ISSUE 62 MARCH 2010
Devil in the detail Tasmanian devils and transmissible cancers
2020 vision Our new ten-year Strategic Plan
Dementia care Andrea Gillies on ‘keeping’ a relative
In this issue Funding New and renewed Senior Fellows
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New head for Neuroscience and Mental Health 7 Clinical funding latest
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8 News Pressure Drop at Wellcome Collection
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Prizes and honours
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Trust launches Investigator Awards
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14
Research Why good news is not bad news
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People move fastest when responding
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Unravelling breast and kidney cancer
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Cancer: one mutation per 15 cigarettes
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Noticeboard
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Features Extraordinary opportunities: new Strategic Plan 4 Sympathy for the devil
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Catching cancer
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Andrea Gillies: my life as a carer
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Wellcome News
Editorial
Wellcome News is published four times a year and is available free of charge. To subscribe, contact: Publishing Department Wellcome Trust FREEPOST RLYJ-UJHU-EKHJ Slough SL3 0BP T +44 (0)20 7611 8651 F +44 (0)20 7611 8242 E publishing@wellcome.ac.uk or go to: www.wellcome.ac.uk/wellcomenews Ideas, comments, suggestions? Get in touch and let us know. Please contact: The Editor Wellcome News Wellcome Trust Gibbs Building 215 Euston Road London NW1 2BE E wellcome.news@wellcome.ac.uk Editor Chrissie Giles Writers Craig Brierley, Chrissie Giles, Mun-Keat Looi Design Anja Fouad Assistant Editor Tom Freeman Photography David Sayer Publisher Hugh Blackbourn All images, unless otherwise stated, are from the Wellcome Library. Copies of images can be obtained through Wellcome Images (images.wellcome.ac.uk).
The Wellcome Trust
We are a global charity dedicated to achieving extraordinary improvements in human and animal health. We support the brightest minds in biomedical research and the medical humanities. Our breadth of support includes public engagement, education and the application of research to improve health. We are independent of both political and commercial interests. www.wellcome.ac.uk This is an open access publication and, with the exception of images and illustrations, the content may, unless otherwise stated, be reproduced free of charge in any format or medium, subject to the following constraints: content must be reproduced accurately; content must not be used in a misleading context; the Wellcome Trust must be attributed as the original author and the title of the document specified in the attribution. The views and opinions expressed by writers within Wellcome News do not necessarily reflect those of the Wellcome Trust or Editor. No responsibility is assumed by the publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. ISSN 1356-9112. First published by the Wellcome Trust, 2010. © The trustee of the Wellcome Trust. The Wellcome Trust is a charity registered in England, no. 210183. Its sole trustee is The Wellcome Trust Limited, a company registered in England, no. 2711000, whose registered office is at 215 Euston Road, London NW1 2BE, UK. PU-4737/13.5K/03-2010/AF
In this issue of Wellcome News, I am delighted to introduce the Trust’s new Strategic Plan, for 2010 to 2020. Our vision is to achieve extraordinary improvements in human and animal health through supporting the brightest minds in biomedical research and the medical humanities. Our new Plan sets out how we aim to achieve this vision and how we will assess whether our funds are being applied successfully. Unlike our previous five-year Plans, our new framework covers the next decade. It takes a long time to make scientific discoveries, so we want to empower researchers to ask difficult and challenging questions and give them the confidence that they will have the time and resources to find the answers. New focus areas What is also new is that we are making explicit the areas where we will focus our resources through our fellowships, Investigator Awards and Strategic Awards. We will continue to develop our international funding. We are also making clear our direction of travel to increase our support for work that will lead to the application of research, capitalising on the many exciting discoveries that are emerging from the scientific community. We believe that an understanding of the social, political and historical contexts of biomedical science and its application is essential for research to deliver its full potential to society and we will continue to strongly support activities in this area.
As part of the Plan, we set out five huge research challenges – on genetics and genomics, the brain, infectious disease, ageing and chronic disease, and the environment and nutrition. These are areas where we already fund many talented researchers and activities, but we are now setting out our vision for how our funding can have a significant impact over the next ten years and beyond. The challenges provide a framework and the context for how we want to work with the research community and with other funders; they are deliberately inclusive and broad, and although some research will be more aligned to the challenges than others, the primary criteria for our funding will remain the quality of the individuals, their teams and their research questions. Environment and health One of our challenges, on environment, nutrition and health, has not been an area that we have explicitly focused on before. Major changes in the environment are affecting high-income as well as low- and middle-income countries. There are strong environmental factors involved in the many health problems seen in countries that have gone through a demographic transition – such as obesity, late-onset diabetes and hypertension. We believe that research can have a major impact on public health, with effects on the health of millions, and this will be an important area of development for us in the coming years. Alongside our Strategic Plan, we are finalising our exciting new Investigator Awards – the full details of which will be available in June this year. Our philosophy for many years has been to fund people; our fellowship schemes have always been innovative and we are now extending the principles behind these to researchers who have established posts within universities and research institutes. We hope that this will broaden the reach of the ‘Wellcome family’, and will bring new ideas for how the Strategic Plan can evolve during the next decade.
Sir Mark Walport Director of the Wellcome Trust
Cover image: Dr Elizabeth Murchison, see pages 8–9.
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This document was printed on material made from 25 per cent post-consumer waste & 25 per cent pre-consumer waste.
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Read more about the Strategic Plan on pages 4–5
News Feel the Pressure Drop at Wellcome Collection neuroscientists, therapists, social scientists, anthropologists, parents and teenagers to discuss the latest research and thinking about this key stage in human development. In April, the series will explore the adolescent brain and how the digital revolution is creating a globally connected, new-mediasavvy generation. Singer-songwriter Billy Bragg (left) and Mick Gordon of On Theatre. One of Wellcome Collection’s highlights of 2009 was ‘Quacks and Cures’, a The Identity Project continues with the spectacular evening that showcased old theatrical experience Pressure Drop at medicinal remedies, diagnoses and cures. Wellcome Collection. Part play, part rock By popular demand, the event returns on concert, part art installation, it follows 4 June, with the same plethora of activities three generations of a family struggling to running throughout the building, define themselves, both in relation to each including the chance to get your hands on other and within a changing social real-life leeches. Also not to be missed is landscape. Opening on 19 April, Pressure ‘Eureka Live’, the ongoing series with the Drop is the latest work from On Theatre Times newspaper, in which experts analyse and Mick Gordon working with the the latest science making the headlines. singer-songwriter Billy Bragg. The next event is in April. Wellcome Collection is also holding a series of talks exploring adolescence. The www.wellcomecollection.org series brings together psychologists,
New windows lead us to ask: what if? Do we change the world to suit us or change ourselves to suit the world? This is the premise behind the new window designs (below) for the Wellcome Trust headquarters at 215 Euston Road, London. Their purpose is not to offer predictions but to inspire debate about the human consequences of different technological futures, both positive and negative. Six different designs, created by students, graduates and staff from the Design Interactions department at the Royal
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College of Art, explore the theme. One features hundreds of plastic dolls used to provoke discussion among young women about the impact of genetic technology and how it affects their choice of lovers. Another scenario shows nanotechnology being used to make clouds that snow ice cream. Others feature giant photographs and video to explore topics including synthetic biology and facial expressions. The display will be refreshed with new designs throughout the year.
