Research - Northern Ireland Chest Heart and Stroke
Northern Ireland Chest Heart & Stroke
Research

PrintNICHS aims to fund high quality local research that demonstrates the greatest impact for the care and prevention of chest, heart and stroke illnesses.

Since 1994, we have invested over £6.6 million into local research enabling us to fund 89 research projects in total. 10 research projects are ongoing in Queen’s University Belfast and 4 in Ulster University – 1 stroke, 6 cardiac and 7 respiratory projects to increase knowledge and identify better way to prevent, treat and care for people living with chest, heart and stroke conditions.

Priorities for funding include research into the prevention, treatment, rehabilitation and care of chest, heart and stroke illnesses. As a consequence of adopting these priorities NICHS is currently funding research involving the study of people and populations, and not animal research.

Applicants must address and demonstrate how their project aligns with our current aims and values outlined in the Research Strategy for 2014-2018 and meet our eligibility and funding criteria.

NICHS is a member of the Association of Medical Research Charities. As such, we ensure the research we fund meets the highest possible standards of quality, accountability, transparency and openness. To ensure high quality research the following processes are in place:

  • Our research is subjected to robust independent peer review
  • Our research is overseen and evaluated by an externally-led Scientific Research Committee
  • Must be aligned with our Research Strategy aiming to provide funding to support research that shows the greatest potential impact and benefit for people living with, or at risk of, developing chest, and heart and stroke illness.
  • Adhere to our Research Grants Terms and conditionsConflict of interest policy and ResearchFish Policy

 

All AMRC members support the AMRC position statement on the use of animals in research. Please visit the AMRC website for the full statement.

Scientific Research Grants 2019 – Call for Applications Now Open

Northern Ireland Chest Heart and Stroke is pleased to announce that applications have now opened for the 2018/19 round of scientific research grants.

Closing date is Monday 20th August 2018.

Our Scientific Research Budget for 2019 is £400,000.

Click here to download an Application Form.

Click here  to download Guidance Notes.

Applications will undergo a rigorous external peer review process before being considered and evaluated by the Scientific Research Committee at its meeting in January 2019. Applicants will be notified of the outcome by February 2019.

Applicants are encouraged to seek professional research design and statistical advice before submission. The Scientific Research Committee is paying particular attention to this requirement and has very high standards and expertise in this field.

Scientific Research Committee

The Scientific Research Committee (SRC) consists of up to 15 researchers/clinicians in the fields of respiratory and cardiovascular health.

If you would like to read short biographies of our current members, please click on any of the photos below.

The research application and assessment cycle runs from June to March. The committee meets in January to allocate funds to those research projects which meet the required standards. The research applications are also subject to rigorous external peer review (2 reviews for each project) by experts.

Throughout the year, the SRC Chair is asked to examine or delegate progress reports from researchers. This is to ensure that research is on track and that it is satisfactory for the charity to meet the agreed costs.

We are very grateful to those who voluntarily assist in the post implementation evaluation of research projects. Scientific Research Committee members give a very considerable amount of time and expertise to contribute to the objective assessment of research grant applications. Independent peer reviewers also donate their time and expertise to provide objective assessments of proposed projects.

2018 Scientific Research Grants

Research Project Number 1 Principal Applicant Amount requested
Pulmonary and systemic effects of hyperoxia – mechanistic study in a human in vivo model Dr Murali Shyamsundar £40,490

We want to learn about what level of oxygen is harmful to us.

Intensive care treatment saves lives but the various supportive therapies have side effects if used excessively. One of the common therapies used to support failing lungs is oxygen. Oxygen is important to sustain life but it can have harmful consequences in excessive amounts. Levels of oxygen used in intensive care and in other medical specialities is still uncontrolled.

There is evidence of harm from oxygen in patients with heart attack, stroke and cardiac arrest. The exact mechanisms through which the harmful effects are initiated is still uncertain with few human studies investigating the basic cellular mechanisms.

