Asthma patients could one day use a smartphone app to manage their condition, after Southampton researchers used voice recordings to check lung health and detect issues. Southampton researchers, including Profs Judith Holloway and John Holloway from the NIHR Southampton Biomedical Research Centre and Dr Faisal Rezwan (now at Aberystwyth University), have successfully detected signs of worsening asthma using voice recordings. The method they developed uses machine learning – a type of artificial intelligence (AI) where computer systems use patterns in data to ‘learn’ without following explicit instructions. The results, published in Frontiers in Digital Health, could pave the way for smartphone apps that people with asthma could use to check their own lung health. Avoiding asthma deaths Asthma is extremely common, with around one in 11 children and one in 12 adults currently treated for it in the UK. It can also be deadly – every 10 seconds at least one person has a potentially life-threatening asthma attack, with an average of three people dying from it every day. Regular monitoring of asthma can help patients receive appropriate treatment in time. Treatment makes symptoms milder and less frequent, and reduces the need for trips to hospital. Yet it’s not always easy to spot the signs of worsening asthma symptoms. Methods exist that allow asthma patients to check their own lung health using a smartphone app. But these require specialist equipment, such as a smart spirometer, which is expensive. Using voice recordings offers the advantage that it doesn’t need any extra equipment, allowing people with asthma to quickly and easily check their symptoms whenever they need to. Detecting worsening asthma The researchers analysed 323 voice recordings from 26 people with mild asthma. Those who took part breathed in the drug methacholine, which simulates an asthma attack by causing the airways to narrow - a standard test used to diagnose and monitor asthma. The researchers measured how well their lungs worked afterwards using a spirometer, which measures how much air you can breathe out in one forced breath. They then recorded their voices for a minute while they read standard texts. They used 70% of the recordings to train the computer system, using three different machine learning algorithms to analyse patterns in speech and breathing and identify features linked with worsening asthma. The remaining 30% of recordings were used to test how well each of the three algorithms could detected lung problems. One worked best, giving an accurate result 85 percent of the time. Prof John Holloway said: “These results are extremely promising, and pave the way for a new voice-analysing app for asthma patients to monitor their condition and for assessing severity of other lung diseases including COVID. “Such an app would be particularly useful in low resource countries where expensive smart spirometers are not available could help patients them spot the signs of an asthma attack so they can quickly treat it, for example by using their inhaler, to stop it getting worse and physicians to remotely monitor patients’ symptoms. This would save lives.”

A new list of top medicine scientists has ranked Southampton’s Prof Cyrus Cooper number one in the UK. This first edition of top scientists ranking for Medicine was published by Research.com, one of the major websites for Medicine research offering credible data on scientific contributions since 2014. Professor Cyrus Cooper from the NIHR Southampton Biomedical Research Centre was number one in the UK, and number 16 on the worldwide list. International reputation Prof Cooper leads an internationally competitive programme of research into the epidemiology of musculoskeletal disorders, most notably osteoporosis. He is Professor of Rheumatology, Director of the MRC Lifecourse Epidemiology Unit and Vice-Dean of Medicine at the University of Southampton. He is also Professor of Musculoskeletal Science at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford. He has published extensively (over 1,200 research papers, h-index 220) on the causes and prevention of osteoporosis, osteoarthritis and sarcopenia. In 2015, he was awarded an OBE for services to medical research. His research contributed to the discovery of an association between mothers not getting enough Vitamin D in pregnancy and their children having reduced bone mass. This had a major influence on public health policy (NICE Guidelines on Maternal Nutrition) through a recommendation to optimise vitamin D status during pregnancy. Elderly people who have low trauma or ‘fragility’ fractures to their bones, caused by something such as a fall from standing height or less, are at high risk of another. Vitamin D and calcium supplements are often recommended to prevent further fractures. However, Prof Cooper’s research has shown these supplements are ineffective at preventing such fractures occurring a second time. Worldwide ranking The ranking contains h-index, publications and citations values collected on December 6th, 2021. It is based on a meticulous examination of 166,880 scientists on Google Scholar and Microsoft Academic Graph. For the discipline of Medicine, over 65,743 profiles were examined. Four other Southampton researchers were also on the list. Professor Sir Stephen Holgate was number 25 on the UK list and 217 on the worldwide list, while Professor David Barker was number 27 and 225. Professor Clive Osmond was 74 and 641, and Professor Philip Calder was number 82 and 788. Professor Cooper said: "While league tables are one means of expressing the value of scientific endeavour, they do not capture the sustainability, impact and legacy of scientific discoveries. Nor do they emphasise the teamwork necessary to make genuine epistemologic progress. “I have had a wonderful team, and have now reached the stage in life where I learn from my former students. It is to my dearest wife, family, and these friends, co-workers and mentors over so many years, that any credit should justly be directed."

