. “Usually, like obesity, air pollution contributes to the acceleration of non-communicable diseases. But these have other factors feeding into causation such as diet, lifestyle and socioeconomic factors. “Air pollution is nevertheless a major contributor to these diseases. The only reason that we were able to link Ella's death to pollution is that, quite fortuitously, there was a government air quality monitoring station close to her home, and the local council had also set up their own monitors independently. “So, in contrast to mean/average pollution levels that are modelled, what we are lacking to attribute air pollution directly to illness and death is a more granular assessment of what we are all exposed to locally where we live work and play.” ‘Extremely large body of evidence’ Dr Loxham has investigated the impact of poor air quality in underground railways and shipping docks. He said: “There is now an extremely large body of evidence which shows that air pollution makes a significant contribution to the shortening of lives, and to chronic diseases which impact on quality of life. “There are a number of reasons why individual cases are almost never ascribed to air pollution. Not least of these is the fact that air pollution exposure combines with other factors to accelerate and exacerbate diseases known to be associated with air pollution. “However, this should not be taken as representing uncertainty or doubt about whether air pollution exposure is important in the health of the public. Nor should it be taken as uncertainty about whether improving air quality will result in health benefits. “The case for the need to improve air quality is clear.”

Southampton researchers are investigating an immune cell that can fight cancer. They aim to better understand why certain ‘natural killer T cells’ are more effective against cancer than others. A subset of white blood cells, these form an important part of our body’s immune system. Boosting the body’s natural defences Dr Salah Mansour and Dr Ali Roghanian at the University of Southampton’s Centre for Cancer Immunology will lead the study. Dr Mansour is part of the NIHR Southampton Biomedical Research Centre. While the research is still at an early stage, they hope it will pave the way for new cancer immunotherapy treatments. These help the body's own immune system recognise and destroy tumour cells. Identifying which immune cells are best at fighting cancer could aid the development of better treatments. Finding the best cancer-fighting cells In the laboratory, invariant Natural Killer T (iNKT) cells have been shown to fight cancer and trigger an anti-cancer reaction in the body. This makes them a key target for immunotherapy. Yet clinical trials with cancer patients have so far been unsuccessful. This new study aims to identify which type of iNKT cell can be used to efficiently kill tumour cells. It is being funded by a pump priming grant from the university’s Southampton Enterprise Fund. This fund provides support to researchers to investigate early concept ideas. Dr Mansour commented: “This study builds on previous work from our group, demonstrating that certain iNKT cells are more effective against tumour cells than others. “We believe that previous iNKT-based approaches have been less successful partly because iNKT cells are defective in cancer patients. But we also believe it is because those studies have not exploited more potent iNKT cell subsets, that have a greater tendency to kill tumour cells. “We are very excited to continue developing this translational project, and hope to be able to demonstrate the efficacy of these cells in bespoke pre-clinical models of cancer developed at Southampton.” Image credit: University of Southampton Centre for Cancer Immunology

New research has revealed that only a small percentage of cancer funding is invested in primary treatments. Cancer is one of the world’s biggest killers. Billions of pounds are invested in research each year to find new ways of preventing, diagnosing and treating the disease. A new study by researchers at the University of Southampton (UoS) and University Hospital Southampton (UHS) with Queen's University Belfast analysed almost £20 billion of investment. They found most funding goes towards very early research. This can mean there is little direct benefit for patients. Researchers published their findings in The Lancet Oncology. Global health concern In 2020, there were almost 20 million new cancer cases around the world. By 2040, that number is expected to reach 28 million. The research team collected data on public and charitable investments between 2016 and 2020. This amounted to £19.7 billion of investment across 66,388 research grants. Breast cancer and blood cancers, such as leukaemia, received the most funding. Lung and thyroid cancers were among the least funded. Just 0.5% of cancer funding had a primary focus on lower-income countries. Failing to reach patients The analysis found that only a small percentage of cancer research funding is invested into primary treatments. This includes just 1.4% for surgery and 2.8% for radiotherapy. The majority (73.5%) goes towards pre-clinical research. The hope is that findings from this early-stage research will lead to new or better treatments for cancer. However, it could be many years before they are in routine use. Prof Ramsey Cutress, a UoS professor of breast surgery and UHS consultant surgeon at the NIHR Southampton Biomedical Research Centre, co-led the study. Prof Cutress said: “Cancer research has led to impressive improvements in survival and outcomes. “However, we found less than 5% of all cancer research funding is invested in surgery, radiotherapy and global health studies. “This is despite primary treatments for most solid cancers including surgery and radiotherapy, and much of the worldwide cancer burden being felt in low and middle income countries.” The researchers also demonstrated cancer research investment is decreasing year on year. A larger drop in 2020 corresponds with the start of the COVID-19 pandemic. Informing policies The study’s findings could inform the future of cancer research funding. Dr Michael Head, Senior Clinical Research Fellow at UoS and study co-lead, said: “There will be long-term consequences of the pandemic on other areas of health, including cancer. We need to understand the worst of the knowledge gaps, which we can potentially fill with new research. “Our analysis can help cancer experts better set priority areas for funding, which will benefit future cancer patients.”