Shaping science education for the future Our Education department, together with an external steering group, is working on an independent report looking at the future of science education. The key question is: what should the future of science education look like to inspire young people and ensure they understand the concepts, processes and role of science in the world? Historically, education has been considered in a piecemeal fashion and consequent policies have not been easily translated into practice. By viewing science education in a holistic manner, the report will bring together aspects of formal and informal learning across the curriculum, and will look at assessment, professional practice and ethos, and leadership and capacity. The group will use the report, scheduled for publication later in the year, as the foundation for a series of nationwide debates. These will see invited audiences from across the learning sectors help to refine the goals and implementation framework set out in the report. “Our long-term visions for science education – the starting-point of our society’s scientific literacy – can only be achieved by working to common goals and addressing the current challenges as a whole,” said Derek Bell, the Wellcome Trust’s Head of Education.
Big Picture brings genetics into context
Prizes and honours
How much do our genes make us who we are? What might the future of genetic research hold? How should this work and its outcomes be regulated? Big Picture: Genes, Genomes and Health brings current genetic research into context to answer these questions and more. This issue is the latest in our Big Picture series, created for teachers, 16+ students and learners of any age. Visit www.wellcome.ac.uk/bigpicture/ genes to order copies or download a PDF of the print magazine, and to browse the wealth of online goodies: everything from downloadable images, videos and animations to a lesson plan based on the National DNA Database.
Michael Zysman/iStockphoto
Win a trip to the Galápagos!
Teachers – fancy a school trip with a difference? Help your students to communicate the science behind the Survival Rivals experiments in an imaginative way before 21 May 2010, and you and four students could be on the way to the Galápagos Islands, 175 years after Charles Darwin himself was there. For more on the competition, and to order or replenish a Survival Rivals kit – which are free for UK secondary schools to celebrate Darwin200 – see www.survivalrivals.org.uk
New Head for Wellcome Library The Wellcome Library has welcomed Dr Simon Chaplin as its new head. Dr Chaplin was previously Director of Museums & Special Collections at the Royal College of Surgeons of England, where he managed the Hunterian Museum and the Wellcome Museum of Anatomy and Pathology.
Professors Uta and Chris Frith. Niels Corfitzen
Congratulations to husband-and-wife team Professors Chris and Uta Frith, who have won the European Latsis Prize 2009 for research into the human brain and mind. The 100 000 Swiss francs (£59 000) prize is presented annually to a scientist or research group who has made the greatest contribution to a chosen field of research, as judged by their peers.
Well done also to Ceri Harrop (above) of the Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, who is the winner of the New Researcher category in the Society of Biology’s Science Communication Awards 2009. Ceri founded the Centre’s public engagement committee in 2007, which she continues to chair, and has developed and coordinated numerous public events and school workshops at the Centre. Last but not least, congratulations to Stephen Boyd from West Yorkshire and Eve Clark from Suffolk, who have each won a copy of Frances Larson’s book An Infinity of Things, in which she explores Henry Wellcome’s collection. The correct answer to the question we posed in Wellcome News 60 (the address of the Wellcome Historical Medical Museum) was 54a Wigmore Street, London.
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Introducing our new ten-year Strategic Plan for 2010–20, which outlines a bold vision for the Wellcome Trust over the coming decade.
Extraordinary opportunities For over 70 years, the Wellcome Trust has supported research of the highest quality with the aim of improving human and animal health. In our Strategic Plan for 2010–20, we present a vision that describes how we will work with our communities to be even more effective in achieving this aim. Our decision to develop a ten-year Plan reflects the long-term view we take in supporting research and the complex and global nature of the challenges that we face. In the Plan, we identify five major challenges for the research community. Each of these challenges contains many important research questions and opportunities. These range across the broadest spectrum of research, from 4 | WellcomeNews | Issue 62
structural biology to public health. We recognise that each of the challenges is enormous and complex and will require ambitious approaches to make progress. We will work in partnership to provide the funding and support to tackle these challenges. We will provide talented and innovative researchers with the freedom and resources they need to generate the discoveries that are essential to overcome these challenges. Our funding philosophy is to support the brightest researchers at all stages of their careers and to create the environments that they need for their research. We will support a wide range of activities to accelerate the application of research that can benefit health. We will maximise
opportunities to engage diverse audiences with medical science and the questions that science raises for society. This Plan for the next decade provides the basis on which we will develop our funding strategies. It also sets out how we will assess progress towards our goals, so that we can help to realise extraordinary improvements in health. Our vision is to achieve extraordinary improvements in human and animal health. Our mission is to support the brightest minds in biomedical research and the medical humanities.
Find out more about our Strategic Plan, focus areas and research challenges at www.wellcome. ac.uk/strategicplan
Our focus areas Supporting outstanding researchers
Accelerating the application of research
Exploring medicine in historical and cultural contexts
We support the most talented researchers at all stages of their careers, giving them the resources they need to fulfil their potential. We build world-class research environments in the UK and in low- and middle-income countries, and provide long-term support for capacity building and research resources. We are a prominent advocate and champion for biomedical research, influencing policy both nationally and internationally to ensure that research can flourish.
We are committed to maximising the application of research to deliver health benefits. Through our Technology Transfer funding, we support the development of new healthcare products, innovations and devices. As a major funder of clinical and public health research and training, we work to accelerate the application of basic research advances. We also work with others to stimulate the uptake and use of research to enhance clinical practice and public policy.
We strive to embed biomedical science within the global cultural landscape, so that it is valued and there is mutual trust between researchers and the wider public. This will require us to gain insight into today’s critical questions by understanding our past, by enabling a range of perspectives on medicine, and by facilitating productive and meaningful engagement about biomedical science between scientists and the public.
fully integrated approach that links basic and clinical biomedical research with key inputs from social sciences, humanities and the arts.
functions and ages, and of the factors that contribute to the onset and development of chronic diseases. We will support basic, clinical and population-based research into chronic diseases, and new and improved approaches for their prevention, management and treatment. We will also engage the public in debate on the broader societal questions raised by research and health provision.
Our five major challenges • Maximising the health benefits of genetics and genomics
We will maximise the power of genetics and genomics research to enhance global health. We will support research to understand how genomes function in health and disease, and work to ensure that this knowledge generates new health innovations for all. We will also explore and address the significant questions these advances raise for society, ensuring that individuals and communities around the world are empowered to use their genetic information to improve their health and quality of life.