Southampton researchers will lead a major new nationwide trial, funded by a charity set up by Natasha Ednan-Laperouse’s parents, to treat peanut and milk allergies. Children and young people with milk and peanut allergies can take part in the pioneering Natasha trial at the NIHR Southampton Clinical Research Facility, as well as other sites across the UK. It aims to prove that everyday foods containing peanut and milk, taken under medical supervision, can be used as a treatment for those who are allergic to them. Natasha’s legacy The three-year oral immunotherapy (OIT) trial will be the first major study funded by The Natasha Allergy Research Foundation. This charity was set up by the parents of Natasha Ednan-Laperouse, who died aged 15 from a severe food allergic reaction. Her death prompted the creation of Natasha’s Law, which set new requirements for allergen labelling at food outlets. The £2.2m trial will be funded by a gift to the University of Southampton and delivered in partnership with University Hospital Southampton. The trial aims to show that everyday foods containing peanut or milk, taken carefully according to a standardised protocol under medical supervision, can be used as an alternative to expensive pharmaceutical drugs to desensitise patients. If successful, participants with persistent food allergy will be able to live their lives without needing to avoid foods that might contain small amounts of allergens due to production. It could also mean they can eat popular foods like cakes, curries and pizza with their friends. Natasha’s Foundation has received donations from its Research Founding Partners (a consortium of food businesses) and fundraising and donations from Natasha’s Army of supporters. Leading the trial The trial will be led by Professor Hasan Arshad at the NIHR Southampton Biomedical Research Centre, in partnership with Dr Paul Turner at Imperial College London. They will run the trial together with University Hospitals of Leicester NHS Trust, Newcastle University and Sheffield Children’s Hospital. It aims to recruit a total of 216 people between the ages of three and 23 with food allergy to cow’s milk, and aged six to 23 with food allergy to peanut. Participants will complete an initial 12 months of desensitisation, carried out to a standardised protocol under strict medical supervision. They will then be monitored for a further two years in order to report on longer-term safety and cost-effectiveness. The aim is to bring the level of evidence to a point where OIT using commercially available foods could be approved for use in the NHS to treat food-allergic patients most at risk of anaphylaxis. Prof Arshad, Professor of Allergy and Clinical Immunology at the University of Southampton and head of the Allergy, Asthma and Clinical Immunology department at University Hospital Southampton, said: “This project presents a unique opportunity to establish immunotherapy as a practical treatment that will allow people with food allergies to live a normal life. “I am immensely proud that the University of Southampton will be leading this trial in collaboration with an elite group of partner universities and clinical allergy centres.” Food not pharmaceuticals In December 2021, NHS England announced the availability of Palforzia – a Nestlé-owned branded immunotherapy treatment for peanut taken daily for at least 2 years to treat children with peanut allergy. In contrast, the first NATASHA trial will use everyday foods instead of expensive pharmaceuticals for OIT. This could open up potential life-long treatment for hundreds of thousands of people living with allergies, at a fraction of the cost to the NHS. Natasha’s parents Nadim and Tanya Ednan-Laperouse, who were both awarded OBEs this year for their services to charity and people with allergies, officially announced the trial today. Tanya said: “We have been determined that Natasha’s death should not be in vain. Following the successful implementation of Natasha’s Law, which has brought new ingredient and allergen labelling, we are delighted to announce the first NATASHA Trial.” For more details about the trial, and for details of how to express an interest in joining the NATASHA Trial, go to www.narf.org.uk/trials. Image courtesy of the Natasha Allergy Research Foundation.