New research has shown genes linked with a longer life are less active in the muscles of older men who are overweight or living with obesity. Obesity is a problem affecting all age groups, but it’s now common in older people. In the UK, 81% of those aged 65-74 are now overweight or living with obesity. Researchers from the University of Southampton and University Hospital Southampton led a study looking at the effect of obesity on muscle health in older age. The collaboration was supported by the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre. Their findings highlight the benefits of maintaining a healthy weight and suggest new approaches for supporting healthy ageing. Researchers published their findings in the Journal of Cachexia, Sarcopenia and Muscle. Preventing excessive muscle loss Muscle loss occurs in almost everyone as they get older, but the rate at which it occurs is influenced by lifestyle. Strength-building exercise, such as walking or lifting, can slow the rate of muscle loss. Excessive loss of muscle strength and mass is known as sarcopenia. It is a common cause of frailty, fractures and falls in later life. Improving our understanding of the factors that influence muscle loss as we age, such as obesity, could help identify new ways to prevent and treat sarcopenia. The new research was led by Southampton Professors Karen Lillycrop and Keith Godfrey, with Dr Mark Burton and Associate Professor Harnish Patel. Dr Burton, Research Fellow at the University of Southampton, said: “Our research has shown fundamental differences in the regulation of older men’s muscles who are obese. “We found many genes associated with a long life are ‘switched off’ and no longer active. This suggests obesity may accelerate the ageing process in men’s muscles, and could contribute to the development of sarcopenia. “There are vast benefits to keeping a healthy weight and these results further show this could help reduce age-related muscle decline and improve life expectancy.” Studying the effect of obesity Researchers took samples of thigh muscle from 40 older men, with an average age of 73 years. All of them were participants in the Hertfordshire Sarcopenia Study. They used BMI to determine if the men were a healthy weight, overweight or obese, and using a dual-energy x-ray absorptiometry (DXA) scan measured their body composition - the relative amounts of fat, bone, and muscle in their body. Using a variety of laboratory techniques, including methods to assess changes in global gene activity within the muscle samples, they showed genes associated with a longer life expectancy were less active in the muscles of men who were overweight or living with obesity, compared to those that were a healthy weight. They also found genes that help muscles use energy effectively were less active, while genes linked to inflammation were more active. Prof Lillycrop, Professor of Epigenetics at the University of Southampton, said: “Low muscle mass and strength are important contributors to poor health in people living with obesity. Measures to support muscle health can make an important contribution to retaining people in the workforce and to them having greater independence in older age.” Dr Patel, Principal Investigator of the Hertfordshire Sarcopenia Study and consultant at University Hospital Southampton, added: “The study findings underscore the importance of having a balanced diet and an active lifestyle throughout life to mitigate adverse effects obesity might have on muscle health.” Image credit: World Obesity Federation

Third dose COVID-19 booster vaccines offer lasting protection after several months, according to the latest results of a nationwide trial. The COV-BOOST study, led by University Hospital Southampton, has provided data to underpin the UK’s booster programmes since 2021. New analysis, published online in the Journal of Infection, is reporting immune responses eight months after third doses of several COVID-19 vaccines. The insight could be important around the globe if longer-term protection becomes a higher priority when choosing vaccines for booster programmes. Researchers found adenovirus-based vaccines (such as Janssen or Oxford-AstraZeneca) may lead to similar immune responses as mRNA vaccines (such as Moderna or Pfizer-BioNTech) at around seven months after the third dose of vaccine. They also report that lower doses of mRNA vaccines may offer lasting protection as boosters. Booster study COV-BOOST provided the world’s first data on the safety and immunogenicity of a third dose in mix and match schedules. It compared immune response to seven vaccines 28 days after use as a third dose in people who had received two initial doses of either the AstraZeneca or Pfizer vaccines. Last year, the study reported strong immune responses were seen 84 days after third jabs in several approved COVID-19 vaccines. A fourth dose sub-study also found that an mRNA vaccine is safe and boosts antibody levels - even higher than that of a third dose. Longer-lasting immunity Third and fourth doses of COVID-19 vaccines have been offered to people considered vulnerable or at higher risk in the UK. Professor Saul Faust, trial lead and Director of