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Climbing the health research career ladder

The HRB is investing €5million to advance research careers of five emerging medical leaders and improve health outcomes for the patients in their specialty areas.

Ground level view of three small saplings sprouting from the soil, each one progressively larger from left to right

Using the HRB funding, the five successful ‘emerging clinician scientists’ must take responsibility for advancing knowledge in their expert areas and ensuring they translate their findings into clinical practice. They will establish themselves as fully independent investigators, become mentors and develop a team-based and collaborative approach to their research programmes.

People who will benefit from the new research include: -

  • Young people at risk of psychosis
  • Older people taking many medications
  • Women with polycystic ovary syndrome
  • People in intensive care with acute breathing difficulty after serious brain injuries
  • People with progressive scarring lung disease and their families

According to Dr Darrin Morrissey, CEO of the HRB:

‘The HRB is committed to creating strong research career paths for people working in health and social care. A research active environment in any health setting leads to improvements in people’s health and care as well as creating a more attractive work environment'.

All research projects will receive €1 million and deliver results to benefit the people’s health and patient care.

A short summary of each project is outlined below.

1. Identifying risk for psychosis in childhood and adolescence

The aim of this project is to identify young people who are at risk of psychosis before the illness takes hold.

Five of the 10 leading causes of disability in young people are mental illnesses. Of these, psychotic disorders, such as schizophrenia, are the most severe and disabling. These are illnesses that affect brain development over the course of adolescence and ultimately result in serious problems with thinking skills, perception, and emotional experience. They are devastating illnesses for the affected young person, as well as for their families and wider community. Early intervention leads to better outcomes but ideally doctors would like to be able to prevent the illness altogether. To be able to do that, doctors need to be able to identify young people who are at high risk of psychosis.

This HRB funded research will take a new approach to improving our ability to identify people at risk of psychosis while still in childhood and adolescence. It will also look at the effect of several neuroprotective medications in reducing risk of psychosis.

According to Dr Ian Kelleher, Child and Adolescent Psychiatrist, Lucena Clinic Child and Adolescent Mental Health Service and Trinity College Dublin:

‘This HRB Emerging Clinician Scientist award represents a huge boost for paediatric psychiatry research in Ireland and internationally. It will allow us to carry out cutting edge research to improve our understanding of childhood risk for schizophrenia, a severe and disabling neuropsychiatric disorder that affects tens of millions of people worldwide'.

Contact: Dr Ian Kelleher, Child and Adolescent Psychiatrist, Lucena Clinic and Adolescent Mental Health Services and Trinity College Dublin. Tel: +353 1 4526333

2. Preventing diabetes in women with polycystic ovary syndrome

The goal of this research is to identify women with polycystic ovary syndrome (PCOS) who are most at risk of high blood sugar, to help identify novel therapeutic targets that will prevent or delay the onset of metabolic diseases such as diabetes in this high-risk patient group.

PCOS affects up to 10% of all women, and it is now clear that PCOS is associated with adverse consequences for women’s health throughout life, including an increased risk of diabetes, fatty liver disease and cardiovascular problems.

Previous research has shown that excess levels of sex steroids called androgens are a major driver of these health risks. It has recently been demonstrated that a new subclass of androgens, known as 11-oxygenated androgens, account for the majority of androgens in the blood of women with PCOS. These steroids do not decline with age like other androgenic steroids and can remain elevated throughout the life of a woman with PCOS. However, we do not yet understand the link between 11-oxygenated androgens and diabetes risk in women.

This HRB funded research will help to define the association between 11-oxygenated androgens and the risk of diabetes in women PCOS by utilising a technique called non-targeted metabolomics, amongst other novel scientific approaches.

Dr Michael O’Reilly who is a Consultant Endocrinologist at Beaumont Hospital in Dublin says,

‘This HRB Emerging Clinician Scientist Award will crucially support my research into the links between androgen excess and diabetes in women with PCOS, which affects up to 10% of all women. By generating evidence highlighting the impact of 11-oxygenated androgens on diabetes risk in women with PCOS, we can strengthen the rationale for routine measurement of these steroids in clinical laboratories across the Irish healthcare system, thereby helping to stratify women with PCOS according to their underlying risk of metabolic disease'.

Contact: Dr Michael O’Reilly, Consultant Endocrinologist, Beaumont Hospital and Clinical Senior Lecturer, RCSI University of Medicine and Health Sciences, Tel: +353 1 8092377

3. Safe prescribing for older people on many medicines

The aim of this research is to maximise the safety and quality of prescribing for older people who need multiple medications.

In Ireland, three in every five people aged over 65 years are prescribed five or more medications and one in every five are prescribed 10 or more medications. This is because as people grow older, they are more likely to live with a mix of chronic conditions such as diabetes, heart disease and arthritis, which require medication.

