Arthritis Collaborating for a cure

[Music]

following the theme of tedx cambridge

2021 i would like to speak about

untangling networks in science

using my research into osteoarthritis as

an example i will highlight the

complexity of issues faced in research

and how we prepare the next generation

of scientists to untangle them

that’s the next generation of scientists

who will develop future tests for

diagnosis

and resurgence are novel treatments for

those diseases

alexia will give her experience of

studentship in my laboratory before

covid

and the fun of dissecting cow feed but

before we talk about

why we need to prepare future scientists

i want to talk about the general

challenges

of research that need untangling since

1998

i have focused my research on

osteoarthritis which is a degenerative

condition of joints typically the knee

in the hip

in healthy joints there’s a tough

slippery smooth surface

which is called articular cartilage

which lines the ends of bones allowing

them to easily glide over each other

facilitating almost frictionless

movements of your joint

when that cartilage becomes worn or

damaged it can start to degrade

that leads to pain swelling and

restricted joint movement

arthritis osteoarthritis being the most

common form

and everyone here will know someone with

this disease one in five adults over the

age of 45 will have

osteoarthritis in the knee and one in

nine suffer with hip

osteoarthritis each year nearly nine

million people

have sought treatment for osteoarthritis

that’s the equivalent of the population

of london

now one of the major risk factors for

this disease is age

you are more likely to suffer from

osteoarthritis the older you are

another key risk factor is body weight

now the relationship between obesity and

osteoarthritis is complicated

but in simplistic terms an increase in

body weight puts more strain on joints

so as an ageing population who are

becoming more obese the incidence of

osteoarthritis is only going to increase

in the uk and across the world

now this has huge implications to us as

a society

osteoarthritis is the biggest cause of

missed working days

it’s the biggest cause of disability it

leads to a huge number of hip and knee

replacement surgeries

every year and that’s with the

associated cost to the national health

service

and those with osteoarthritis um there

may be in too much pain to be able to

work and to contribute to taxes to

society

so osteoarthritis can have a dramatic

effect on the sufferer too with living

having to live with chronic pain as an

increased risk of depression

they’ll have a higher risk of metabolic

diseases and

their lifespan will on average be five

years less

so the impact on osteoarthritis and

other musculoskeletal diseases

has both on the individual and

population is therefore very well

recognized

uh indeed in 1998 experts from around

the world supported by international

governments and the then secretary

general of the united nations

established the ten years from 2000 to

2010 as the bone and joint decade

this was to focus resources into this

area

now before twos out the year 2000 if you

searched for research articles using the

term osteoarthritis

there was about 40 000 publications and

the first in 1883 that’s 40 000 journal

papers

in 116 years during the bone and joint

decade there was a further 20 000

articles published so this clearly had

the effect of generating research into

osteoarthritis

and since 2010 over 50 000 more articles

in scientific journals were published

so we have seen a dramatic rise in

research and this this is

goes along with amazing new technologies

to support research scientists

but despite all of this there’s still no

cure

now i’d suggest this isn’t because a

cure isn’t achievable we are making

progress

for example a group based in the us

recently discovered similarities between

human ankle joints

and those of axolotls now these are

animals which have the potential to

completely regenerate their limbs

including their joints

and their cartilage so this novel

understanding could

lead the way to a cure it’s just an

example of a potential step towards our

goal we don’t know if this avenue of

research will lead to a cure

maybe one of the other many research

areas will be successful and there lies

a problem

now it’s wonderful that so many

brilliant minds are focused on the

problem of osteoarthritis

they have access to technology which can

generate more data than we could have

dreamed of 20 years ago

but there is so much research it’s

difficult to see through the tangle of

it all

to give you an idea of the scale of the

problem in 2019 there was

815 institutions involved in

non-surgical treatment of osteoarthritis

research

and that was across 69 different

countries and the slide shows the

complexity of those global networks

but it’s not only the human network

networks i’m also talking about the

networks of scientific data

the technology available available to

researchers allows us to investigate

genetics

pathways gene expression biochemical

pathways and so much more

all contributing to a mountain of data

and the more complex these networks

become the more

challenging they become so future

scientists are going to need to access

access to the research networks around

the world but also the skills to

navigate through the complexity of the

data

an anonymous of the university of

cambridge once said if i have seen