• Understanding the brain We will support research to improve understanding of how the brain functions and to find improved approaches for treating brain and mental health disorders. This will require the characterisation of how nerve cells function and interact in complex networks to enable specific cognitive and behavioural functions. It will also demand a
• Combating infectious disease We will promote an integrated approach to the study of infectious disease in humans and animals. Recognising the ‘One Medicine, One Health’ concept, we will support and facilitate research to understand the emergence, transmission, pathogenesis and control of acute and chronic infectious diseases at the global level. We will also work to engage the public in this area and to explore the impact of political, cultural, ethical and social contexts on infectious disease.
• Investigating development, ageing and chronic disease
We will aim to develop an integrated understanding of how the body develops,
• Connecting environment, nutrition and health
Global health is under serious threat from the interlinked issues of access to nutrition, food security and climate change. We will foster multidisciplinary research to address these problems and to inform the global response – working in partnership with others and ensuring that health is at the heart of the policy agenda. We will build a portfolio of high-quality research that considers the interplay between the biological, physical, social and natural environments, and informs behaviour change. WellcomeNews | Issue 62 | 5
News Trust launches Investigator Awards We have announced a major new scheme to support world-class researchers, providing better support to pursue bold, individual visions without constraints. Wellcome Trust Investigator Awards will provide researchers and their teams with the support and freedom to be creative and innovative in their approach. The scheme will operate at two levels of experience and seniority: Wellcome Trust Investigator Awards and Wellcome Trust Senior Investigator Awards. Funding will be awarded by interview, giving the opportunity for researchers to present and argue their cases to groups of world-class peer reviewers. In an opinion article in Times Higher Education, Trust Director Sir Mark
Walport outlined the benefits of this approach compared with the shortand medium-term grants upon which researchers currently rely. Such project and programme grants can tie researchers into a cycle of focusing on securing funding rather than tackling major research problems. “The watchword of the Awards will be flexibility, in length and scale of funding. The challenge to all research funders is to nurture and support the best scientists and enable them to ask the most important questions,” said Sir Mark. “We intend to provide Wellcome Trust Investigators with the creative opportunities and resources they need to tackle tough problems.” www.wellcome.ac.uk/investigatorawards
Keeping track of your career
In 2009, we launched a longitudinal survey to track the careers of Trust-supported award holders. The survey will run
Fake drug danger A report published by the Trust and the American Pharmaceutical Group outlines the challenges and urgent action needed in the global fight against counterfeit medicines. It summarises the discussions from an international conference on the subject, hosted by the Trust in October 2009. For the full report and videos of some of the speakers, visit www.wellcome.ac.uk/counterfeits
Exhibition of the Wellcome Image Awards.
annually, helping us to gain a better understanding of award holders’ career choices, and informing how we provide research and career support. A number of award holders from our basic PhD studentship, Research Career Development Fellowship and International Senior Research Fellowship schemes took part in the study. Early findings show that the majority who finished a Trust award went on to find full-time work in academic research: 73 per cent of PhDs, 99 per cent of Research Career Development Fellows and 93 per cent of International Senior Research Fellows. Award holders developed key skills and achieved key scientific outputs. The majority of those who had chosen to leave academia had moved into a career that drew on their scientific background. Participants felt positive about an academic career for its intellectual challenge, flexibility and independence, with 81 per cent of award holders saying they would recommend a career in academic research to others. www.wellcome.ac.uk/careertracker
Making history A new book charts the history of the Trust, from Sir Henry Wellcome’s interest in medicine and the challenges of establishing a medical research charity, to the shaping of the organisation it is today. Written by former Trust Director Peter Williams, The Story of the Wellcome Trust is published by Quiller Press and priced at £16.95. www.countrybooksdirect.com
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News bites
Picture research In March, Wellcome Images held a networking event for picture researchers working in the history and science media. The event promoted the use of scientific images to picture researchers, and gave existing and potential Wellcome Images users the chance to meet the team behind the service. To view the catalogue and discover how you can use Wellcome Images, visit images.wellcome.ac.uk
Part of the Big Bang’s human periodic table.
Big Bang From gadgets to goo, farming to fashion and space to surgery, the annual Big Bang Fair aims to show how much science and engineering affect our lives, world and future. With support from the Trust, the show took place in Manchester in March, welcoming thousands of school and college students to experience experiments, explosions, simulators and shows, including the finals of the National Science & Engineering Competition. www.thebigbangfair.co.uk
Funding New and renewed Senior Fellows
Mast cells are involved in allergic reactions. University of Edinburgh
Our International Senior Research Fellowships launched in selected European countries in 2002. In Hungary, Dr Attila Mocsai from the Department of Physiology at Semmelweis University is the first recipient to have his Fellowship renewed. His research looks at mast cell signalling (frequently involved in allergic reactions) and how this affects non-allergic inflammation. In the UK, Mark Jobling, Professor of Genetics at the University of Leicester and
a former Research Career Development Fellow, has had his Senior Research Fellowship in Basic Biomedical Science renewed for a second time. Meanwhile, two new Senior Research Fellowships in Biomedical Science have brought two scientists from Europe to conduct research in the UK. Dr Anton Wutz has travelled from Austria to join the Wellcome Trust Centre for Stem Cell Research in Cambridge, where he will study how changes in cellular identity are regulated when stem cells differentiate. Dr Markus Meissner has moved from Germany to the Wellcome Trust Centre for Molecular Parasitology at the University of Glasgow, where he will investigate the parasitic organism Toxoplasma gondii and its highly specific way of invading cells.
• The 2010/11 competitions for our
International Senior Research Fellowships (www.wellcome.ac.uk/ isrf) and Senior Research Fellowships in Basic Biomedical Science (www.wellcome.ac.uk/uksrf) open again in June.
Neuroscience and Mental Health welcomes new head
John Williams (left) and Richard Morris.
John Williams has been appointed Head of Neuroscience and Mental Health at the Wellcome Trust; his predecessor Richard Morris becomes Senior Neuroscience Adviser. John remains Head of Clinical Activities, a role in which he has helped to expand our support for clinicians at all career stages (for current funding opportunities, see right). “I’m delighted that a neuroscientist of such international renown as Richard will remain working with the Trust,” says John. “His considerable experience and insight will help me push the Trust towards fulfilling one of its major challenges in understanding the brain. My commitment to supporting clinical academics in the UK will continue, and I look forward to
Clinical funding latest
combining both my roles to take a broader look at how we carry out translational research across all our funding areas.” Richard’s new role takes him away from day-to-day responsibilities for funding committees and grant applications and will enable him to focus on strategic issues, including the Sainsbury–Wellcome Centre for Neural Circuits and Behaviour, which is being established at University College London. He also continues to run a very active laboratory in Edinburgh, where he serves as Director of the Centre for Cognitive and Neural Systems. For information on our Neuroscience and Mental Health funding, email nmh@wellcome.ac.uk
We support clinical academics with a suite of schemes that provides funding at all career stages. In the latest round of funding we have awarded 14 Research Training Fellowships, which will allow aspiring clinical academics to undertake highquality training in research that leads to a PhD. For clinicians looking to develop independent research careers, we have awarded four Intermediate Clinical Fellowships and two Postdoctoral Training Fellowships for MB/PhD Graduates. The latter scheme was launched in late 2008 to meet the requirements of clinical academics who undertook a PhD during or before starting their medical degree. For details on all clinical fellowships, see www. wellcome.ac.uk/clinicalfellowships. Some 40 candidates received Starter Grants for Clinical Lecturers in 2009, over the two opening rounds of competition. Managed in collaboration with the Academy of Medical Science, these grants support research-active clinical lecturers by helping them to maintain momentum in their research. For details, see www. acmedsci.ac.uk/p176.html.