COVID-19 vaccines given as fourth doses in the UK offer excellent boosting immunity protection, according to the latest results from a nationwide study. The latest results from the COV-BOOST trial, led by University Hospital Southampton, show that a fourth dose mRNA vaccine is safe and boosts antibody levels - even higher than that of a third dose. Researchers have published their findings today in The Lancet Infectious Diseases. Increasing immunity Fourth doses of COVID-19 vaccines have been offered as a spring booster for those most vulnerable in the UK. This has been a precautionary strategy to maintain high levels of immunity prior to the study data being available. A wider group of people may be offered a fourth dose booster later this year. The latest COV-BOOST findings now show that fourth dose mRNA booster vaccines for COVID-19 are well-tolerated in people who received Pfizer as a third dose. They are also effective at increasing both antibody and cellular immunity up to and above baseline and peak levels observed following third dose boosters. Professor Saul Faust, trial lead and Director of the NIHR Southampton Clinical Research Facility, said: “These results underline the benefits of the most vulnerable people receiving current spring boosters and gives confidence for any prospective autumn booster programme in the UK, if the Joint Committee on Vaccination and Immunisation considers it needed at that time.” Health and Social Care Secretary Sajid Javid, said: “This is further evidence underlining the importance of people coming forward for their booster as soon as they are eligible. “We’re able to live with Covid thanks to the protection provided by our phenomenal vaccine programme and a booster dose will top up your immunity to continue to keep you and your loved ones safe.” Fourth dose study COV-BOOST provided the world’s first data on the safety, immune responses and side-effects of third dose in mix and match schedules. The study was key to shaping the UK’s 2021 autumn booster programme and gives vital evidence for global vaccination efforts. In the fourth dose study, 166 people who had received a third dose of Pfizer, following Pfizer or AstraZeneca initial doses in June 2021, were randomised to receive full dose Pfizer or half dose Moderna as a fourth dose. These were approximately seven months after their third dose. While pain at vaccination site and fatigue were the most common side effects, there were no vaccine-related serious adverse events and fourth doses were safe and well tolerated. The two vaccines trialled in the fourth dose sub-study were those deployed in the UK NHS third dose booster campaign: ● Pfizer (Pfizer-BioNTech) ● Moderna (half dose – 50 micrograms) Supporting UK booster programme Professor Andrew Ustianowski, NIHR Clinical Lead for the COVID-19 Vaccination Programme and Joint National Infection Specialty Lead, said: “The COV-BOOST study has continuously supported the UK's booster vaccination programme and had further impact on how vaccines are administered globally. “The study's latest results once again show the importance of sustained research into COVID-19 vaccines and how they are best used to keep the virus at bay. We knew that it was important to offer a fourth dose to those most vulnerable earlier in the year. These new study findings support that decision and provides the public with the confidence that fourth doses are both safe and even more effective than third doses at boosting immunity against COVID-19. “It is thanks to the endless efforts and contribution of study participants and staff across the UK that we can keep discovering more about the use of vaccines, and they continue to play a pivotal role just as they have done throughout the pandemic.” Professor Lucy Chappell, Chief Scientific Adviser for the Department of Health and Social Care, Professor of Obstetrics at King’s College London and NIHR Chief Executive said: “These results show the benefits of having a fourth COVID-19 booster dose for those eligible, to top-up immunity. “It is important to recognise the achievement of the COV-Boost study team, participants and all involved who have helped deliver this research to inform the best use of COVID-19 booster vaccines in the UK. “The COV-Boost study, commissioned through the NIHR, is continuing to deliver world-leading research on booster vaccination.” Continuing sub-studies COV-BOOST is being 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 Vaccine Taskforce and the National Institute for Health and Care Research (NIHR). It is delivered under the National Immunisation Schedule Evaluation Consortium (NISEC). Delivery partners are Oxford Vaccine Group (University of Oxford), Imperial College London Clinical Trials Unit, PHARMExcel Ltd and the NIHR Clinical Research Network. Current sub-studies are investigating the interval between second and third doses, fourth doses of mRNA vaccines, an omicron variant vaccine and fractional dosing in young people aged 18-30 years (the young adult trial is funded by CEPI, the Coalition for Epidemic Preparedness Innovations Foundation).

