Annual Review 2021: Health and Care Research

Advances and discoveries in health and care research

Research breakthrough for meningioma diagnosis

A simple blood test could reduce the need for intrusive surgery when determining the best course of treatment for patients with a specific type of brain tumour. Researchers at the Brain Tumour Research Centre of Excellence have discovered a biomarker (Fibulin-2) that helps to distinguish whether meningioma – the most common form of adult primary brain tumour – is grade I or grade II. The grading is significant because lowergrade tumours can sometimes remain dormant for long periods, not requiring high risk surgery or harsh treatments. In total, 70–85% of meningioma cases are lower grade so, if the blood test – or liquid biopsy – is carried out, these patients may well be spared surgery or radiotherapy.

The identification of FBLN2 as a biomarker for meningioma has significant potential to improve the diagnosis, treatment, prognosis and follow-up of meningiomas.

Professor Oliver Hanemann, Head of the Brain Tumour Research Centre of Excellence.

Experimental antiviral proves effective in halting spread and damage of COVID-19

An experimental antiviral drug developed by scientists has been shown to significantly reduce both the levels and the impact of the virus that causes COVID-19. The team at the US National Institutes of Health (NIH), working with Dr Michael Jarvis from the University, has found that MK-4482 was effective when provided up to 12 hours before or 12 hours after infection with SARS-CoV-2.

In a study published in Nature Communications, the researchers say treatment with MK-4482 – which was first developed to tackle influenza – could potentially mitigate high-risk exposure to SARS-CoV-2 and might be used to treat established SARS-CoV-2 infection alone or in combination with other agents. The drug is currently undergoing human clinical trials, but researchers say its ability to be provided orally could offer a significant advance on existing antivirals being used to treat COVID-19.

This is an exciting result that identifies MK-4482 as an additional antiviral against SARS-CoV-2. If the final human data show a similar antiviral effect, our preclinical animal data suggests it may be suitable for use as an orally administered pill following exposure to the virus, similar to the way we use Tamiflu for influenza. I think this additional control measure could prove to be really useful in the current pandemic.

Dr Michael Jarvis, Associate Professor in Virology and Immunology.

Common antidepressant should no longer be used to treat people with dementia

A University-led study has found that a drug used to treat agitation in people with dementia is no more effective than a placebo – and might even increase mortality. The research, published in The Lancet, showed that the antidepressant mirtazapine – routinely prescribed after non-drug patient-centred care has not worked – offered no improvement in agitation for people with dementia. Funded by the National Institute for Health and Care Research (NIHR), the study recruited 204 people with probable or possible Alzheimer’s disease from 20 sites around the UK.

Dementia affects 46 million people worldwide – a figure set to double over the next 20 years. Poor life quality is driven by problems like agitation and we need to find ways to help those affected. This study shows that a common way of managing symptoms is not helpful – and could even be detrimental. It’s really important that these results are taken into account and mirtazapine is no longer used to treat agitation in people with dementia.

Professor Sube Banerjee, Executive Dean of the Faculty of Health, and Research Lead.

Research shows links between loot boxes and problem gaming

The rise of loot boxes – purchasable video game features that offer randomised rewards – has resulted in the creation of a UK market estimated to be worth around £700 million. But their use has prompted considerable public debate, and now research by academics at Plymouth and Wolverhampton has shown that they are structurally and psychologically akin to gambling.

Their study, commissioned by GambleAware and published in the journal Addictive Behaviours found that 93% of children in the UK play video games, and that up to 40% of these have opened loot boxes. And an analysis of 7,771 loot box purchasers found that around 5% of them generate around half of industry loot box revenues. A third of these gamers were found to fall into the ‘problem gambler’ category (PGSI 8+), establishing a significant correlation between loot box expenditure and problem gambling scores.

Our work has established that engagement with loot boxes is associated with problem gambling behaviours, with players encouraged to purchase through psychological techniques such as ‘fear of missing out’. We have also demonstrated that at-risk individuals, such as problem gamblers, gamers and young people, make disproportionate contributions to loot box revenues. We have made a number of policy suggestions to better manage these risks to vulnerable people, although broader consumer protections may also be required.

Dr James Close, Senior Research Fellow in Biomedical and Health Informatics.

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Cell adaptation in critically ill patients could be difference between life and death

Creating the best conditions for cells to make energy and survive critical illness is a challenge little understood in modern medicine. But a study led by scientists at the University, in collaboration with University College London and the Universities of Cambridge and Southampton, has revealed early signs that cells in some critically ill patients actually adapt to their conditions by producing energy more efficiently. The research, published in the journal Redox Biology, took muscle and blood samples over 7 days from 21 critically ill patients in intensive care, and 12 healthy people, comparing cell behaviour. The study showed that all of the critically ill patients produced energy more efficiently than healthy people, in a pattern of changes that has previously been identified in cells adapting to low oxygen levels. There were also differences in the ways cells produced energy in the patients who survived, compared to those who died.

When a body is going through trauma, there’s the temptation to think we need to give more oxygen or stimulate cells to survive. However, this research suggests that some cells can actually adapt to the conditions they’re in. If we can unravel the cellular and molecular foundation of human resilience, we can enable the development of more effective life-support strategies.

Dr Helen McKenna, National Institute for Health and Care Research Academic Clinical Fellow and Lead Author.

New technology to aid medical research and discovery

Biomedical science research at the University has received a significant boost following the procurement of a new state-of-the-art mass spectrometer – partfunded by a capital grant from the prestigious Wolfson Foundation. Used in proteomics – the in-depth study of proteins – the machine will enable researchers to analyse samples up to ten times faster than their current technology permits, meaning accelerated results and potentially faster rollout of treatments. The versatility of the new model of mass spectrometer will also result in a wider range of research applications, increasing the potential for local, national and international collaboration.

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The advanced technology of the new mass spectrometer will substantially improve our ability to craft a global view of the processes underlying healthy and diseased cellular processes at the protein level. The work that we do in this area already has huge real-world implications and this new investment will speed translation of research into action. We’re incredibly grateful to the Wolfson Foundation for their funding and for recognising how much impact this piece of equipment will have on the work taking place here.

Professor Sube Banerjee, Executive Dean of the Faculty of Health.