• The deadline for preliminary applications
for the next round of Fellowships for MB/ PhD Graduates is 16 April 2010. If you or a colleague are interested in applying, see www.wellcome.ac.uk/mbphd for details.
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Sympathy for the devil
Dr Elizabeth Murchison in her lab at the Wellcome Trust Sanger Institute.
Last century, the Tasmanian tiger was declared extinct. Now, a similar threat hangs over another famous inhabitant of the Australian island – the Tasmanian devil. Chrissie Giles met Dr Elizabeth Murchison, who works on a transmissible cancer threatening these distinctive creatures, to find out what can be done to save them. The small plastic tube is cloudy with condensation, but just visible inside is a pale chunk of tissue, floating in a colourless liquid. Holding the tube is Dr Elizabeth Murchison, who is telling me about her travels across the world to pick up samples for her research at the Wellcome Trust Sanger Institute, near Cambridge. Unlike the other researchers working there on the Cancer Genome Project, she isn’t concerned directly with human 8 | WellcomeNews | Issue 62
disease. The samples she’s holding are from dog tumours, and there’s also a freezer drawer containing tissue from Tasmanian devils (Sarcophilus harrisii). Also unlike her colleagues, she’s dealing with a type of cancer that is transmissible – spread by the physical transfer of cancer cells from one animal to another. These rare cancers have been noted in the dog, devil and hamster, but – thankfully – not in humans (see ‘At a glance: transmissible cancers’).
Devilish history The Tasmanian devil, a marsupial the size of a small dog, is now found in the wild only on the Australian island of Tasmania, after becoming extinct on the mainland some 400 years ago. Ferocious predators of lambs and poultry, devils were often trapped and poisoned, until a law was passed in 1941 to protect them. Now a new scourge threatens the devils: a transmissible cancer called devil facial tumour disease.
was relatively unknown then, but updates from friends working on programmes to protect the devil back on the island showed Dr Murchison how serious a threat it was. She got some devil tumour samples sent over from Tasmania and began working on the cancer, research that she continues today, having moved to the Sanger Institute in January 2009. Tasmanian devil with facial tumours. Save the Tasmanian Devil Program
At a glance: transmissible cancers • Transmissible cancers spread by •
•
the exchange of cancer cells from one individual to another. As well as the Tasmanian devil facial tumour disease, there is a transmissible cancer in dogs that may have arisen thousands of years ago. No such cancers are known in humans.
For more see pages 10–11 of this issue and: Murchison EP. Clonally transmissible cancers in dogs and Tasmanian devils. Oncogene 2009;27:S19–30.
This tumour first appears on the head and mouth of devils. It grows and grows, eventually preventing the animals from feeding, causing them to starve to death typically six to nine months from the onset of symptoms. There is no treatment for the disease, and the effects on the devil population have been devastating. It’s estimated that there could be as few as 20 000 devils left on the island; in 2008, the devil was listed as endangered by the International Union for Conservation of Nature. As she hails from Tasmania herself, it may not seem surprising that Dr Murchison ended up working on the devil. “I’d always been interested in biology and Tasmanian wildlife,” she says. “I became aware of the Human Genome Project as I was finishing school – I was quite disappointed as it was just ending and I thought there’d be nothing left to do!” Discovering that a whole field of molecular biology existed, she completed a biology degree in Melbourne. In 2002, she left Australia to start a PhD in genetics at Cold Spring Harbor Laboratory in the USA. The devil disease
Rapid spread The first case of the devil disease was noted in 1996, and it spread across Tasmania rapidly, showing all the signs of an infectious disease. This got scientists thinking: was this a transmissible cancer, spread by an allograft – the transfer of tissue between different devils? Certainly, the mechanics could work: devils bite each other frequently (during feeding, fighting and mating), and the tumours can crumble, so cancer cells could, in theory, be passed from one animal to another. The allograft theory gained more weight in 2006 when scientists showed that the chromosomes from tumours from 11 different devils were rearranged in a similar way.1 Dr Murchison and colleagues subsequently used microsatellite markers (repeated sequences in DNA that vary greatly between individuals) to confirm that the devil tumours were genetically identical. Why isn’t the tumour rejected by the devils? Research2 has shown that the devil immune system does not recognise these tumours as foreign, and so doesn’t destroy them. In part, this is thought to be because of a lack of genetic diversity in the devil population, caused by inbreeding within the island-bound population. This means that the tumour cells (which originated from a devil) are recognised as ‘self’ rather than ‘non-self’ and are not flagged for destruction. How can the genetic particulars of the tumour be used to understand its biology? In work published recently in Science,3 Dr Murchison and colleagues set out to identify genes unique to the cancer. They found that tumour cells expressed many genes, but only one that was set at markedly different levels compared with non-tumour devil cells. Somewhat unexpectedly, the genes were unique to Schwann cells, which insulate nerve fibres with a fatty substance called myelin. Why would this be?
For an extended version of this article see www.wellcome.ac.uk/devils
“It’s a clue to the tumour’s cell of origin – we propose that the devil cancer might have evolved from a Schwann cell that became cancerous,” says Dr Murchison. But how does a humble nervous system cell become a transmissible cancer? “We think that a Schwann cell accumulated mutations and became a cancer cell, somewhere in the body of the devil with the first tumour.” How it became transmissible remains poorly understood, but she suggests that the original devil may have been cannibalised, or that a tumour was growing on its face and it spread to others from there. From this work, Dr Murchison was able to define a diagnostic marker for the cancer, to differentiate this tumour from others. In future research she plans to look at tumours taken from devils in different parts of Tasmania, to explore how the tumour has evolved to improve its ability to ‘live’ in the devil. Saving the devil Ultimately, it’s hoped that research to understand the tumour will prove useful in finding ways to prevent and treat the disease. There are also many other avenues being explored to save the devil. What does the future hold? Well, unlike the transmissible cancer in dogs that Dr Murchison also studies, the devil cancer is rapidly fatal, and looks to be spread in a frequency-dependent manner. This means that the spread depends more on the frequency of interactions between the devils than on the number of devils.4 “The devil tumour is effectively wiping out its host, and there’s real potential that the disease could drive the population to zero.” Our interview over, Dr Murchison returns the samples to the freezer box. Undoubtedly, things look bad for the devil, but with work such as hers going on, there’s still hope that, nearly 75 years since the Tasmanian tiger went extinct, the devil will be spared the same fate.