Southampton researchers have demonstrated a quick and accurate method to diagnose bacterial infections. The technique has the potential to detect infections in cystic fibrosis patients in minutes rather than days. In future, the simple analysis could be performed on hospital wards to deliver faster and more effective treatment. The approach could also be expanded to target a variety of diseases and counter anti-microbial resistance. Symptoms of cystic fibrosis Cystic fibrosis is an inherited condition that causes sticky mucus to build up in the lungs and digestive system. This causes lung infections and problems with digesting food. It affects around 1 in every 10,000 births in the UK. Treatments are available to help reduce the problems caused by the condition. Yet recurring infections still dramatically reduce the quality and length of life. The current methods for diagnosing immediate (acute) and longer-term (chronic) infections are complex and time-consuming in the laboratory. For biofilm infections, it can take days from collecting and processing a patient’s sample to achieving a result. This delays effective treatments and impacts patient outcomes. Molecular ‘finger-printing’ of bacteria A multi-disciplinary team from the University of Southampton and University Hospital Southampton set out to develop a diagnostic tool that would be rapid, accurate and simple-to-use for doctors. They have developed a new chemical analysis technique called multi-excitation Raman spectroscopy. This non-invasive method emits a scattering of multiple colours of light into a patient’s sample. Prof Sumeet Mahajan, Head of Chemical Biology and the Associate Director of Institute for Life Sciences at the University of Southampton, explained: “When light is applied to a sample’s molecules they can vibrate which helps us understand their characteristics. By using different colours of light, a different set of such vibrations can be triggered meaning we can get more information about their composition than previously possible. “This then allows ‘finger-printing’ that can be used to identify the properties of the pathogens that cause cystic fibrosis. In many current techniques, a reagent needs to be added to a sample or a tag needs to be attached to the molecules of interest to analyse their composition. This is not required under this new approach which uses natural properties of the molecules to analyse them.” Professor Mahajan continued: “Our new Raman spectroscopy based method offers many advantages over resource-intensive, culture-based methods, allowing rapid and label-free analysis. It is reagentless and avoids complex sample-preparation steps with sophisticated equipment. Here, we have developed a method that is highly accurate yet rapid and neither requires nanoscale materials for enhancing signals nor fluorophores for detection.” Need for rapid and effective treatment Long term infections in the lungs of people with cystic fibrosis are extremely hard to treat. There is evidence that the Pseudomonas aeruginosa bacteria exists as biofilms in the body, protecting the bacteria from antibiotic action and driving antimicrobial resistance. This increases the urgency for rapid and effective treatment. The Southampton research, published in Analytical Chemistry, showed 99.75% accuracy at identifying Pseudomonas aeruginosa and Staphylococcus aureus across all studied strains. This included 100% accuracy for drug-sensitive and drug-resistant Staphylococcus aureus. The project drew together expertise from the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre (BRC) and Southampton Clinical Research Facility (CRF), the National Biofilms Innovation Centre (NBIC), together with the University of Southampton’s School of Chemistry and Institute for Life Sciences (IfLS). It was led by Professor Mahajan, Professor Jeremy Webb and Professor Saul Faust. Prof Faust, Director of NIHR Southampton CRF, said: “Our study demonstrates an important step toward a rapid and reagentless diagnostic tool requiring only simple or routine sample preparation. “Such a platform could also prove useful in a variety of other disease areas and help address the mounting challenge of anti-microbial resistance.”