Healthy human volunteers will be administered a high percentage of oxygen, to help the researchers investigate and understand the mechanisms driving oxygen toxicity. The researchers will check blood oxygen levels and use a routine camera test to collect fluid from a lung segment, and will look at a number of markers linked to inflammation.

Dr Murali Shyamsundar hopes that this project will have a significant impact on clinical oxygen use. The results will be applicable to not only patients in critical care but also to other patient groups such as during surgery, heart attack and after cardiac arrest.

 

Research Project Number 2 Principal Applicant Amount requested
A Comprehensive database for Stroke in N. Ireland Dr Anna Gavin £147,004

 

We want to create a database linking information together to tell us about the stroke journey of people in Northern Ireland.

Research has shown that it is important to control and treat risk factors for strokes combined with increasing access to scans and clot dissolving treatments. Having complete information on stroke patients age, gender and background is extremely important to give the researcher:

  • accurate numbers and trends of newly diagnosed patients and those living with stroke;
  • treatments received and services used;
  • whether patients had risk factors and whether treated;
  • whether stroke patients have other diseases;
  • the chances of complications or second events;
  • survival and cause of death.

Current information sources only gives pieces of the story. It is important that Dr Anna Gavin and her team combine all of these to get the full picture. Stroke causes over 1000 deaths here each year. This project has the support of an active stroke research network within the health care system.

This ambitious 2 year project aims to link multiple electronic data sources, which are routinely collected to produce accurate population based data on strokes occurring over the previous 5 years in NI. It would also form the basis for monitoring the patient pathway from acute care to long term. Such a database could also facilitate monitoring of the impact of changing risk factors in an ageing population.

 

Research Project Number 3 Principal Applicant Amount requested
Assessing Microbial, Inflammatory and Clinical Outcomes in Community Acquired Pneumonia. Dr Damian Downey £60,897

 

We want to design better tests to diagnose and monitor Community-acquired pneumonia (CAP).

Different types of pneumonia account for a quarter of all deaths from lung disease in the UK, the death rate is higher in Northern Ireland. Community-acquired pneumonia (CAP) is a common illness caused by bugs (bacteria and viruses) which can result in a serious infection in the lungs. It can cause a cough, sputum, breathlessness, pain, fevers and a shadow on a chest X-ray. Currently the bug causing the CAP is only identified in about 40% of cases. As it can take several days before the result is available, doctors don’t wait for the result and use antibiotic(s) which cover a wide range of bacteria to treat it.

We are likely using too many antibiotics and this can lead to more side-effects and bacteria becoming resistant to the antibiotics. There are newer tests that identify more bacteria and viruses by looking at their DNA (genetic fingerprint) and the result is usually available sooner. Dr Damian Downey therefore propose to assess patients with CAP and compare the standard tests with these newer DNA tests. This study will help to design better tests to diagnose CAP and monitor how the treatment is working.

The results from this study will help to ensure patients are on the right treatment for them and hopefully help reduce antibiotic resistance in the future.

 

Research Project Number 4 Principal Applicant Amount requested
Exploratory study of the prevalence & experience of cardiac cachexia within a population of people with advanced heart failure Northern Ireland Professor  Donna Fitzsimons £108,557

 

We want to increase our knowledge of cardiac cachexia in patients with advanced heart failure.

This research study aims to investigate the wasting disorder known as cachexia, in people with advanced heart failure. Cachexia is associated with poor quality of life and increased risk of premature death. Evidence suggests cachexia is present in many patients with advanced heart failure however health care professionals lack guidance on how to identify and treat it within clinical practice.

Professor Donna Fitzsimons will assess and define cachexia in a proportion of patients with advanced heart failure. It is important to understand how patients who have the condition and their carers feel about it, and its possible effect on daily life. Professor Donna Fitzsimons and her team will complete patient and carer interviews that explore their experience and identify important themes within their experience.