the NIHR Southampton Clinical Research Facility, said: “The rapid development and delivery of COVID-19 vaccines has been vital to forging a path out of the pandemic. Looking to the future, vaccines that provide longer-lasting immunity may now be preferred to those that need to be given at shorter intervals. Different doses may be an option depending on the duration of immune response. “This further data, taken over 240 days after third doses, will support global policymaking on the choice of future boosters and inform manufacturing.” UK-wide research effort The seven vaccines trialled in the main COV-BOOST trial were: · AstraZeneca (Oxford-AstraZeneca) · Pfizer (Pfizer-BioNTech) · Moderna · Novavax · Valneva · Janssen · CureVac (first-generation vaccine no longer in clinical development) The trial initially included ten experimental vaccine arms (seven full-dose, three half-dose) delivered at three groups of six sites. The latest report analyses the responses to third doses of the original (wild type) vaccines from 817 participants in seven study arms. The current mRNA vaccines recommended by the Joint Committee on Vaccination and Immunisation (JCVI) are bivalent vaccines that have been upgraded to target two circulating variants of COVID-19. This study used wild-type mRNA vaccines that targeted the original strain of COVID-19 and therefore cannot be directly compared to the vaccines used in more recent campaigns. COV-BOOST is led by University Hospital Southampton NHS Foundation Trust and delivered by a network of trial sites across the UK. The study is funded by the former Vaccine Taskforce (now the COVID Vaccine Unit in the UK Health Security Agency) and the National Institute for Health and Care Research (NIHR). Delivery partners are Oxford Vaccine Group (University of Oxford), Imperial College London Clinical Trials Unit, PHARMExcel Ltd and the NIHR Clinical Research Network.

Southampton researchers have joined calls for national policies to improve health before pregnancy. Experts say expectant mothers and fathers are being failed by the UK Government’s “outdated” public health plans. The review was published by the Children’s Alliance, with the University of Southampton (UoS) and the NIHR Southampton Biomedical Research Centre (BRC). Southampton contributors include Professor Keith Godfrey, Dr Danielle Schoenaker, Dr Kalyanaraman Kumaran, Dr Kath Woods-Townsend, Professor Christina Vogel and Professor Mark Hanson. Preparing for pregnancy Preconception care supports women before pregnancy and parenthood. The report’s authors say it should be included at every stage of the Government’s health strategy. The review found that women and men are unaware of how poor personal health can impact their babies’ early development. Many are overweight and still smoking or drinking at the start of pregnancy. Research shows that public health messages about preparing for pregnancy are often overlooked by frontline professionals. They are also not part of the national school curriculum. Professor Keith Godfrey is the Theme Lead for Nutrition, Lifestyle and Metabolism in the NIHR Southampton BRC. Prof Godfrey said: “Preparation for parenthood is crucial for levelling up opportunities for children. It can help tackle disparities in their health. “However, preconception care remains undervalued in the UK. The Government’s health policies have either failed to help people of reproductive age or are too late for women entering maternity care.” Health ‘revolution’ The new Preconception Care Strategy was created to improve life chances for children. It was jointly produced by Children’s Alliance and several UK universities. Helen Clark, lead author, says fixing preconception care would leave a worthy legacy for the political party that includes it in their manifesto. She added: “Studies have shown us that parents who practice good health before and in pregnancy give their children the best start to life. They are likely to be healthier growing up. “Ill health costs money. Recent data from the Office for National Statistics shows two-and-a-half-million people are not working due to health problems. “Throwing money at outdated public health policies won’t work. Improving preconception care is the smart 21st-century approach the NHS should take. It is a 'revolution' that will cut future waiting lists and won't break the bank either.” Reducing inequalities Data highlighted in the study revealed mass inequalities among richest and poorest families. 24 per cent of stillbirths are attributable to socioeconomic deprivation. Nine in ten women in England enter pregnancy with at least one indicator that risks the health of the child. Almost three quarters do not take a recommended folic acid supplement. Other results show: Women from Black ethnic background in England are one-and-a-half-times more likely to enter pregnancy with obesity compared with white women, People from low-income families are three-times more likely to smoke at the time of conception, Women living in deprived areas are nearly two times more likely to have a pre-existing mental health condition. The report’s authors have published a five-point action plan. You can read the full report here.