The drug bemcentinib could help to further improve the care COVID-19 patients receive in hospital, a sub-study of the Southampton-led ACCORD trial has shown. Accelerating COVID-19 drug discovery The ACCORD trial, led by Southampton’s Professor Tom Wilkinson, is a UK-wide clinical trial platform which aims to accelerate the development of new drugs for patients hospitalised with COVID-19. It assesses several potential COVID-19 treatments for those with severe COVID-19. These treatments are given on top of standard care, and compared with standard care alone. Patients join the trial within a day after they are admitted to hospital. Eligible patients are categorized by a 9-point clinical scale system developed by the World Health Organization (WHO). Faster recovery with bemcentinib The biopharmaceutical company BerGenBio, who ran the sub-study, found bemcentinib helped to boost the recovery of hospitalised COVID-19 patients when given on top of the treatments they were already receiving as part of standard care. Overall, 26 of the 29 patients (90 percent) treated with bemcentinib recovered to the extent that they improved by two points on the WHO scoring system or were discharged from hospital. They took an average of seven days to reach this point. By comparison, 22 of 32 patients (69 percent) on standard care alone reached this point in their recovery, taking an average of nine and a half days. Following this success, bemcentinib will now progress onto the next stage of development. It will be studied in up to 500 hospitalised COVID-19 patients as part of the EU-SolidAct trial. Professor Tom Wilkinson, Professor of Respiratory Medicine at the University of Southampton and Chief Investigator on the ACCORD program, said: "With COVID-19 still driving hospital admissions globally it is key that new, more effective treatments are being developed. “These results from the ACCORD2 program indicate that bemcentinib has demonstrated real promise as a new therapeutic option for hospitalised patients, and it now warrants testing in larger studies. These results are a testament to the great collaboration between the NHS, NIHR, the MEU and our Southampton research teams, with more exciting results to follow from the platform."

Southampton researchers have found a new way to estimate how long someone with a progressive lung disease have left to live. A study led by the NIHR Southampton Biomedical Research Centre has shown the size of lymph nodes in the chest can indicate how long patients with idiopathic pulmonary fibrosis (IPF) will survive. The results, published in the European Respiratory Journal, could help identify which patients’ disease will progress fastest. They could then be given treatments to reduce the rate. Slowing down the disease IPF is a condition in which the lungs become scarred and breathing becomes increasingly difficult. It's not clear what causes it, but it usually affects people who are around 70 to 75 years old, and is rare in people under 50. The average life expectancy from diagnosis is two to four years. Several treatments can help reduce the rate at which IPF gets worse, but there's currently no treatment that can stop or reverse the scarring of the lungs. Measuring lymph node swelling The researchers looked at mediastinal lymphadenopathy (MLN) – the swelling of lymph nodes in the chest, in the area between the lungs that contains the heart, windpipe and food pipe (oesophagus). They analysed data from two groups of patients with IPF – 51 patients at University Hospital Southampton between 2011 and 2016, and 92 patients at Ege Hospital Izmir in Turkey between 2008 and 2015. All patients had at least two chest CT scans. This allowed the researchers to see if they had MLN, and if they did, to measure the size of the largest node. They measured the same node again at a later CT scan to see if it had grown. Most of the patients had MLN at the start. Those whose lymph nodes remained the same size or reduced in size lived longer on average than those whose nodes got bigger. The study was led by Dr Tim Wallis, BRC Respiratory Clinical Fellow, and performed in collaboration with researchers at University College London. Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton, said: “This is, to our knowledge, the first study to assess the impact of lymph node progression over time on IPF survival. “We are now investigating the reasons why lymph nodes increase in size in patients with IPF, and hope that this could ultimately identify new treatments for patients.”