Results from both these phases will be used to inform a workshop where patients, carers and professionals can discuss the findings and agree implications for practice and further research.

This study is worthwhile because living with a condition no one acknowledges is frustrating for patients and their families. Adding to the knowledge of this condition will help begin to develop interventions that seek to improve patients’ quality of life at the end of life.

 

Research Project Number 5 Principal Applicant Amount requested
Airways Clearance Treatments in adults with BronchiEctasis (ACT-BE): A Northern Ireland pilot survey of patients and physiotherapists to establish current practice and plan future research Professor Judy Bradley £72,156

 

We want to find about current Airways Clearance Treatments in adults with BronchiEctasis (ACT-BE) in Northern Ireland.

Airway clearance treatments provided by physiotherapists can help clear phlegm from the lungs. People with bronchiectasis often clear lots of phlegm and have chest infections.

However, in Northern Ireland, we do not know what airway clearance treatments adults with bronchiectasis do, or how frequently they do these treatments. Airway clearance treatments are one of the most burdensome aspects of treatment, yet we do not know whether doing airway clearance improves your wellbeing and decreases chest infections in the long term.

In this research proposal, we will develop a survey collecting information from adults with bronchiectasis and from physiotherapists who care for adults with bronchiectasis in Northern Ireland.  Professor Judy Bradley and her team will involve people with bronchiectasis and the public in developing the surveys to make sure they ask the right questions.

They can use the results to find out what treatments people with bronchiectasis do and what physiotherapists in Northern Ireland provide. They will also look for any link between airway clearance treatments, how well you are and how many infections you get.

These results will tell them about current practice and provide more evidence to support airway clearance treatments in bronchiectasis. They hope these results will inform a bigger survey Europe wide and a study to improve service delivery for people with bronchiectasis.

 

PhD Funded 2018

PhD Project Number 6 Principal Applicant Amount requested
Reducing sedentary behaviour and promoting physical activity in children aged 8-9 years: developing, feasibility and pilot testing a low-cost, multicomponent, school-based classroom intervention Professor Marie Murphy & Professor Alison Gallagher £114,893

 

We want to develop an intervention to increase physical activity and reduce sedentary behavior in 8-9 year olds in schools.

Children living in Northern Ireland are the least active in the UK, with only 43.4% of children meeting current recommended levels. The decline in physical activity and increase in sedentary behavior starts from a young age, probably at 8-9 years old and then tracks through adolescence into adulthood, with inactive, sedentary children becoming inactive, sedentary adults.

There is an urgent need to develop low-cost, scalable interventions to increase daily physical activity and reduce sedentary time. School is recognised as an ideal environment for promoting physical activity because school-based interventions target all pupils, providing access to those who may benefit most and overcoming potential health inequalities, as all children can participate irrespective of their socioeconomic status.

Multicomponent interventions that encourage increased physical activity and reductions in sedentary time through a combination of school and out-of-school initiatives, including changes in the environment, the curriculum and parental/family involvement are recommended.

This PhD studentship will draw upon the available research evidence and best practice to design and test the feasibility of a low-cost, school-based intervention to increase physical activity and reduce sedentary behaviour in 8-9 year olds. If such a low cost, feasible intervention, developed to target PA and SB in schoolchildren, could be scaled-up across all primary schools in Northern Ireland, it would have a significant potential to impact population health and well-being.

2017 Scientific Research Grants

‘Cessation in Pregnancy Incentives Trial (CPIT): A phase III Randomised Controlled Trial’

Professor Frank Kee of Queen’s University Belfast received £50,000 towards the Northern Ireland element of a UK-wide research project that will examine the effectiveness of offering financial vouchers to pregnant smokers as incentives to engage with smoking cessation services and quit during and after pregnancy. The local Public Health Agency and Cancer Research UK are also funding this research.