References 1 Pearse A-M, Swift K. Allograft theory: transmission of devil facial-tumour disease. Nature 2006;439(7076):549. 2 Siddle HV et al. Transmission of a fatal clonal tumour by biting occurs due to depleted MHC diversity in a threatened carnivorous marsupial. Proc Natl Acad Sci USA 2007;104(41):16221–6. 3 Murchison E et al. The Tasmanian devil transcriptome reveals Schwann cell origins of a clonally transmissible cancer. Science 2010;327(5961):84–7. 4 McCallum H. Tasmanian devil facial tumour disease: lessons for conservation biology. Trends Ecol Evol 2008;23:631–637.
WellcomeNews | Issue 62 | 9
Catching cancer
Cancer is traditionally thought of as a noncommunicable disease, yet infectious forms have been found in several species, challenging our conceptions of what cancer is and how it spreads. By Chrissie Giles.
Check in any medical dictionary, encyclopaedia or website and you’ll find cancer listed as a non-communicable disease. Yet transmissible cancers – which can spread between individuals – have been known about for over 130 years, when a Russian vet found that he could successfully transplant a tumour from one dog to another unrelated to it. Thankfully, no transmissible cancers have been found in humans, although, as well as the dog, they are known to affect the hamster and Tasmanian devil. Researchers are studying these strange cases of cancer to try to understand more about how the disease, including the non-communicable types, occurs. Spot the difference As well as differing in whether they’re infectious or not, transmissible and non-transmissible cancers vary in their genetic relationship to their host. In non-transmissible cancers, a host cell undergoes a series of genetic mutations that ‘transform’ it into a cancerous cell, resulting in a cancer cell genome that shares similarities with the host genome. In transmissible cancers, the cancer cells originate from the first ever organism to have developed the cancer, and so are not related genetically to subsequent hosts. The genetic make-up of tumours taken from different animals with the same transmissible cancer will be very closely related, however. Transmissible cancers are spread by the exchange of cancer cells from one individual to another, in the form of an allograft. This is essentially a tissue transplant between animals from the same species but with different genetic makeups. Ordinarily, allografts (which include organ transplants and tissue grafts) are recognised as foreign by the host’s immune system and are attacked and destroyed.
However, transmissible cancers are not recognised in this way. Researchers think that transmissible cancers have somehow evolved to evade the host’s immune responses. The transmissible cancer of dogs has been seen to reduce the expression of dog leukocyte antigen (DLA) genes, the molecular system by which the dog’s immune system tells the difference between ‘self’ and ‘non-self’.
For an extended version of this article, see www.wellcome.ac.uk/ transmissiblecancer
Anna Subbotina-Kononchuk/iStockphoto
Hamster In a paper published in 1961, Darlene Brindley and William Banfield described the spontaneous appearance of a tumour on the top lip of a male laboratory hamster. What research has been done? The researchers explored how the tumour spread between the hamsters. First, the tumour spread to healthy hamsters when they were caged with affected hamsters but separated by a mesh – the researchers think the physical contact afforded was enough to transmit the tumour. The tumour was also spread when healthy hamsters were fed tumour material, and later lab work showed that the tumour could be transmitted by mosquitoes between cancer-bearing and healthy hamsters. What’s the conclusion? The researchers concluded that the physical transfer of cells between hamsters was important. Other research showed that tumours from affected hamsters all had the same chromosomal changes. Banfield WG et al. Science 1965;148(3674):1239. Brindley DC, Banfield WG. J Natl Cancer Inst 1961;26;949–57.
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This is thought to help the cancer to sneak under the radar of the animal’s immune system, allowing it to grow and live within the animal’s body – at least for a limited time. The known types of transmissible cancer are detailed below and right, along with some rare instances in which cancers have been transmitted by the exchange of cancer cells from one human to another.
Dog Canine transmissible venereal tumour (CTVT) was first characterised in 1876. Also known as Sticker’s sarcoma, the tumour is spread through sex and by licking, sniffing and biting affected areas.
Anaspides Photography/Ian D Williams
Human
Tasmanian devil
No transmissible cancer is known in humans, although there are several documented ways in which cancer cells have been transmitted between people.
As featured on pages 8–9, devil facial tumour disease was first observed on a Tasmanian devil in 1996 by a wildlife photographer in north-east Tasmania. It is transmitted by the transfer of cancer cells that occurs when devils bite each other on the face, for example, during feeding, fighting and mating. The cancer kills devils within six to nine months and there is no treatment.
What research has been done? In the USA, around 3500 women each year get cancer while they’re pregnant. Melanoma, acute leukaemia and carcinoma are examples of cancers that have been passed from mother to fetus. Acute leukaemia cells have also been passed from baby to baby in multiple births. Another possible – but rare – route of tumour cell transmission is organ transplantation. There is also a case of a surgeon who developed a tumour with the same genetic origin as that of his patient after injuring his hand during an operation to remove an abdominal tumour. What’s the conclusion? One theory is that cancer is not an infectious disease in humans because we all (identical twins excepted) have different human leukocyte antigen (HLA) genes, allowing our immune systems to differentiate between self and non-self. Some researchers have suggested that the diversity of the HLA system in humans may mainly be to prevent cancer from being transmissible. Dingli D, Nowak MA. Nature 2006;443(7107):35–6. Welsh JS. caonline.amcancersoc.org/cgi/eletters/59/5/282
What research has been done? Research published in 2006 showed that the chromosomes from tumours from 11 different devils were rearranged in a similar way, as they would be if the cancer were spread as an allograft. The spread of the cancer across the island of Tasmania also suggested that it could be transmissible. Recent research has showed that the origin of the tumour is a nervous system cell called a Schwann cell.
What research has been done? Historically, the scientific community has gone back and forth on the question of whether this tumour is spread by viable cancer cells. This was pretty much settled by a paper published in 2006. Murgia et al. showed that tumour samples taken from dogs from five continents were all genetically distinct from their hosts but shared a common origin – proving that the tumour is indeed spread by an allograft. Where normal dogs have 78 chromosomes, CTVT cells from different animals typically have 58 to 59. The original case was thought to have occurred thousands of years ago in a wolf or an East Asian breed of dog. What’s the conclusion? The dog tumour has been around for a long time, and so has developed some mechanisms to avoid rejection by its host. As it’s mainly sexually transmitted, its spread requires the animals to live long enough to have sex. This means that it’s not a very aggressive disease, and coexists with dogs relatively peacefully. In fact, many dogs eventually mount an immune response and reject the cancer without treatment. Murgia C et al. Cell 2006;126(3):477–87. Rebbeck CA et al. Evolution 2009;63(9):2340–9.