Southampton’s LifeLab programme is being rolled out across the world to inspire healthier life choices. The programme gives young people the knowledge and skills they need to improve their own health. Its expansion comes as LifeLab celebrates hosting its 13,000th students at Southampton General Hospital. LifeLab is a partnership between the University of Southampton (UoS), the NIHR Southampton Biomedical Research Centre (BRC) and University Hospital Southampton. Supporting young people Southampton researchers are working with Dr Lisa Ware at the University of the Witwatersrand to launch a LifeLab programme in South Africa. The project is funded by the South African National Research Foundation. It will focus on young people between 18 and 25 years old. A previous study in South Africa found 80% of 18-25 year olds in low resource urban environments had low literacy scores. “Life stress” was also a common feature, which carries health risks. The team has developed and implemented a LifeLab curriculum for people living in Soweto. They are assessing its impact with a view with to rolling it out more broadly. Shane Norris, Professor of Global Health at UoS, is part of the Southampton team. He is also a researcher in the NIHR Southampton BRC’s Nutrition, Lifestyle and Metabolism theme. Prof Norris said: “The early research emphasised the need for a community-based intervention like LifeLab in Soweto. We are really pleased with how the first curriculum has been received. “It has helped young people in the area to understand the science behind health messages. This understanding is helping them engage with their own health, think about how to take responsibility for it and make improvements.” Global partnerships LifeLab programmes are also running in Dublin and Sydney. Dr Kath Woods-Townsend is the Programme Manager. She said: “We have found LifeLab resonates very strongly with young people no matter where they live. “We have worked with our global partners to provide not only the physical LifeLab resources and programme structures, but also our experience with securing funding, engaging local health and political organisations and working with schools to enable their journey to deliver LifeLab to be as smooth as possible. “It has been an educational process for us to see how LifeLab needs to be amended to fit different cultural contexts and curriculums.” Reaching new milestones LifeLab is a state-of-the-art teaching laboratory at the heart of Southampton General Hospital. 13,000 students have visited the lab since it opened its doors in 2014. The milestone attendee was from St Anne’s Catholic High School in Southampton. “This is a remarkable milestone for us. It reiterates the importance of what we are trying to do,” said Dr Woods-Townsend. “The LifeLab team create experiences that empower young people to understand the science behind the health messages they see and hear on a daily basis.” LifeLab has engaged with over 90 schools across Southampton and Wessex. It offers programmes for both secondary and primary phase settings. Primary phase settings in Southampton can take part in Early LifeLab. The programme is helping to tackle obesity among primary school children in the city through a series of ‘teaching toolkits’. These make the science behind the need for healthy diet, physical activity and sleep accessible to children. Find out more at lifelabonline.org. LifeLab Sydney students extract strawberry DNA. Image credit: LifeLab

New research has found that a drug used to treat high blood pressure could help women with persistent acne. SAFA is the first large-scale clinical trial to show that spironolactone is an effective treatment for the skin condition. The results, published in the British Medical Journal, could inform routine acne treatment. This would help reduce the amount of antibiotics prescribed for the condition. Professor Miriam Santer from the University of Southampton co-led the trial. It was run by the Southampton Clinical Trials Unit (CTU). The research was aligned with the NIHR Southampton Biomedical Research Centre’s Microbiology, Immunology and Infection theme. A need for new treatments Acne is very common, particularly in adolescence, and often clears with age. But almost a third of women are still affected in adulthood. This can be a huge physical and psychological burden to those who suffer from persistent outbreaks. Topical treatments (creams and gels), available from a pharmacy or on prescription, are the first-line treatment for acne. They are effective for many people. If they don’t work, GPs will often prescribe oral antibiotics to be used alongside the creams and gels. This can add to the