According to Dr Emma Wallace, HRB Emerging Clinician Scientist, Senior Lecturer in General Practice at the RCSI University of Medicine and Health Sciences and a General Practitioner:

‘While the purpose of these medications is to improve symptoms and the underlying condition, sometimes these medications can have harmful side-effects. The greater the number of medications we take, the more likely it is we are to have side-effects. It is therefore very important for patients and their doctors to understand, discuss and weigh up the benefits and risks of each medication'.

This HRB Emerging Clinician Scientist Award will enable me to examine the prevalence of this issue using data from Ireland and the Netherlands and to develop a list of medications causing side-effects that are difficult to recognise. This research will support clinicians, working together with patients, to optimise prescriptions ensuring maximum therapeutic benefit with the lowest possible risk'.

Contact: Dr Emma Wallace, Senior Lecturer in General Practice at the RCSI University of Medicine and Health Sciences and a General Practitioner in Dublin city centre. Tel: +353 1-4022304

4. Acute Respiratory Distress Syndrome (ARDS)

The aim of this project is to better understand why patients with brain injury in intensive care are more susceptible to a drop in blood oxygen levels and to develop therapies that may reduce death and disability from the condition.

After a major brain injury, a patient’s blood oxygen levels can fall to dangerously low levels, this is known as Acute Respiratory Distress Syndrome (ARDS). This condition is common in Intensive Care Units worldwide and it can worsen brain damage and reduce organ utilisation for lung transplantation. It is also a leading cause of death and disability.

There are no treatments for ARDS. This is due to the inaccessibility of the lung, which makes it difficult to study, and an over-reliance on animal models of disease. This project proposes to overcome these problems by studying the development of ARDS in patients with brain injury, and by using human lungs from brain-injured donors that have been rejected for transplantation. This method will provide insight into how the lung works, and specifically how immune cells in the blood and lung respond to brain and lung injury.

According to Prof Gerard Curley, Professor of Anaesthesia at RCSI University of Medicine and Health Sciences and Anaesthesia & Intensive Care Physician, Beaumont Hospital.

‘The HRB Emerging Clinician Scientist Award will enable me to gain a better understanding of the contribution of inflammation to the development of ARDS during brain injury, and to develop and test therapeutic strategies using a unique technology known as Ex Vivo Lung Perfusion, where human lungs are maintained and repaired outside of the body. The ultimate goal is to discover and validate new biomarkers to develop treatments that improve quality of life for patients who experience ARDS in intensive care and save lives'.

Contact: Prof Gerard Curley, Professor of Anaesthesia at RCSI and Anaesthesia & Intensive Care Physician, Beaumont Hospital and RCSI University of Medicine and Health Sciences. Tel: 01 8093810

5. Improving care for patients with progressive scarring lung disease and their families

Pulmonary fibrosis, a devastating scarring lung condition is more likely to run in families in Ireland. The aim of this project is to improve our understanding of the condition and find new therapies for patients and families world-wide.

While new drugs offer hope of slowing the disease, lung transplant is the only effective cure. We know that genetic factors contribute significantly to the risk of developing pulmonary fibrosis or idiopathic pulmonary fibrosis (IPF) internationally. In Ireland, the IPF National Registry suggests that almost one in five cases cluster in families called familial pulmonary fibrosis, one of the highest rates of any country in the world.

Familial pulmonary fibrosis may have a worse prognosis than non-familial fibrosis, responds poorly to current treatments and some patients can have serious reactions to immunosuppression medications after lung transplantation. Currently, in Ireland, there is no pathway of diagnosis for patients with familial pulmonary fibrosis, no information in terms of the progression of symptoms or how long they live.

Understandably, patients have questions about how this disease might affect their family but there is little specific advice or treatments available now. This HRB award will support research which aims to answer some of these important questions and to develop new cutting-edge laboratory techniques to find new therapies for patients and families worldwide.

Dr Killian Hurley, Consultant Physician in Respiratory Medicine at Beaumont Hospital and Senior Clinical Lecturer, RCSI University of Medicine and Health Sciences says,

‘We want to improve the quality and safety of care for patients with pulmonary fibrosis in Ireland by conducting genetic testing and counselling for those with a strong family history of fibrosis. We also aim to find new treatments for patients with familial pulmonary fibrosis. Our vision is that patients and families with familial pulmonary fibrosis will have the ability to attend a special clinic to better understand their disease and receive specific treatments and advice based on our research'.

Dr Killian Hurley Consultant Physician in Respiratory Medicine at Beaumont Hospital and Senior Clinical Lecturer at RCSI University of Medicine and Health Sciences. Tel: +353 1 8093058.