In Northern Ireland, around 43% of women give up smoking before or during their pregnancy, while 18% of mothers continue to smoke during their pregnancy. This project will inform policymakers on whether financial voucher incentives work for smoking cessation in pregnancy and for primary prevention of cardiovascular disease and cancer.

2016 Scientific Research Grants

Baby Hearts Research

Baby Hearts Research for additional funding request 2016 Professor Helen Dolk. Amount awarded: £49,687

We are allocating funds for a brief extension to the Baby Hearts Study to ensure that the team reach their original target sample of 1,200 participants, which will greatly increase the value for money and power of research findings. We are looking forward to the final results, which are expected in April 2017.

 

“Development of a supportive intervention to meet the needs of carers of people with advanced heart failure.”

Professor Donna Fitzsimons from Ulster University aims to develop a supportive intervention for carers of people with advanced heart failure and evaluate its acceptability to carers. These results will undoubtedly help us improve services for patients living with heart failure and their carers in Northern Ireland. The project was awarded £49,595.

 

“Effects of Riboflavin (Vitamin B2) supplementation on people with genetically high blood pressure.”

EpiRiboSH: Epigenetic Effects of Riboflavin Supplementation in a Randomised Control Trial of Hypertensive patients stratified by MTHFR genotype

Dr Diane Less-Murdock was awarded £60,595 to examine the effects of riboflavin (Vitamin B2) supplementation on individuals who have been shown to have a specific genotype which predisposes them to high blood pressure. The findings of this study will provide important information about the mechanism linking this novel genenutrient interaction with hypertension.

 

“Development of the GUT faecal microbiome in infants with chronic airway disease.”

Dr Bettina Schock (above) of QUB was allocated £56,078 to examine how gut bacteria and the immune system develop in infants with chronic lung disease, including cystic fibrosis (CF). The bacterial community of the gut of babies and infants is different from that in adults, but usually stabilises by the age of 12 months.

 

“Why do young people in NI use E-Cigs?”

Using the Theory of Planned Behaviour to determine attitudes and knowledge of e-cigarette use in a sample of Northern Irish young people (11-16yrs) and their parents

Dr Liz Simpson of Ulster University was allocated £116,453 to examine e-cigarette use within NI. This two-stage study employs the theory of Planned Behaviour (theory-driven research) and will provide a better understanding of the personal and social factors influencing e-cigarette use.

2015 Scientific Research Grants

“The eye as a window to the circulatory system.”

Professor Tara Moore from Ulster University aims to develop a simple new test to enable opticians to predict the risk of heart disease. It would involve examining tiny blood vessels at the front of the eye. The project was awarded £51,247.

 

“Modulation of persistent inflammation in asthma by drug repositioning.”

Dr Bettina Schock of QUB was allocated £68,500 to analyse samples from airway cells in children with and without asthma to test the effectiveness of drugs, potentially leading to new treatments.

 

“Determination of the effect of peer support to encourage the adoption and maintenance of a Mediterranean diet.”

The Mediterranean diet has been shown to have beneficial effects in preventing cardiovascular disease. Professor Jayne Woodside of QUB has been allocated £80,018 to evaluate if mutual support among members of established community groups can help people change their diet.

 

“Feasibility study involving a shared decision tool to help patients take their first steps in making lifestyle changes to reduce cardiovascular risk”.

Professor Margaret Cupples of QUB, who is also a practising GP, was allocated £43,866 to explore the development of a tool that could be used in general practice to assess patients’ physical activity and diet to help them achieve healthy lifestyles.

 

“Investigate microRNAs as serum markers of blood pressure”

Dr Declan McKenna of Ulster University has been allocated £58,787 to try to develop a simple blood test that would identify which patients with high blood pressure are most at risk from cardiovascular disease (CVD). It would also differentiate between the different types of CVD – such as stroke, heart failure and acute myocardial infarction.

2013 Scientific Research Grants

The effect of increased fruit and vegetables intake on epigenetic and transcriptomic endpoints: a pilot randomised controlled trial.”