growing burden of antibiotic resistance in the population. “For several years, dermatologists have been prescribing a drug called spironolactone to treat severe acne,” says Professor Alison Layton, consultant dermatologist and co-lead of the SAFA trial. “This is a cheap medication which has been used for decades in the treatment of high blood pressure. The drug also reduces the main hormone that leads to the development of acne. “However, previous studies of spironolactone for acne have been very small and there was no definitive proof that it actually worked.” An effective treatment The SAFA trial recruited over 400 women aged 18+. They all had persistent acne, and oral antibiotics would have been their next treatment. Half were randomly allocated to take spironolactone. The other half were given a placebo pill. The women completed questionnaires on their acne and quality of life at the start of the trial. They did this again when they were 12 and 24 weeks into the treatment. “The women taking spironolactone saw a significant improvement in their acne after 12 and 24 weeks compared to those on the placebo,” says Professor Santer, GP and co-lead of the trial. “A significantly higher proportion of people said they felt satisfied that the treatment had helped their skin. Any side effects were uncommon and very minor. “These results show that spironolactone could offer an alternative to antibiotics for many women with persistent acne to use alongside topical acne treatments.” Making a difference Kelly Cornick, 39, began suffering with severe acne in her teens. Since then, she has been prescribed various creams, antibiotics and the contraceptive pill to try and control her skin. “Nothing seemed to work,” says Kelly. “It might go away for a while, but then it would flare up again. It was sore, almost like blisters. I would get thick, red, lumps all along my jawline and at its worst it spread up onto the rest of my face. If I knocked a spot, it would really hurt and would bleed for ages. It was just horrible.” The mum-of-three from Dorset says it had a huge effect on her physical and psychological health. “It was embarrassing. People would stare and you almost feel that they’re looking at you like you’re dirty and don’t wash properly. “I think the worst thing for me was when one of my nieces asked if I had Chickenpox. She was only about two and kids are always quite honest, but that’s how bad it looked. It used to get me down. I’m a confident person but my skin just took over how I felt a lot of the time.” Kelly heard about the SAFA trial from her dermatologist and contacted the trial team at Poole Hospital. “Initially I started on the lower dose and there was an improvement. I then went onto the higher dose and within about three months everything was gone, all the spots had disappeared.” Since finishing the trial, Kelly has been able to stay on spironolactone and has now been acne-free for over two years. “Knowing how much it’s helped me, I hope that other people will now be given this treatment as an option instead of just trying antibiotics. I want people to be able to experience it, because everyone should feel confident and happy, and not have spots.” Encouraging results Zina Eminton is a Senior Trial Manager at Southampton CTU. She said: “This was a challenging trial which began just as the COVID-19 pandemic hit the UK. This meant we had to adapt to be flexible in the way the trial was run, using social media to help recruit participants and conducting virtual follow-up appointments. The results are a fantastic achievement for everyone involved and will benefit many more women in the future.” Professor Andrew Farmer, Director of NIHR’s Health Technology Assessment Programme, said: “The findings from this important trial provide compelling evidence which could help thousands of women with persistent acne. The treatment provides a valuable alternative to antibiotics. It ensures clinicians can also better avoid the harms that can arise from antimicrobial resistance. “High quality, independently funded research like this is crucial in providing evidence to improve health and social care practice and treatments.” Professor Santer concludes: “We hope the publication of these results will mean more GPs and dermatologists feel confident to prescribe spironolactone as a treatment for acne. The drug is already included in treatment guidelines for persistent acne in the US and Europe. We hope this trial will lead to a change in the UK guidelines.” The SAFA trial was funded by a Health Technology Assessment grant from the National Institute for Health and Care Research. It was sponsored by the University of Southampton.