further it is by standing on the

shoulders of giants

and sir isaac newton was referring to

how advances in science build upon the

work of our predecessors

and the same holds true today but i

would suggest

that the view from the giant shoulders

is now impeded by a thick fog of data

so are still reliant on the future

generations of scientists to progress

our understanding of disease

but with the challenges of tangled

networks how do we encourage the next

generation research

scientists to rise to that particular

challenge how do we give them the skills

and opportunities

to find the cure amongst the complexity

of these networks

now when considering the content of this

talk i reflected on my journey and how i

arrived as a research scientist

after completing my a levels i studied

life science degree at the university of

portsmouth

and between my second and third year i

saw an advert that was posted onto the

course notice board

it offered a summer studentship at the

university of aberdeen in north scotland

now my thought process was along the

lines of well my mother was born in

scotland therefore i am half scottish

i’d never been to aberdeen before like

to visit now you might think this wasn’t

the best motivation for me choosing a

studentship and i would agree

and i was very surprised when the person

who offered the studentship dr kenneth

page

picked me he gave me that opportunity

and it changed my life

spending eight weeks in a research

laboratory really opened my eyes to

scientific research

now i’d always enjoyed lab classes but

this was different it was challenging it

was tough

it was all of those things that make

science hard and i loved it

on a personal level dr page he’d showed

that faith in me

as an undergraduate student he’d never

met so

being that young undergraduate knowing

someone had the confidence in me taking

their time to mentor me

helped to give me that belief to

consider research as

a possible future career route now from

aberdeen as a place to spend the summer

the experience changed my aspirations

wanting to base myself in academic

research following that studentship dr

campage offered me a phd and i

really haven’t looked back and i am now

in that position where i can provide

students those opportunities that people

gave me

and this is where i hand over to alexia

to give her view on the experience

in the first days of my biomedical

science undergraduate degree

i’m probably a little longer than i

would care to admit

i remember romanticizing myself in a lab

coat

stepping up to receive some sort of

successful scientist award

whatever that might be and why wouldn’t

i

our degree was highly immersive in terms

of learning the ins and outs of

human biology and their application to

contemporary research

we were trained for three years with the

goal to start working in labs and become

leading experts in our field

i had readied myself for overflowing job

offers

internships research opportunities and

more

it was only when i had to start thinking

of where to apply

myself and where to find these

opportunities

but i realized these were not so much

expectations

as much as they were goals

breaking into science is not your

average achievement

and the statistics for those that do are

much bleaker than you think

confronting this world as a budding

scientist

is daunting as much as it is challenging

and exactly why opportunities like the

ones dr bush and i had

are so valuable i remember learning

about funding research

and all the formalities that go with

research grants

really dampened the successful scientist

in a lab coat fantasy for me

and so to prevent my expectations

getting bruised any further

keep it real and work hard became a big

mantra of mine of course

this completely went out the window when

i discovered that

out of all people dr bush had awarded me

a highly sought-after research

scholarship

following his groundbreaking work

it felt surreal to be conducting

research

that i could only dream of reading about

at that stage

and i was getting paid to do so

no surely somebody’s pranked me my new

mantra

the cutting-edge techniques dr bush

taught me

and the experiments i could design

following them were enough

to make me fall in love with the lab and

never think of leaving one again

i even became strangely in love with

dissecting cow feet

to extract cartilage cells that’s as

much detail i can get into before it

gets gory

so what actually came from this

experience

did i become some sort of a wunderkind

nobel winning scientist

you know shockingly no

did we publish our findings no

did we finish our experiments also no

ordinarily i think these would be common

things

one might consider to measure a

successful experience like this

and certainly all of these things

are tremendously valuable to prepare

oneself for the research world as

it turns out though the success of this

opportunity

and any that i gained after that really

were determined far less by things like

these

i came to realize that what the

studentship gave me

was an environment where i could

question

create and even fail confidently

knowing that the only consequence of

that was learning

for first immersion into professional

work i think

we could probably all agree this was a

very rare opportunity

usually in a new job we’re all so caught

up

in looking good and deserving of that

opportunity to work

that we rarely question does it deserve

