Ulster University: Leading the field in personalised medicine
The Northern Ireland Centre for Stratified Medicine at Ulster University is undertaking some of the most exciting and advanced research in personalised medicine globally, with leading researchers in the field and a bright future ahead
Professor Tony Bjourson, director of the Northern Ireland Centre for Stratified Medicine: “Information is key to personalised medicine, that is the bottom line.”
Personalised medicine is essentially about choosing the right medicine for the right person at the right time.
This new era in medicine aims to move away from the current “one size fits all” model and replace trial and error medical diagnoses and treatment.
It’s a simple premise that is now globally recognised as the way forward in healthcare. But realising the goals of personalised medicine is a complex process which involves collecting and deciphering huge amounts of data - on diseases, our individual genes, lifestyle and environmental factors.
This is where the Northern Ireland Centre for Stratified Medicine (NICSM), with the largest single critical mass of researchers solely focused on this area in Ireland, comes in. The centre, under director Prof Tony Bjourson, aims to distil such data into clinically useful knowledge, and apply it to develop personalised medicine diagnostic tools for a range of degenerative diseases.
Currently, individual patient responses to a particular drug treatment or therapeutic intervention vary widely; for some diseases as few as 20-30 per cent of patients respond to the standard level of care, he explained.
“So for example, looking at biologic (anti-TNF) drugs for rheumatoid arthritis, they are life-changing for about 60 per cent of suitable patients, but they don’t work for the other 40 per cent. These patients could be on them for about six months before this becomes clear, at a cost of thousands of euro to the health service - not to mention potential adverse side effects for the patient with no therapeutic benefit. So there is a societal, economic and personal need there to address this issue,” Bjourson outlined.
The NICSM was established in 2013 following an £11.5 million award to Bjourson, from the European Union Regional Development Fund (ERDF), alongside partners within the Northern Ireland Public Health Agency (HSC R&D), ILEX and Ulster University. Bjourson has also since secured further major EU funding for personalised medicine research under the NICSM.
The five current research clusters within the NICSM’s Centre for Personalised Medicine; Clinical Decision Making and Patient Safety (CPM) are looking at heart disease, emergency surgery, acute kidney injury, unscheduled care in diabetes and diagnostic accuracy in dementia. These disease areas are associated with significant clinical need and commercial potential, Bjourson said.
The research aims to facilitate better targeting of treatment to specific disease pathways, better matching of available treatments to particular groups of patients, and co-development of accessible, fast and accurate diagnostic tests to ensure all patients can receive personalised, targeted treatments for their particular condition.
“The diagnostic panels we create are not just tests on an instrument; they are clinical decision tools that assemble the relevant information and arrive at a diagnosis or a prediction of what medicine the patient will respond to based on the totality of that information. So information is key to personalised medicine, that is the bottom line.”
The NICSM’s degenerative disease biobank of samples with integrated clinical, genomic and lifestyle data and its use of advanced IT data analytics is key to this work. Approximately 7,000 patients/participants are being recruited, of which 3,600 have been recruited to date. Many have co-morbid conditions with an underlying thread of inflammation.
In partnership with Genomics Medicine Ireland, the centre has sequenced the genomes (the body’s blueprint) of nearly 3,000 of its patients to date.
“All this information helps us identify genetic information or proteins or any other biological reasons for developing a particular disease, and thus create a diagnostic test for that disease and or sub-classify disease much more finely than is currently achieved,” Bjourson said.
The NICSM’s work is now beginning to bear fruit, he said, with patents being filed for between 20-25 potential new diagnostics tests across each of its current research areas. One of these is a panel of biomarkers that identifies heart attack patients who are at a high risk of mortality within 12 months, which would help clinicians prioritise those who need urgent treatment and monitoring to address this risk.
“We are now at a stage of where we are deciding if we should license these tests to diagnostic and pharmaceutical companies, sell the intellectual property, or set up a spin-out company here ourselves, which is something we are looking at,” Bjourson confirmed.
The NICSM is located at Ulster University’s Clinical Translational Research and Innovation Centre (C-TRIC) facility, which is embedded in the Altnagelvin Hospital in Derry. This is a unique and very beneficial partnership and, coupled with University Ulster’s specialised stratified medicine courses that deliver perfectly tailored researchers to work in the NICSM, ensures that it can translate its biomedical research outputs from laboratory bench to patient bedside.
“Because we have these new tests and discoveries coming out and because we have bio-incubation facilities and close working relationships with clinicians and businesses it is working as a magnet to attract innovative start ups. We are currently in discussions with four or five genomics and diagnostics companies that want to locate here at C-TRIC and that is part of our objective as well - contributing to economic development and regeneration of the Derry region and the north west of Ireland.”
In line with this objective, there are plans and grant applications for further major expansion of the NICSM’s work. In addition, Bjourson is now in the process of setting up a connected community healthcare company in the region, based on the ethos of the co-operative or credit union model. Under this initiative, participating citizens who provide their genetic, clinical and lifestyle data to the company will be shareholders in owning and deciding what happens to it, and thus benefit from revenues generated and hopefully the health and wellbeing improvements arising from the use of this data. This innovative approach could potentially allow everyone to be involved in advancing the field of personalised medicine. So watch this space.
For more information see www.ulster.ac.uk/NICSM