Dr Jayne Woodside at Queen’s University of Belfast awarded £64,765 to study the effect of increased fruit and vegetables intake on epigenetic and transcriptomic endpoints: a pilot randomised controlled trial.

Increased fruit and vegetable intake (FV) is thought to lead to reduced risk of heart disease and stroke, yet exactly how eating more FV is beneficial for heart health remains to be established, whilst people in Northern Ireland still do not eat recommended number of portions of FV each day. The proposed project uses samples already collected, where 30 healthy volunteers who were low consumers of FV were asked to eat either 2, 5 or 8 portions of FV every day for 4 weeks. All food was provided for the volunteers, and two meals a day were consumed under supervision by the research team. Dr Jayne Woodside and her team will analyse these samples for alterations to genetic information that has been shown to be related to risk of heart disease to see whether increasing FV can produce these changes that might improve heart health. This will add to their knowledge of whether increasing FV is good for cardiovascular health, and how exactly these foods are acting in the body.

 

“The role of intermedin and related peptides as markers of stroke severity and inhibitors of reperfusion injury during stroke therapy.”

Dr Mark Harbison at Queen’s University of Belfast awarded £26,000 to study the role of intermedin and related peptides as markers of stroke severity and inhibitors of reperfusion injury during stroke therapy.

Stroke is caused by blockage of blood vessels in the brain, usually by blood clots, with resulting damage to brain cells (‘infarction’). ‘Clot busting’ drugs reduce stroke morbidity by dissolving the clot and restoring blood flow. Despite the benefits of restoring blood flow, blood returning to the damaged area (reperfusion) may itself cause further brain cell injury by mechanisms such as oxidative damage. Dr Mark Harbison’s group has shown in a model simulating infarction and reperfusion in human heart cells (where the situation is almost identical to that in stroke) that a novel protein intermedin is released by cells locally and protects them from damage. In stroke, therefore, intermedin or closely–related proteins produced during infarction and reperfusion may similarly protect the brain from injury. This study will determine whether these proteins are elevated in the blood of patients following stroke, validating that it is involved in the response to stroke. In parallel laboratory studies in human brain and vascular cells, the source of these proteins will be determined and potential benefits of administering them to protect such cells from simulated clotting and reperfusion injury examined. A successful outcome would justify a clinical trial of co–administering such proteins with ‘clot busting’ drugs in stroke patients, to potentially ameliorate the negative consequences of reperfusion injury.

 

“The effect of vitamin D3 supplementation on insulin resistance and cardiovascular risk factors in people at high risk of cardiovascular disease and type 2 diabetes.”

Dr Michelle McKinley at Queen’s University of Belfast awarded £79,811 to study the effect of vitamin D3 supplementation on insulin resistance and cardiovascular risk factors in people at high risk of cardiovascular disease and type 2 diabetes.

Heart disease and type 2 diabetes are closely related and are two of the leading causes of ill–health and death in the UK, and their prevalence is increasing. Insulin resistance is a condition that predicts the development of type 2 diabetes and heart disease. If simple dietary interventions were effective in reducing insulin resistance this could lead to an improvement in the management of patients at high–risk of heart disease and diabetes. Some intervention studies have shown that vitamin D supplementation might improve insulin resistance but scientific experts have indicated that more studies are needed. The overall aim of this study is to investigate if taking a vitamin D supplement for 6 months can improve insulin resistance in people who are at high risk of heart disease and diabetes. This has clear economic and social implications given the current, and projected, burden of both diabetes and heart disease.People who have low levels of vitamin D in their blood and are at high risk of heart disease will be recruited. They will be assigned by chance to either take a placebo tablet or a vitamin D supplement every day for 6 months. The placebo and vitamin D tablets will look exactly the same so the researchers and people taking part will not know which they are taking. Insulin resistance, vitamin D levels in the blood, blood vessel function, blood pressure and levels of inflammation in the body will be measured at the start and end of the study. Volunteers will come to the Regional Centre for Endocrinology and Diabetes at the Royal Victoria Hospital in Belfast for these assessments. The research team has extensive experience in conducting these low risk assessments and will be in regular contact with participants should they have any questions or concerns. Participants’ travel expenses will be reimbursed and they will also receive a payment on completion of the study as they will be required to give up a few days of their time to come to the RVH in Belfast for assessments.This study would provide robust evidence on whether this straightforward and low–cost health care intervention could be recommended for people at high risk of heart disease and diabetes. The study outcome can be communicated to high risk groups as soon as the research is completed, therefore this research could be of benefit to such people in the short term.