Southampton researchers have shown that skulls keep their strength even when other bones become weaker. They found that while poorer quality of diet and lifestyle does impact bone health, the body prioritises keeping our skulls strong. The study supports skulls not being included in whole-body bone scans in children as they don’t reflect wider health. Researchers have published their findings in Bone. Strength through density The skull has an important role in protecting the brain from injury. Its bones contain dense mineral, which makes them hard and able to resist blows and impacts. Bones in the arms and legs contain less mineral. Southampton researchers investigated what determines the amount of mineral in different types of bone in children. They discovered that how much milk a child drinks, the amount of muscle they have, and the quality of their diet affects bone mineral in the arms and legs. But these factors have a much smaller effect on the amount of mineral in the skull. Southampton Women’s Survey The study included over 1,200 children. These children have been taking part in research since before they were born. Prof Cyrus Cooper at the MRC Lifecourse Epidemiology Centre leads the Southampton Women's Survey, which aims to increase knowledge of how the skeleton develops through pregnancy and into adulthood. The children had a body scan between the ages of six and seven years to measure the amount of mineral in their bones. Skulls stay strong Dr Rebecca Moon, a Clinical Lecturer and paediatrician at the University of Southampton and University Hospital Southampton, led the analysis. She said: “These findings are important. It shows that the amount of mineral in the skull is resistant to changes in diet, weight and the amount of muscle in the body that do affect other bones. “If a child reduces the amount of milk they eat and drink, the bones in their arms, legs and spine may become weaker. This will increase their risk of breaking a bone. But the bones in the skull will stay hard to protect the brain.” Misleading bone scans Dual-energy X-ray absorptiometry (DXA) is the gold standard for measurement of bone mineral density (BMD). Professor Nicholas Harvey, Professor of Rheumatology and Clinical Epidemiology, and Honorary Consultant Rheumatologist, said: “Doctors use these type of bone scans to assess BMD in children at risk of poor bone health. The study results highlight that the skull should not be included in the scan as it may falsely increase the result.” The research was supported by experts from the MRC Lifecourse Epidemiology Centre, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Nutrition Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, NIHR Applied Research Collaboration Wessex and the NIHR Musculoskeletal Biomedical Research Unit, University of Oxford.

Southampton researchers have given new insight into the mechanisms of a chronic, progressive lung disease. The understanding could help identify potential targets to improve treatment. Idiopathic Pulmonary Fibrosis (IPF) is a serious condition in which the lungs become scarred. The new study, published in eLife, has been driven by experts from the NIHR Southampton Biomedical Research Centre. It identified imbalances that affect collagen in the lungs and cause it to stiffen. This then triggers fibrosis progression over time. Treating a chronic condition IPF usually affects people who are around 70 to 75 years old. The condition causes difficulty breathing and symptoms tend to get slowly worse over time. Mark Jones, Associate Professor in Respiratory Medicine and Honorary Consultant Respiratory Physician, said: “Patients with IPF survive between two to five years and so we need to develop new and improved treatments. “We previously found that changes in collagen structure caused increased tissue stiffness and that this promoted fibrosis progression over time but we didn’t know why this was happening. Our study has identified a key upstream pathway responsible for this and provides new understanding of how progressive fibrosis can be triggered.” The research was co-led by Dr Jones as part of respiratory and allergy research in the NIHR Southampton Biomedical Research Centre (BRC). The team involved the BRC’s Dr Chris Brereton as well as other researchers at Southampton, Yale, the University of Oxford, and University College Dublin. Increasing tissue stiffness Researchers analysed lung tissue from patients with IPF. They found that the two enzymes that modify collagen – PLOD2 and LOXL2 – were expressed in the same lung cells at the same time. In lab experiments, they then found that a family of proteins called Hypoxia Inducible Factors (HIFs), which can regulate the body’s response to varying oxygen levels, activated the genes for PLOD2 and LOXL2. This increased the number of cross-links between the collagen fibres and made the fibres stiffer. Using an electron microscope, they were able to see HIFs change the collagen’s structure. Finally, they investigated what could be causing increased HIF activity in patients with IPF. They identified that the presence of oxidative stress reduced activity of a protein called FIH (short for Factor Inhibiting HIF). Loss of FIH caused cells to enter ‘pseudohypoxia’, a state in which cells behave as if oxygen levels are low despite being in normal conditions. This led to higher levels of HIF activity, so altering collagen structure and increasing tissue stiffness. Yihua Wang, Associate Professor from Biological Sciences who co-led the study, said: “These findings suggest that intervening at the level FIH or HIF could be better at treating IPF than targeting the machinery that synthesizes collagen, which is currently considered to be the most effective treatment approach. We are now investigating this new targeting approach.” Image: Altered collagen (yellow) within human lung fibrosis tissue. Imaged by second harmonic generation.

