What is your current role?
I was awarded an NIHR Academic Clinical Fellowship in 2014 and joined the Wessex Rheumatology SpR Rotation. In 2016 I gained a Wellcome Trust Clinical Research Training Fellowship and am currently undertaking a PhD.
Tell us a bit about your research?
I’m currently working towards a PhD based at the Medical Research Council (MRC) Lifecourse Epidemiology Unit , University of Southampton under the supervision of Professors Cyrus Cooper and Nick Harvey . Here we work towards improving human health at a population level, by understanding factors which influence human health and development from pre-conception, through pregnancy, and then childhood.
As a rheumatologist, I’m particularly interested in the musculoskeletal system and my research is focused on the early life determinants of osteoporosis – specifically how epigenetic changes (modifications external to the genetic code which switch genes on and off) are linked to bone health in childhood. This research stems from a developmental model for the origins of non-communicable disease, where maternal, infant and childhood nutrition, health, exposure to infections, and lifestyle permanently “program” an individual’s metabolism and growth – and, in doing so, determine the pathologies of old age. We are studying this using a randomised controlled trial of vitamin D supplementation in pregnancy (the MAVIDOS trial ), and in a large cohort of mothers and children, the Southampton Women’s Survey. In both studies, mothers and children are carefully phenotyped, including DXA and high resolution peripheral quantitative CT scanning, and biological samples from the umbilical cord and peripheral blood are collected for epigenetic analyses.
How has your work benefitted patients and the public? Or how will they benefit in the future?
Osteoporosis is common, with 1 in 2 women and 1 in 5 men over the age of 50 suffering a fracture. Major osteoporotic fractures (e.g. of the hip or spine) have a massive impact on health, including shortened life expectancy, creating a huge burden on individuals and the NHS. Demonstration of switching on and off of particular genes in relation to bone development will help us to understand the mechanisms whereby factors in early life, (e.g. maternal vitamin D status in pregnancy), affect early bone development, and thereby later risk of osteoporosis. I hope that my work will inform health policy with regard to vitamin D supplementation during pregnancy, and other health measures during early life for improved bone development. In the future, in the emerging area of stratified and personalised medicine, epigenetic marks may help us to target interventions such as dietary supplements towards those children most at risk of osteoporosis in old age.
Why did you choose to apply for a NIHR academic clinical fellow post? What opportunities did the post provide? What did it enable you to achieve? How has being a NIHR Academic Clinical Fellow benefitted your career?
During my undergraduate medical career I was always extremely interested in the science underlying the medicine that I learnt. This crystallised into a desire to undertake an academic clinical career in the long term, so an NIHR ACF post gave me the opportunity to work towards this. The ACF allowed me the time and exposure to develop a proposal for a PhD fellowship and I was fortunate to gain the funding for this next step on the academic career path. My NIHR ACF has given me the opportunity to work with a wide range of experts in the fields of rheumatology, bone research, ageing and epigenetics, to publish and to travel the world… but most importantly to feel as though I am making a contribution towards improving human health for the future.