 

“The Northern Ireland Baby Hearts Study: A case–control study of risk and protective factors for congenital heart disease.”

Professor Helen Dolk at University of Ulster awarded £172,130 for the Northern Ireland Baby Hearts Study: A case–control study of risk and protective factors for congenital heart disease.

Each year in Northern Ireland over 200 babies are born with congenital heart disease (CHD), of which approximately 50 will require paediatric cardiac surgery in the first year of life for severe lesions and more will require interventional cardiac catheterisation and other treatments. Improvements in health care mean that the vast majority of affected children will reach adulthood, CHD contributing significantly to heart disease in the adult population. Primary prevention of CHD, where babies are born with healthy hearts, is possible if the risk factors for CHD are known, and preventive strategies implemented. The overall aim of this project is to contribute to the primary prevention of CHD in Northern Ireland. The objectives are to investigate whether periconceptional folic acid prevents CHD; to investigate risk factors for CHD, including medication use and smoking in pregnancy; describe the prevalence at birth of CHD in Northern Ireland including socioeconomic and geographic distribution, clinical spectrum and survival; estimate the proportion of preventable CHD with specific risk factors. These objectives will be met by a case–control study, and by a birth prevalence study based on the paediatric cardiology database. The case–control study will recruit 400 mothers of babies with CHD, and 800 mothers of unaffected babies.

 

“A study of therapy against respiratory syncytial virus (RSV).”

Dr Ultan Powers at Queen’s University of Belfast awarded £18,974 to study therapy against respiratory syncytial virus (RSV).

Respiratory syncytial virus (RSV) primarily attacks cells lining the airways in the nose and lungs. Intense inflammation follows with excessive mucus production causing airways obstruction and ‘acute bronchiolitis’. RSV bronchiolitis occurs in winter epidemics and causes illness and occasionally death to infants, especial those with heart or lung diseases. In fact, RSV is the most important cause of bronchiolitis in young infants worldwide. It also causes pneumonia and death in the elderly. There are no adequate treatments or vaccines against RSV. Preventative antibody therapy is expensive and limited to high risk infants. Most infants hospitalized with RSV are not in these high risk groups. To better understand how RSV causes disease in humans, we developed the means in the laboratory to recreate airway cell cultures that look and behave like they would in the nose and lungs. Using these cultures, we were able to recreate the kinds of damage that RSV does in the nose and lungs when it infects young infants. Essentially, this is as close as we can get to infecting authentic cells lining the airways of young infants without actually infecting the infants. These cultures, therefore, provide a unique opportunity to find out how RSV causes disease in young infants. When airway cells are attacked by RSV, they respond by producing substances, such as interferons, that help fight the infection. Interferons, of which there are 3 types (I, II and III), are powerful molecules capable of inhibiting virus propagation. Indeed, type I interferons are successful drugs against hepatitis B and C viruses. Our previous work demonstrated that type III interferons appear to be the most important in responding the RSV infection. In this study we want to determine whether type III interferons have potential as drugs to either prevent or treat RSV infections. The research team will use their laboratory model of paediatric airway cells, which closely resemble those in the lungs, to address these important questions. If successful, this project may provide the basis for new drugs that help prevent RSV spread or treat people who are suffering from lung infections caused by RSV.