What’s the conclusion? Modelling studies suggest that the cancer is spread in a frequencydependent manner, not a densitydependent one. This means that the spread depends more on the frequency of interactions between the devils, rather than the number of devils. In theory, the disease could wipe out devils altogether. Pearse AM, Swift K. Nature 2006;439(7076):549. Murchison E et al. Science 2010;327(5961):84–7.
Megan Lorenz/iStockphoto
WellcomeNews | Issue 62 | 11
Research Why good news is not bad news
Randy Plett/iStockphoto
Does being given a ‘clean bill of health’ actually encourage unhealthy behaviour in some people? For diabetes screening, this appears not to be the case. A team led by researchers from the University of Cambridge and the MRC Epidemiology Unit in Cambridge followed patients from 15 general practices in the ADDITION (Cambridge) trial, which is looking at the effectiveness of a screening and treatment strategy for type 2 diabetes. At ten practices, patients were invited to be
Latest YouTube films online Our YouTube channels are packed with fascinating films – in glorious high definition – for you to watch, share with friends and colleagues, and embed online wherever you like. Already proving a particular hit at www.youtube.com/wellcometrust is ‘Talking heads – rebuilding language after stroke’, which explores the ways that researchers at the Wellcome Trust Centre for Neuroimaging are using magnetic resonance imaging (MRI) to unpick how language works in the brains of healthy people and those who have had a stroke. Also filmed at the Centre is ‘Laughing in the face of reality – the science of optimism’. And ‘MRI – deciphering inner space’ features Dr Nikolaus Weiskopf, who explains how the powerful imaging technique works. Over on the Wellcome Collection channel (www.youtube.com/ wellcomecollection) you can watch our Wellcome Image Awards films. These explore the science of the techniques behind the winning images, from scanning electron microscopy to a new innovative technique for creating 3D images.
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screened for diabetes; at five control practices, patients were not screened. People who tested negative for diabetes did not appear to be falsely reassured by their results. Comparing patients who had a negative test result with patients in the control group showed that there was no significant difference between the two groups in terms of people’s perceived risk of diabetes in the future, or how healthy they saw themselves. The two groups also scored similarly on their intentions to adopt health behaviours – including cutting down on the fat and sugar they eat, and doing more exercise. The researchers conclude that widespread diabetes screening is unlikely to lead to an increase in unhealthy behaviour – good news for the estimated 500 000 people in the UK with undiagnosed diabetes, who may well benefit from screening. Paddison CAM et al. Are people with negative diabetes screening tests falsely reassured? Parallel group cohort study embedded in the ADDITION (Cambridge) randomised controlled trial. BMJ 2009;339:b4535.
Stills from films available through the Trust’s YouTube channel.
arental mental illness P linked to infant death A study has found evidence to support the notion that the risk of sudden infant death syndrome (SIDS) is higher in families affected by mental illness. Researchers from the University of Manchester looked at data from 2.5 million Swedish births over a 26-year period. They found that risk of SIDS was higher if either or both parents had a history of mental illness or if the mother had an alcohol or drug disorder. The risk persisted even if the parent had experienced no relapse five years before the infant’s birth. The researchers say tailored approaches are needed to ensure that standard safety advice reaches the most vulnerable families. Webb RT et al. Influence of environmental factors in higher risk of sudden infant death syndrome linked with parental mental illness. Arch Gen Psychiatry 2010;67(1):69–77.
Round-up The eyes have it Researchers at University College London have demonstrated a new technique that enables the death of cells in the retina – linked to brain cell death – to be measured in real time. The method, demonstrated in an animal model, could refine the diagnosis of neurodegenerative disorders and help to track disease progress. Cordeiro MF et al. Cell Death Dis 2010 [Epub ahead of print].
Drugs database is go A vast online database of information on the properties and activity of over half a million drugs and drug-like small molecules has launched. ChEMBLdb should be useful in translating information from genomic research into successful new drugs. The database was transferred from biotech firm Galapagos NV in July 2008 through a £4.7 million Wellcome Trust Strategic Award. www.ebi.ac.uk/chembldb/
Dr Abdisalan Noor.
Putting policy into practice The Wellcome Trust Major Overseas Programme in Vietnam has helped the World Health Organization to devise the first new update in 12 years for its guidelines for dengue. Meanwhile, research by Dr Abdisalan Noor from the KEMRI–Wellcome Trust Research Programme has fed directly into the Kenyan government’s ten-year plan for malaria. Noor et al. BMC Infect Dis 2009;9:180. Electronic goods The Wellcome Trust and Research Councils Joint Initiative in Electronic Patient Records and Databases in Research has generated its first published research. The two papers illustrate the potential of electronic patient databases to deliver key analyses that can help improve healthcare and public health.
The dueller who shoots first may be slower on the draw – but probably more accurate.
People move fastest in response to events, researchers find Scientists at the University of Birmingham have carried out laboratory ‘gunfights’ to show that we move faster when we react to something in our environment than we do when we initiate the action ourselves – an idea inspired by cowboy movies. The researchers set up a competition between two people who were challenged to press a row of buttons faster than their opponent. There was no ‘go’ signal so all they had to go by was either their own intention to move or a reaction to their opponent. The team found that the participants who reacted to their opponent executed the movement on average 21 milliseconds faster than those who initiated the movement. However, they did not respond as accurately in the test. “As a general strategy for survival, having this system in our brains that gives us quick-and-dirty responses to the environment seems pretty useful,” says Dr Andrew Welchman, who led the research. “Twenty-one milliseconds may seem like a tiny difference, and it probably wouldn’t save you in a Wild West duel because your brain takes around 200 milliseconds to respond to what your opponent is doing, but it could mean the difference between life and death when you are trying to avoid an oncoming bus!”
Exploring asthmatic airways Previous studies have shown that exposure to different microbes during infancy helps to protect against asthma, but infection with the wrong bacteria can make the condition worse. Researchers at Imperial College London studied the bacterial communities found in our airways and compared those from asthmatic children with those from people without asthma. They came across some strains of pathogenic bacteria much more frequently in the asthma airways, while conversely some ‘friendly’ bacteria were found far less frequently than normal. This suggests that the finely balanced microbial communities in the airway are disturbed in people who have asthma. Hilty M et al. Disordered microbial communities in asthmatic airways. PLoS One 2010;5(1):e8578. TommL/iStockphoto
Welchman AE et al. The quick and the dead: when reaction beats intention. Proc Biol Sci 2010 [Epub ahead of print].
Gulliford M et al. J Public Health (Oxf) 2009;31(4): 512–20. Gulliford M et al. PLoS One 2009;4(9):e7168.
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Research Unravelling the changes in breast and kidney cancer
Dr Andy Futreal.