New results from an international study show a treatment could greatly reduce the number of babies admitted to hospital with a common virus. Respiratory Syncytial Virus (RSV) affects 90% of children before the age of two. It is one of the leading causes of hospitalisation in all infants worldwide. These new results from the HARMONIE study show nirsevimab, a monoclonal antibody immunisation, could help prevent large numbers of babies with an RSV infection needing hospital care. Nirsevimab was approved for use in the NHS in November 2022. This study is exploring if it could stop babies being hospitalised with RSV and help the NHS decide how best to use it. More than 8,000 babies under 12 months old are taking part across France, Germany and the UK, including many families in the Southampton area. The study is being delivered locally by the NIHR Southampton Clinical Research Facility at University Hospital Southampton (UHS) and by local GPS and hospitals across the region. The new results have been reported by BBC News in a visit to UHS. Preventing hospitalisations RSV often causes only mild illnesses, like a cold. However, for some babies, it leads to more severe lung problems such as bronchiolitis and pneumonia. Nearly 80% of the children admitted to hospital with RSV are previously healthy. The trial aimed to see if nirsevimab could protect babies entering their first RSV season. Babies who received a single dose of nirsevimab showed an 83 percent reduction in hospital admissions compared to babies who had standard care. Dr Katrina Cathie, UHS consultant paediatrician and Southampton study lead, said: “This is a fantastic result, and I’d like to say a big thank you to all the families who took part across our region. “Through your help, we’ve been able to show nirsevimab can protect babies against serious RSV infections requiring hospital care.” Reducing winter pressures The HARMONIE study is a collaboration between Sanofi and the National Institute for Health and Care Research (NIHR). Thomas Triomphe, Executive Vice President, Vaccines, Sanofi, said: “This winter saw higher rates of RSV-related infant hospitalisations than during pandemic or pre-pandemic years. The HARMONIE data demonstrate the real-world impact nirsevimab has on paediatric hospitalisations, and illustrate its importance for infants, their families and public health.” The results were presented at the 41st Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID). Dr Simon Drysdale, Consultant Paediatrician in Infectious Diseases at St. George’s University Hospital NHS Foundation Trust and Co-Chief Investigator of HARMONIE, said: “RSV-related chest infections lead to high numbers of infants under 12 months old being hospitalised every year. These data reinforce the potential public health benefit of nirsevimab in terms of helping to reduce the strain on hospitals caused each year by RSV.”

An international study involving Southampton researchers is assessing support for parents that could reduce childhood obesity, starting before pregnancy. The Healthy Life Trajectories Initiative (HeLTI) was developed with the World Health Organization (WHO). It is recruiting 22,000 women in China, India, South Africa and Canada. The programme is assessing care from before pregnancy until children are five years old. Supporting families The project will research support to help mothers eat well, maintain a healthy weight, reduce stress and prevent mental illness. They also aim to investigate parenting skills support, such as how to help babies and children eat, exercise, and sleep well. Prof Shane Norris, Professor of Global Health at the University of Southampton, is leading the South Africa arm of the project. He is a researcher in the NIHR Southampton Biomedical Research Centre’s Nutrition, Lifestyle and Metabolism theme. Dr Kalyanaraman Kumaran, Associate Professor of Epidemiology and Public Health, is leading the India arm of the programme. Women recruited to the study who conceive (an expected 10,000) and their children will be contacted at various stages of life. This will start before pregnancy, continuing through pregnancy, infancy, and early childhood up to the age of five years. Meeting health leaders HeLTI leaders recently met in South Africa to discuss the project’s early findings. They were joined by the South African Minister of Health, Dr Joe Phaahla, the Director General of WHO, Tedros Adhanom Ghebreyesus, and the President of the South African Medical Research Council, Professor Glenda Gray. Discussions focused on how health and care before pregnancy could reduce childhood obesity. They also spoke about how the first 1,000 days are particularly important for mothers’ and children’s health. Prof Norris said: “Being healthy before pregnancy is extremely important for women to have a healthy pregnancy and birth, and for her baby to be healthy. “Supporting women and young children from these very early stages, including during the critical period of the ‘first 1000 days’, helps to give all children the best start in life. “We are very proud to be taking a leading role in such an important international study. The recent meeting was very productive, especially as we had the opportunity to discuss the HeLTI with policymakers.”