2012 Scientific Research Grants

“The impact of telomeres on cardiovascular risk in renal transplant recipients.”

Dr Amy–Jayne McKnight at Queen’s University of Belfast, awarded £26,500 to study the impact of telomeres on cardiovascular risk in renal transplant recipients.

Cardiovascular disease is a major public health issue in the UK and remains the commonest cause of death (from sudden cardiac arrest; heart failure; and stroke). Cardiovascular disease is also the most common cause of death in persons with chronic kidney failure and especially in those treated with dialysis. In Northern Ireland, cardiovascular disease is still responsible for almost half of deaths in people who receive a successful kidney transplant.

Telomeres are specialised structures that help to protect DNA in every living cell in the body. Telomeres act to prevent DNA unraveling (in some ways telomeres are like the ends of shoelaces that prevent the lace from fraying). Telomeres are vital to health and are so important that the 2009 Nobel Prize was awarded for the discovery of how they protect our DNA (genetic) material throughout life. Telomere length has been independently associated with cardiovascular disease and kidney disease; however, research last year showed that the biology behind this effect was complicated and urgently needed further research.

The research team have successfully completed a pilot study that examined two inherited markers that influence telomeres. This work was presented in the USA in 2010 and led to their team developing a cost–effective, efficient approach to comprehensively investigate telomere biology.

This project will use this approach to investigate the impact of telomere biology on cardiovascular disease, kidney disease and the risk of death. Several commercial companies already plan to offer ‘telomere tests’ to assess individual health (e.g. www.telomehealth.com) and drugs are now being marketed to reduce the risks associated with telomere shortening (e.g. www.tasciences.com/ta–65/testimonials). Altered telomere biology may have an impact on a patient’s long term health or on an individual’s response to treatment. The research team plan to identify key factors that influence how telomeres work in health and disease.

This work could lead to new screening tests for cardiovascular disease or even be developed as tests that will predict response to drugs. Finding out which telomere patterns are linked to higher risks of cardiovascular disease may allow more accurate prediction of those individuals most at risk, or help to identify persons who would benefit from earlier treatment to prevent cardiovascular and kidney disease.

 

“The physical activity intervention versus pulmonary rehabilitation in COPD.” 

Dr Brenda O’Neill at University of Ulster, awarded £79,643 to study the physical activity intervention versus pulmonary rehabilitation in COPD.

Patients with COPD who completed recent studies with our team told us that they are interested in including exercise and physical activity to help improve their health. Pulmonary rehabilitation is an exercise programme which is effective. However, it does not suit everyone with COPD, and is not widely available throughout all of Northern Ireland. Other options for increasing exercise and physical activity do not seem to be offered.

The purpose of this study is to explore a home–based walking programme to improve the physical activity levels of patients with COPD. The research team will compare the physical activity levels of patients who receive the home–based walking programme, to those who receive pulmonary rehabilitation. Methods. Half the patients (25 patients) will receive the walking programme, and half (25 patients) will receive the pulmonary rehabilitation programme.

The walking programme includes advice about physical activity, and a small monitor called a pedometer which people can wear. It counts how many steps people can walk each day. During the study patients will try to walk a little further every week. The pulmonary rehabilitation programme will be delivered twice weekly to small groups of patients attending a hospital gym. The research team will ask patients for their views about the two programmes and we will find out what people liked or disliked about them. The research team will also measure patients’ physical activity levels and quality of life at the start and end of the study, and after 3 months. Lastly they will calculate how much it costs to deliver the two programmes and we will be able to compare this cost.

The research team are keen to provide important information on the benefits of these 2 treatments. The physical activity treatment could offer an exciting, cheap and alternative choice to pulmonary rehabilitation. This study will provide us with all the information we need to carry out a large study on physical activity training in COPD.