Professor Elaine Dennison has been awarded the IOF Olof Johnell Science Award by the International Osteoporosis Foundation (IOF). The honour was one of several prizes for Southampton researchers at a prestigious global prizegiving. The World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases was followed by thousands online last week. Dr Nick Fuggle was presented the Pierre Meunier Young Scientist Award. He was one of four Southampton Early Career Researchers to be recognised on the world stage. Outstanding Southampton research The IOF Olof Johnell Award recognises outstanding contributions to the field of osteoporosis in science or policy worldwide. Elaine Dennison is a Professor of Musculoskeletal Epidemiology, MRC Lifecourse Epidemiology Centre (MRC LEC), University of Southampton, and a key investigator at the NIHR Southampton Biomedical Research Centre (BRC). She has worked as principal investigator of many research studies, including the Hertfordshire Cohort Study. Across her career, she has published more than 400 original scientific publications. Professor Dennison said: “I am truly honoured to be recognised in this way. It is testimony to the many colleagues and collaborators I have had the good fortune to work with, and I look forward to continuing our work into musculoskeletal aging in the coming years.” Professor Cyrus Cooper, Director, MRC LEC, and President of the International Osteoporosis Foundation, said: “I am delighted to present this prestigious award to Elaine Dennison, who has been a valued colleague for over 25 years. “She is an internationally recognised clinician, researcher, and educator who has been instrumental in driving research in the field of musculoskeletal aging, osteoporosis and metabolic bone diseases. The MRC Lifecourse Epidemiology Centre is privileged to have Professor Dennison on the team.” Early career excellence The Pierre Meunier Young Scientist Award is presented by the IOF and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). The prize recognises young investigators who have demonstrated outstanding scientific merit early in their careers. Dr Fuggle is an NIHR Academic Clinical Lecturer in Rheumatology, again from the MRC LEC, Southampton. He also received an ESCEO-IOF Young Investigator Award alongside NIHR Southampton BRC’s Dr Jean Zhang. Dr Faidra Laskou, also of the BRC, received an ESCEO-AgNovos Healthcare Young Investigator Award with Southampton peer Dr Millie Parsons. The World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases is the world’s largest forum for the presentation of clinical research and new advances in the prevention and management of musculoskeletal disorders, including osteoporosis, osteoarthritis, sarcopenia, and frailty. The virtual event attracted over 7,000 delegates and more than 1,000 abstract submissions, from musculoskeletal researchers from across the globe. Plenary presentations and meet the expert sessions included contributions by Southampton’s Professor Cyrus Cooper, Professor Nicholas Harvey, Professor Elaine Dennison and Professor Kate Ward.