Scientists have conducted the first detailed search of breast cancer genomes – revealing the genomic rearrangements that cause the disease. Rearrangements involve the reshuffling and reorganisation of the genome and may include deletions and duplications of DNA sequences. The insights obtained from this study will aid
tumour classification and help to refine diagnosis and treatment. Researchers at the Wellcome Trust Sanger Institute looked at 24 cases of breast cancer. The study shows that breast cancer samples can differ greatly in the way their genomes were broken and put back together. Some are relatively undisturbed whereas others are fractured extensively and reassembled in more than 200 rearrangement events. “It looks as though some breast cancers have a defect in the machinery that maintains and repairs DNA and this defect is resulting in large numbers of these abnormalities,” said Dr Andy Futreal from the Sanger Institute. “At the moment we do not know what the defect is or the abnormal gene underlying it, but we are seeing the result of its malfunction in the hideously untidy state of these genomes. Identifying the underlying mutated cause will be central to working out how some breast cancers develop.”
Scientists at the Sanger Institute have also identified new mutations behind the most common type of kidney cancer. This could ultimately help in diagnosis of the disease and the selection of treatment for clear cell renal cell carcinoma, which causes 102 000 deaths worldwide each year. The majority of clear cell renal cell carcinoma cases are known to be driven, at least in part, by mutations in a single gene, VHL. By sequencing thousands of genes from over 100 cases of this cancer, the researchers found VHL mutations in more than half of the cases examined, but also additional mutations in other genes. In particular, they showed that two genes – JARID1C and SETD2, which help control gene expression on a genome-wide level – had been inactivated by mutations. Stephens PJ et al. Complex landscapes of somatic rearrangement in human breast cancer genomes. Nature 2009;462(7276):1005–10. Dalgliesh GL et al. Systematic sequencing of renal carcinoma reveals inactivation of histone modifying genes. Nature 2010;463(7279):360–3.
One mutation per 15 cigarettes: genome maps reveal how cancer develops Research led by the Wellcome Trust Sanger Institute has revealed for the first time almost all of the mutations in the genomes of two cancers: a malignant melanoma and a lung cancer. Cancers are caused by mutations in DNA, which are acquired during a person’s lifetime. Lung cancer causes around one million deaths worldwide each year and almost all are associated with smoking. The number of mutations found in the genome of the lung cancer cells – almost 23 000 – suggest that a typical smoker would acquire one mutation per 15 cigarettes smoked. Although malignant melanoma accounts for only 3 per cent of skin cancer cases, it is the cause of three out of four skin cancer deaths. The melanoma genome contained more than 30 000 mutations that carried a record of how and when they occurred during the patient’s life. “These are the two main cancers in the developed world for which we know the primary exposure,” said Professor Mike Stratton, from the Cancer Genome Project at the Sanger Institute. “For lung cancer, it is cigarette smoke and for malignant melanoma it is exposure to sunlight. With
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these genome sequences, we have been able to explore deep into the past of each tumour, uncovering with remarkable clarity the imprints of these environmental mutagens on DNA, which occurred years before the tumour became apparent. “We can also see the desperate attempts of our genome to defend itself against the damage wreaked by the chemicals in cigarette smoke or the damage from ultraviolet radiation. Our cells fight back furiously to repair the damage, but frequently lose that fight.” “The knowledge we extract over the next few years will have major implications for treatment,” said Dr Peter Campbell from the Sanger Institute. “By identifying all the cancer genes we will be able to develop new drugs that target the specific mutated genes and work out which patients will benefit from these novel treatments.”
Small-cell lung cancer genome, including (from outside in): chromosomes; insertions and deletions (light and dark green blocks); mutation of one or a pair of DNA bases (light and dark orange bars); mutations in protein-coding genes (coloured squares); copy number variations (blue lines); rearrangements within or between chromosomes (green and purple lines). Nature (see papers below), © 2009 Pleasance ED et al. A small-cell lung cancer genome with complex signatures of tobacco exposure. Nature 2009;463(7278):184–90. Pleasance ED et al. A comprehensive catalogue of somatic mutations from a human cancer genome. Nature 2009;463(7278):191–96.
Q&A: Dr Anthony Bullock Wound dressings have come a long way from the sticking plasters applied to the grazed knees of our childhoods. Dr Anthony Bullock from the University of Sheffield tells us about recent work in which he and colleagues describe a gel-based dressing for burns and scalds that promotes healing and reduces skin contraction.
Tracking transmission of drug-resistant bacteria Researchers have developed a new tool that can track the transmission of MRSA (methicillin-resistant Staphylococcus aureus), the drug-resistant bacterium, from one person to another in hospitals. The technique, developed by researchers from the Wellcome Trust Sanger Institute, can ‘zoom in’ from large-scale transmission events between different continents to the much finer detail of person-to-person infection within a single hospital. This will enable researchers to understand how strains spread so rapidly and develop novel infection-control strategies for MRSA and other emerging superbugs. To test the method, the researchers analysed samples from a Thai hospital. This showed that no two infections were caused by the same strain of bacterium, and that infections were caused by two different groups of MRSA strain introduced to the hospital separately. Working with teams and samples from North and South America, Europe, Australia and Asia, the researchers were also able to determine a mutation rate and evolutionary tree for the MRSA. The strain studied acquired about one single-letter change every six weeks. Analysis of European isolates also suggested that this MRSA emerged in the 1960s in Europe, supporting theories that MRSA emerged with the introduction of widespread antibiotic use. Harris S et al. Evolution of MRSA during hospital transmission and intercontinental spread. Science 2010;327(5964):469–74.
What was your aim? We wanted to make a gel that would change the conditions within a wound to speed up healing. When skin is wounded, cells called keratinocytes move in a sheet from the edges to the centre of the wound. In the lab, the top speed of a keratinocyte is 50 μm/h. On the skin they go a little slower, around 10 μm/h. We wanted to speed this migration, promoting healing. Why did you use a gel-based dressing? Previous work has shown that low calcium and high magnesium levels increase the speed of keratinocyte migration, so we wanted to include something to produce these conditions. We used a hydrogel, which is essentially a jelly. They’re used in many things, including wound dressings, dental adhesives and contact lenses. We tested different gels that our team in Chemistry produced and found one that can accelerate and improve healing of superficial burns and scalds. Why is calcium so important? Calcium makes the world go round! The fluid that fills wounds has a lower calcium level than tissue fluid, but a higher level of magnesium. Reproducing these conditions in a skin model of wounding increases the rate of migration. We reproduced other groups’ experiments, varying concentrations of calcium and magnesium to find the ‘sweet spot’ in terms of the rate of migration. We then set about making a gel that would mop up the right amount of calcium and donate sufficient magnesium to reproduce those amounts. What skin model did you use? Traditional models were keratinocytes growing in a single layer on plastic dishes. We now have more complex
models. We use a piece of dermis [the lower layer of skin that provides mechanical strength and flexibility] donated from patients undergoing reconstructive surgery through our colleagues in Plastic Surgery. We add cells grown from skin and grow it in conditions similar to those real skin is exposed to, creating a 3D model. The resulting epithelium looks and behaves like skin. Just like skin, if you wound it, it heals up. Why did you focus on burns? Wounds caused by burns often require skin grafts, which can contract as they heal. Enzymes in the skin cells that migrate during healing start remodelling the dermis, which can get smaller. This contraction makes wounds look puckered and wrinkly as they heal and can cause deformity of limbs as, for example, large burns heal. Patients who receive skin grafts often require further surgery to release this contracted skin. Did you find anything surprising? We found that skin contracted less with gels that didn’t donate magnesium. However, we also know that magnesium is required to promote cell migration, so you could imagine using one formulation of a gel loaded with magnesium for the first two weeks of healing, to promote cell migration. You could then switch to a magnesium-free formulation to block contraction. We didn’t expect to find this link between magnesium and contraction – it’s a nice result. What’s your ultimate research aim? To work with burns surgeons to make something which we can move to the clinic to reduce skin graft contraction, which is particularly bad in children who have suffered burns injuries. What do you do outside of work? I’m a keen guitarist, although most of my time is taken up raising two boisterous girls (aged five and two). I enjoy climbing and tinkering with cars and motorbikes. Bullock AJ et al. Development of a calcium-chelating hydrogel for treatment of superficial burns and scalds. Regen Med 2010:5(1):55–64. Supported by a Wellcome Trust University Translation Award.