us and why do we only consider

what happens when we become who we want

the goal so to speak rather than

the process of getting there the reality

perhaps because we aren’t always given

the chance of doing so

i still hold it an immeasurable

privilege to have seen my value

and my potential through the eyes of

somebody who was once in my very own

shoes

it evoked a level of trust and of

empathy

that i think are largely uncommon in

science

but should be more prevalent

we all deserve the privilege to grow

into and take ownership of the

confidence

that somebody had seen within us all

along

taking ownership over my interests and

optimizing my existing knowledge

is what i learned from my first

experience in research

when deciding whether to pursue research

i think

what deters a lot of people is the

possibility

of dedicating your life to the

unanswerable

it is definitely true that we may not be

able to answer the unanswerable

but we may be able to change the

question if we start from changing

ourselves

this for me meant temporarily leaving

research

and joining the very exciting field of

artificial intelligence

and data science we live in an age

of unprecedented amounts of information

and technologies

that can help dakota it seems

so satisfying to me in biology at least

that untangling built up information of

the past

has become a mission of our present and

of our future

in fields everywhere but most important

to me

healthcare ai and data science hold

enough

potential as to warrant a true

revolution

it may seem scary at first but why not

develop technologies that help

humans focus more on humans

the pathological complexity of

osteoarthritis

the center of my undergraduate degree

still requires much investigation to

prevent the condition altogether

but who appropriately manages the

realities

of depression and chronic pain that this

condition

still causes and in a broad sense this

is one of the many ways

in which developing technologies to take

on greater responsibilities

can help humans get back to their

humanity and

offer true unmitigated support in

situations like these

this kind of feedback of nurturing the

continuity

and heritability of ideas and science

but also

the drive to question and to create

i believe are essential to a generation

of conscientious new scientists

for me it all started from cow feet

and from a mentor who believed in me

where will it start for you

so out of everything alexi just talked

about the thing that resonated most with

me was the importance of having the

opportunity to fail to make mistakes

my experiences weren’t such a long time

ago but i’d

forgotten all the mistakes i’ve made in

my aberdeen studentship now that isn’t

because i’m now infallible far from it

but challenging yourself and making

mistakes is kind of now the normal

now this mindset was fostered at first

in my studentship and hopefully with

experience i now make less mistakes

but what is really important is i’m not

afraid to make them and take those

those sort of gambles sometimes

now in a lecture i can see that

enthusiasm for research now it was there

before the summer studentship but

hopefully the opportunity nurtured it

allowed it to grow and to flourish

it changed her aspiration and she’s now

preparing herself for a possible

future research career um and her

postgraduate studies now into artificial

intelligence

she is far better equipped to untangle

networks than i am

so by providing studentships we can

never guarantee that that student will

become the next research scientist

but they will however benefit from the

experience wherever they end up

but if we cannot be sure that each

student will add to a conveyor belt of

talent carrying them directly into a phd

you know is it worth it well i would

answer yes in fact we need more

studentship so we can guarantee that

more of them will go on to those medical

research careers

so how do we get more studentships well

those

people the ones who funds research

scholarships we need them to fund more

those universities who host them we need

to give them the opportunities and the

time to host more

and this will give more opportunities

for our young scientists to experience

the rewards

of scientific pursuits now when

considered in the context of the cost of

medical research in general

they are incredibly good value about one

to three thousand pounds for a summer

studentship

now this might sound a lot but when

compared to a half million pound

three-year research project

it really isn’t so we also need

universities to be able to free up their

academics time

my my colleagues have little time to

take on just some annual leave most

years

and so rather than thinking about

maximizing staff workload in talk

courses

universities should also consider the

time for staff to supervise

these studentships that’s the real

opportunity to

encourage the next generation i mean

after all isn’t this what universities

are meant to be about

now i’m looking forward to being

successful in securing future research

studentships

to give other students the opportunities

i was given these are the scientists who

are going to develop the cures for those

ailments that i

my family the wider community that’s you

um that may be afflicted by and you

never know it might be an injection

alexa has played a role in developing to

clear the arthritis in all of our knees

thank you for listening

you