Women with irregular periods may have a greater risk of developing non-alcoholic fatty liver disease (NAFLD). An international study, co-funded by the Southampton NIHR Biomedical Research Centre (BRC), has identified the link for the first time. The results show that women with long or irregular menstrual cycles may need greater advice to reduce risk through a healthy lifestyle. Preventing NAFLD NAFLD is the term for a range of conditions caused by a build-up of fat in the liver. It's usually seen in people who are overweight or obese, and is estimated to affect around 25% of the world’s population. In the early stages many people are unaware they have it. However, if it progresses to the later stages the liver becomes so damaged it stops working properly and treatment options are limited. It is therefore important to identify who is most at risk before it develops, or during the early stages of the disease, when lifestyle changes such as healthy eating and exercise are most effective. First to find link with periods Women with long or irregular periods are known to have a higher risk of type 2 diabetes and heart disease, but researchers found these women may also be at risk for NAFLD. The researchers studied data on 72,092 women under 40 years old. About 28% of these women had long or irregular menstrual cycles, and 7% had NAFLD at the start of the study. The researchers followed up four years later and found new cases of NAFLD occurred in almost 9% of the women. The researchers concluded that there was an association between long or irregular menstrual cycles in young, premenopausal women and an increased risk of NAFLD. They found this link was not explained by obesity. International research partnership Prof Christopher Byrne from NIHR Southampton BRC worked on the study with Professors Yoosoo Chang and Seungho Ryu from Sungkyunkwan University in Seoul, South Korea, and Prof Sarah Wild from the University of Edinburgh. The study was led by Profs Ryu and Chang. They have published their findings in The Journal of Clinical Endocrinology and Metabolism. Prof Byrne, Professor of Endocrinology and Metabolism, Honorary Consultant Diabetologist & Metabolic Physician, said: “It is becoming clear that NAFLD is a multisystem disease that has effects beyond the liver. This work provides evidence that there is an association between metabolic liver disease and irregular periods. “Whether there is a causal link between NAFLD and irregular menstrual cycles is uncertain but we are undertaking further research to understand whether the effects of NAFLD differ according to menopausal status.” The study received funding from Sungkyunkwan University and the NIHR Southampton BRC.

Southampton researchers are building understanding of tuberculosis (TB) by studying it in droplets – much like frogspawn. Southampton researchers are building understanding of tuberculosis (TB) by studying it in droplets – like frogspawn. A new study, announced today (24 March) on World TB Day, centres on a 3D system developed in Southampton over the last decade. Unlike the laboratory-standard 2D culture system, where cells are placed in a flat plastic dish, the 3D system uses an engineering technique to suspend them in droplets. Researchers are then able to better observe changes that occur in cells infected with TB. In the new study, Dr Liku Tezera will advance the system further with researchers from the NIHR Southampton Biomedical Research Centre. They will develop new imaging and sequencing approaches to analyse TB progression. Global TB epidemic “TB is a lung infection that has killed more humans than any other and until 2020 was the top infectious killer around the world,” Dr Tezera says. “Globally, an estimated 10 million people develop the disease each year. “The insights we will gain from this new study are essential to informing new strategies for controlling this global epidemic and highlights the impact of bridging cell biology and engineering approaches to understand human disease.” The research at the University of Southampton is funded by the Medical Research Council. Dr Tezera is working with Professor Paul Elkington and Dr Marta Polak from the Faculty of Medicine and Hywel Morgan, Professor Bioelectronics in the School of Electronics and Computer Science. Understanding TB processes This latest study expands on important TB research from the team. Last year, the 3D cultural system helped shed new light on TB’s processes. It identified key genetic changes that cause damage in the lungs and a drug treatment that could speed up recovery. In the study, the team found that the TB-infected cells in droplets responded very closely to cells in the lungs of patients with the disease. This observation has widespread implications for further studies into infectious diseases, including COVID-19. In parallel, the group carried out complex sequencing techniques on the cells to identify the events through which TB causes excessive inflammation and damage to the lung. World TB Day takes place on 24 March every year to highlight the impact of the disease. This year, the theme is ‘Invested to End TB. Save Lives’, seeking to reinforce global leaders' commitment to end TB.