WellcomeNews | Issue 62 | 15
My life as a carer Andrea Gillies at the awarding of her Wellcome Trust Book Prize.
The role of carer – or ‘keeper’ – of the ill is often a faceless, thankless one. At times it is an obligatory one, owing to familial ties. In fact, three-quarters of an estimated 6 million people in the UK are caring for a partner, parent or child with a disability, according to the Princess Royal Trust for Carers. Andrea Gillies was one of those carers, when she and her husband Chris promised his parents Morris and Nancy that they would look after them until the end. An unexpected journey A writer and journalist by trade, Andrea had no medical or care-giving background other than “having a keen interest in my own pregnancies” and being a mother of three. It wasn’t until her experience of caring for Nancy that she resorted to journal writing and researching dementia as a “cathartic channel for coping”. Those journals would become Keeper, the book that won the first ever Wellcome Trust Book Prize in November 2009. Andrea found that coping with the reality of day-to-day life for someone with Alzheimer’s had a knock-on effect on her health and that of those around her. “At that early stage, I didn’t understand that dementia robs people of the ability to make those trivial sequential steps that make life possible as an independent being. It hadn’t occurred to me that I would have to dress
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Looking after a relative with Alzheimer’s disease both opened Andrea Gillies’s eyes to the demands of the role and changed her as a person. She explained to Jennifer Trent Staves how she immortalised her experience in Keeper, winner of the inaugural Wellcome Trust Book Prize.
her, bathe her, cut up her food and spoon it in to her, get her on and off the loo, and that I was to be, in sense, a mother again,” she says. As Nancy’s health declined, Andrea struggled too: “I was all at sea, making it up as I went along, and realised what an amateur I was.” Depression sunk in, as it does for many carers. But Andrea didn’t seek help for it: “I would have been embarrassed to admit to it. I felt acutely that I was failing.” “I began to empathise with Nancy so much that I felt as if I were undergoing a sort of parallel disaster, and that my own mental powers were dimming. This, I discovered later, is quite a common experience that is often called caregiver’s dementia.” Her journal was an outlet for these feelings, ones she didn’t want to lay on her family. “I started reading and making notes on Alzheimer’s, how it works and how it has been seen to affect people. And those notes became part of the finished book, interleaving the personal and often quite grim bits with some hard science and philosophical speculation.” This blend is one of the reasons that the judges awarded her the Prize; Jo Brand, chair of the judging panel and a former psychiatric nurse, said that Keeper was “the perfect fusion of narrative with enough memorable science not to choke you”.
Memorable lessons Andrea’s experience came to an end when Nancy started becoming aggressive towards the children and was found a place in a care home. But Andrea’s interest in dementia is far from finished. Five years on, she says she feels like a completely different person. “I have a stronger sense of what a privilege it is to be possessed of a healthy brain,” she says. “Our personalities are physical, biological things, and the truth is that they are incredibly fragile.” While she doesn’t consider herself an activist for the cause, she is always happy to speak up if she’s asked. She believes the government’s National Dementia Strategy is “deeply misguided” and has been disappointed with the media for considering dementia a “niche” subject: no national newspaper had reviewed Keeper until the Prize brought it greater publicity. More recently, the BBC bought the rights to it. She’s now working on a novel called Sanctuary Wood, originally conceived as being as different from Keeper as possible. “But it has grown into a book that’s concerned with memory and identity and self and soul. I don’t seem to be able to get away from these ideas.”
• Find out more about Andrea’s
winning book, and details of the 2010 Wellcome Trust Book Prize, at www.wellcomebookprize.org
Applications are now invited for two of our flagship fellowship schemes for biomedical science In the UK and the Republic of Ireland
Our Senior Research Fellowships in Basic Biomedical Science fund the most outstanding postdoctoral scientists based within academic institutions across the UK and the Republic of Ireland. We provide five years of full salary support and research costs in the first instance with the potential for renewal.
Preliminary applications for this competition must be received by 4 June 2010. Full applications will be invited by 2 July 2010.
In Croatia, the Czech Republic, Estonia, Hungary, Poland, the Slovak Republic and Slovenia Our International Senior Research Fellowships fund the most outstanding researchers, either medically or scientifically qualified, who wish to establish an independent career within an academic institution in one of the seven European countries listed above. We provide five years of full salary support and research costs in the first instance with the potential for renewal. We particularly encourage applications from researchers working outside their own countries who wish to return home. Preliminary applications for this competition must be received by 4 June 2010.
www.wellcome.ac.uk/uksrf/wn
Full applications will be invited by 2 July 2010.
www.wellcome.ac.uk/isrf/wn
Courses, conferences and workshops
Melanocytes producing melanin, for pigmentation of skin and hair. Alistair Hume
GC: Event takes place at the Wellcome Trust Genome Campus, Hinxton, Cambs. For information on Wellcome Trust Conferences, see www.wellcome.ac.uk/conferences. For information on Advanced Courses and Open door Workshops, see www.wellcome.ac.uk/advancedcourses.
July 4–9 Practical Aspects of Small Molecule Drug Discovery Advanced Course GC 18–24 Next Generation Sequencing Advanced Course GC
21–27 Human Genome Analysis: Genetic analysis of multifactorial diseases Advanced Course GC
29–4 Sep Genomic Epidemiology of Malaria Advanced Course, Bangkok, Thailand
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September
August 11–15 Systems Biology: Networks Conference GC 22–26 Wellcome Trust School of Human Genomics 2010 Course GC 23–27 Design and Analysis of Geneticbased Association Studies Advanced Course GC
4–7 16th Meeting of the European Society for Pigment Cell Research Conference GC 7–10 Signalling to Chromatin 2010 Conference GC 12–15 Infectious Disease Genomics and Global Health Conference GC 15–19 Genome Informatics Conference GC
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