 

“The accumulated brisk walking and cardiovascular risk in an ‘at risk’ population: investigation of novel effects on HDL functionality.”

Dr Alison Gallagher at University of Ulster, awarded £57,478 to study the accumulated brisk walking and cardiovascular risk in an ‘at risk’ population: investigation of novel effects on HDL functionality.

It is recognised that people who are overweight or obese are at greatly increased risk of developing heart disease. As a result of less physical exercise and poor diet the levels of obesity are increasing in our population. This will result in higher rates of heart disease and other obesity related problems. It has long been known that physical exercise is an important way of helping to control weight and reduce the risk of heart disease. However, recent evidence suggests that exercise may have benefits for the heart even if it is not associated with weight loss.

Experts recommend that every adult should take at least 30 minutes of moderate intensity physical activity every day. For obese individuals, not used to regular activity, even this modest amount and intensity represents a significant change from their normal daily routine. Accumulating 30 minutes of walking in short bouts spread throughout the day and incorporated into one’s normal daily routine may be a simple effective way of meeting current recommendations. To date this ‘lifestyle’ approach to exercise has been shown to modify traditional CVD risk factors in normal weight individuals, but it has yet to be fully evaluated in overweight/obese individuals.Waking is a popular, familiar, convenient and inexpensive form of exercise that can be easily incorporated into everyday life. Given the rising rates of obesity in our population the successful implementation of a walking programme that reduces heart disease risk would represent a simple, inexpensive and effective intervention, which could be applied widely.

Recent research suggests that changes in functionality of HDL (a blood lipid fraction) may help protect against CVD development. Factors (such as exercise training) which reduce systemic inflammation may also help reduce CVD risk. We recently undertook a 6–month brisk walking intervention in a group of overweight/obese individuals and observed beneficial effects on arterial stiffness (a novel marker of CVD risk) and fitness and these beneficial effects were sustained four months after the end of the intervention. Furthermore we observed these beneficial effects in the absence of any changes in body weight or diet of the participants over the study period.The proposed project will analyze stored blood samples from this study to determine whether exercise training in ‘at risk’ individuals results in favourable shifts in the function of the so–called good cholesterol (HDL) fraction. These novel results will provide valuable insights on the impact of exercise on lipid sub–fractions in a CVD ‘at risk’ group.

 

“The role of Suppressor of Cytokine Signaling (SOCS1) in refractory asthma.”

Professor Liam Heaney at Queen’s University of Belfast, awarded £109,080 to study the role of Suppressor of Cytokine Signaling (SOCS1) in refractory asthma.

In the UK, 5.1 million people suffer from asthma, which is a condition that affects the airways causing breathlessness, cough and wheeze. Most asthmatics respond well to currently available inhaled medication but 10% have “difficult asthma”, with poor control and frequent hospital admissions accounting for 60% of total NHS asthma spend, equating to ca £700 millions per annum. These patients with severe disease do not respond to treatment with standard doses of inhaled ‘steroid’ therapy and they require systemic steroid tablets to maintain some degree of disease control.

The problem with steroid tablets is that they cause very severe side–effects including obesity, diabetes, high blood pressure, brittle bones and depression amongst many others. If they could understand the reason why these patients do not respond to steroids, they could potentially treat this and thus make them more responsive to normal steroid doses in asthma.

In the last year, the research team has studied small tissue samples taken from the airways of patients with severe asthma, who require steroid tablets to maintain disease control. They have examined the expression of thousands of genes in these samples using modern techniques which allow us to look at the entire human gene set. From this unique information, they have identified that a very important ‘molecular switch’ called SOCS1 is reduced in the lining cells of the lungs of patients with severe asthma.

This project will try and understand why there is this failure to turn on this important switch. It will also examine, in the laboratory, a potential strategy to ‘switch on’ SOCS1 in the airway, using a naturally occurring compound called interferon gamma to try and increase or improve the response to steroid treatment.