The incidence of this cancer has doubled in the past two decades and there are 300 new cases each year.
‘We wanted to investigate why obesity is so closely linked with this particular cancer,’ says Dr Joanne Lysaght, Assistant Professor at the Department of Surgery, Trinity College Dublin. ‘And we found some clues in the immune cells that turned up deep in the obese belly fat’.
Her team analysed fat samples from 40 patients who underwent surgery for oesophageal adenocarcinoma and discovered that the fat from obese patients contained high levels of active immune cells called T cells.
‘We found that about 40% of the T cells were activated and inflammatory, and these are exactly the types of cells you want to kill a cancer tumour. These T cells could be contributing to inflammation, which is generally linked to cancer, or the obese fat could be acting as a sink for these cells meaning they can’t do their job and go and fight the tumour. There is still a lot to find out, but these findings will help shed light on how to intervene to help ensure the T cells can do their job in fighting cancer,’ she explains.
The annual Picture of Health publication highlights, in non-technical language, recent and exciting developments arising from Irish health research funded by the HRB. Selected research featured includes projects completed in 2012 that seek to improve patient care, search for better treatments and inform health policy and practice.
The outcomes from all 117 HRB grants completed in 2012 include:
- 19 new products and interventions in development
- 104 influences on policy and practice
- 3830 patients able to participate in 255 clinical studies
- 304 international collaborations
- 248 research related jobs supported across the health services and academia
- €32.4 million leveraged in additional research funding for Ireland
Enda Connolly, Chief Executive at the Health Research Board says;
‘Research is of most benefit when it is applied in policy or practice. The HRB Picture of Health clearly demonstrates how our funding is delivering improvements for people’s health, patient care and health service delivery. But it also highlights the calibre, innovative thinking and expertise of the health professionals and academics involved in health research here in Ireland. Our current investment is actively supporting these experts in their pursuit of better treatments, innovative approaches to care and provision of strong evidence to support positive changes in health policy and practice’.
A selection of short summaries from the publication are featured below including; advances in the fight against cervical cancer, Psychosis – the importance of early intervention and a new approach to a wound healing for diabetics.
For more information contact:
Gillian Markey, Communications Manager
Health Research Board
m 00353 87 2288514
t 00353 1 2345103
Notes for editors:
The Health Research Board is the lead agency funding health research in Ireland. We aim to improve people’s health and patient care and transform delivery of health services by providing new evidence to inform policy and practice.
Selection of summaries
Advances in the fight against cervical cancer
Cervical cancer is a silent killer, particularly of young women. Yet if it is detected early in the neck of the womb, it can be treated effectively. An HRB-funded initiative, CERVIVA, is transforming screening and clinical management of cervical pre-cancer and cancer, both in Ireland and internationally.
The programme has assessed digital technology to improve the screening of samples.
‘When CERVIVA was established back in 2005, cervical smear tests were scanned manually by cytologists, which is very labour intensive. So we analysed more than 35,000 cervical smear samples to compare the manual and automated approaches,’ explains John O Leary, Principal Investigator with CERVIVA, Consultant Histopathologist at St James’s Hospital and Director of Pathology at the Coombe Hospital.
‘The results showed the value of using automated platforms to screen samples initially and mark potentially abnormal cells that could then be followed up by the human eye. We found the automated cytoscreening was as good as the manual approach, but it was also more cost effective, at about 50-60% of the manual cytoscreening,’ says Prof O Leary.
The CERVIVA study has also brought forward numerous biomarkers which help clinicians decide how to manage individual patients
‘These biomarkers can help identify which women are at low risk of cancer and can be branched off the intensive monitoring or treatment path earlier, sparing the women themselves and the Irish healthcare system from lengthy monitoring or unneeded interventions, which in turn saves valuable time and money,’ says Cara Martin, Assistant Professor of molecular pathology at the Coombe and Programme Manager with CERVIVA.
The CERVIVA programme is also identifying how education could be improved to encourage women to step forward and take part in screening, particularly around Human Papilloma Virus (HPV) which can be passed between sexual partners.
The research, led by epidemiologist Dr Linda Sharp from the National Cancer Registry, found that early on in the programme many women did not understand the link between HPV and cervical cancer, but that knowledge has grown as CervicalCheck and the HPV vaccination programme have been rolled out in Ireland. Based on the findings, CERVIVA is now carrying out further research and interventions relating to HPV and other psychosocial barriers to cervical screening and follow up.
Commenting on the success of the CERVIVA Programme to date, Prof John O Leary says,
‘We set out to develop a research programme that could contribute to a quality cervical screening programme in Ireland and internationally and we have achieved that. The original investment for CERVIVA by the Health Research Board has been multiplied by 10 through national and international collaboration. A new round of funding from the HRB will ensure we continue to make great advances in tackling Cervical Cancer in the future’.
Psychosis – the importance of early intervention
If you catch and treat heart disease or cancer early, there tends to be a better outcome. So it seems intuitive that the longer a psychosis goes untreated the worse the outcome and that starting treatment quickly would be of benefit. Now a HRB-funded study has shown that the impact of delays to treatment in psychosis can be seen as long as 12 years later.
The findings have their roots in a study in Dublin in the 1990s, which involved 171 people with a first episode of psychosis and individuals were followed up at intervals of six months, four years and eight years after treatment. ‘Those who had a shorter delay to treatment generally had fewer symptoms and better general functioning,’ explains Consultant Psychiatrist Dr Mary Clarke, who works with the DETECT early intervention for psychosis service, a HSE service managed by the Cluain Mhuire Community Mental Health Service of the St John of God Community Mental Health Services Ltd.
The new study shows that even 12 years on from initial treatment, people who had experienced shorter delays to treatment had fewer symptoms and better quality of life. ‘It makes a strong argument for early treatment in psychosis,’ she says.
‘And delay to treatment is something we can address,’ notes Niall Turner, project manager and the Head of Occupational Therapy at DETECT.
‘A lot of the predictors of outcome for people with schizophrenia and psychosis are fixed – like gender or family history – but treatment delays are malleable. And through DETECT, with the co-operation of primary care and community mental health services, we have reduced delays by more than 50 per cent in our area’.
‘The findings of the 12-year follow up study should inform a move towards early detection and treatment of psychosis in line with the public health messages used for heart disease and cancer,’ he adds.
New approach to wound healing for diabetics
If a cut, sore or ulcer does not heal up, it can lead to bigger problems such as infection, or even amputation in severe cases. But in diabetes, the process of wound healing can be compromised.
‘People who have diabetes have poor blood supply and the level of inflammation is very high, which creates a difficult environment for wounds to heal,’ explains Prof Abhay Pandit, Director of the Network of Excellence for Functional Biomaterials at NUI, Galway.
He and his group are taking a pathology driven approach to look at the problem with a view to creating a better environment for wounds to heal.
‘In the lab, we activated the immune cells involved in healing, called macrophages, to stimulate the type of stress they would experience in diabetes. Then we looked at what happened to the biochemical pathways in the cells that are involved in inflammation and creating new blood cells,’ explains Prof Pandit.
‘By doing this we were able to identify important genes that were involved in diabetic wound healing. We then developed a tailored biomaterial delivery system that would promote healing, which is now the subject of a patent application.
We hope to take it forward and the next step will be to carry out a clinical study for non-healing wounds where there is no treatment option. We want to see if applying this biomaterial, which is tailored to the biology of the wound makes a difference to wound healing,’ he says.