INFANT Centre Announces Collaboration with the HRB Mother & Baby Network

INFANT Centre announces collaboration with the HRB Mother & Baby Network to investigate the benefits of an additional diagnostic blood test to improve the outcomes of pregnant women with suspected pre-eclampsia.

Investigating a point of care diagnostic tool to enable appropriate stratification of the antenatal management of women presenting with suspected pre-eclampsia.

INFANT, a world leading Science Foundation Ireland research centre at University College Cork (UCC) and Cork University Maternity Hospital, announced it has commenced an all-Ireland study of 4,000 women, in collaboration with the Health Research Board (HRB) Mother & Baby Network. The research will investigate a point of care diagnostic platform that will measure the potential benefits of offering an additional blood test to measure Placental Growth Factor (PlGF) to improve the outcomes for both mother and baby when pre term pre-eclampsia (PET) is suspected. Pre-eclampsia is a pregnancy complication that can affect any woman and there is no treatment for it.

The HRB Mother and Baby Clinical Trial Network Ireland brings together leading Irish obstetric and neonatal researchers, with an international reputation to address problems in women and children’s health that will have a global impact.

The PARROT Ireland research programme aims to more effectively diagnose pregnant women when it is suspected they may have PET so that their care may be managed more efficiently. Diagnosing mothers earlier would have an impact on their medical outcomes and also upon hospital resources, reducing unnecessary admissions.

The PARROT Ireland programme is a follow on to the PELICAN study. INFANT took part in this multicentre prospective study to evaluate the use of PlGF tests in women presenting with suspected PET. The study suggests that PlGF testing presents a realistic and innovative adjunct to the management of women with suspected PET, especially in those presenting preterm.

PlGF is a protein produced by the placenta in pregnancy and it is known to exist in much lower levels in women with pre-eclampsia at all stages of their pregnancy. Pre-eclampsia is a disease of pregnancy usually characterised by high blood pressure and protein in the urine and is known to complicate 2-8% of pregnancies. If present it can result in significant maternal and neonatal morbidity and mortality.

Launching the PARROT Ireland project, Professor Louise Kenny, co-director of the INFANT centre said, “this study is a unique opportunity to make immediate changes to a patient suspected of having pre-eclampsia’s care using a point of care device. Results of the test are available within 30 minutes, ensuring information is relayed to the treating clinician in a timely manner. This study will combine the wide range of expertise in the INFANT centre and the HRB Mother & Baby Network and contribute to a more stratified system of patient management which in turn will lead to better outcomes for mother and baby.”

This all-island study will invite 4,000 pregnant women over two years in 7 centres around Ireland – Cork University Maternity Hospital, the National Maternity Hospital, Coombe Women & Infants University Hospital, the Rotunda Maternity Hospital, University Hospital Galway, University Maternity Hospital Limerick and the Royal Jubilee Maternity Service Hospital in Belfast.

Professor Fergal Malone, Co-Network Lead of the HRB Mother & Baby Network, said, “this research has the potential to have enormous impact on the management of pregnant women with suspected pre-eclampsia and the resulting outcomes. We are very happy to see Ireland’s health researchers continuing to foster research and innovation in our health care services.”

Evidence from the PARROT Ireland study may inform national guidelines on the management of suspected pre-eclampsia and contribute to the better care and management of pregnant women.

Oatmeal, Healthy Bugs And A Happy Heart

“Oatmeal; healthy bugs and a happy heart “ according to research published today by scientists at the Science Foundation Ireland-funded APC Microbiome Institute in Cork.
Pictured are (left to right):
Prof Noel Caplice, Professor of Cardiovascular Science, Director of the Centre for Research in Vascular Biology and investigator APC Microbiome Institute, UCC, Prof Catherine Stanton, leader of the research, APC Microbiome Institute and Teagasc Food Research Centre, Moorepark, Co. Cork, and Dr Paul Ryan, APC Microbiome Institute, UCC.
Picture: Cathal Noonan

PC Microbiome Institute scientists have confirmed that gut microbes play a role in heart health.  We also demonstrated that we should consume porridge regularly to get the benefits of oat beta glucan for heart and gut health!

Our study, published in Microbiome, found that consumption of oat beta glucan not only lowered blood cholesterol in mice, it also helped keep body weight down and altered both the composition and functionality of the gut microbiota.  The level of butyrate, a type of fatty acid produced by gut bacteria which has been previously shown to protect against diet-induced obesity in mice, was elevated in this study. Oat beta glucan also acted as a prebiotic, and increased bacteria in the gut which are being explored by others to treat obesity.

Plant sterol esters, which too were tested in this study, were found to be the most effective in lowering blood cholesterol and helping to avoid plaque build-up, but caused the greatest weight and adiposity gains and adversely affected the gut microbiota composition of the mice.

Cardiovascular disease is currently responsible for approximately 30% of deaths annually across the globe.  Diet and exercise are known interventions to prevent or slow down the development of atherosclerosis but it has become evident that our gut bacteria also contribute.

In the study mice were fed a high fat diet together with either a food supplement or medication over a period of 24 weeks.  The food supplements used in the study were plant sterol ester (the plant equivalent of cholesterol, currently added to some foods) and oat beta glucan (found in porridge).  The drug used was Atorvastatin, one of the ‘statin’ group of drugs. The particular mice used are susceptible to the build-up of cholesterol in their arteries because they are apoE-/- deficient.

Atorvastatin and plant sterol esters are known to reduce levels of ’bad‘ cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of ’good‘ cholesterol (high-density lipoprotein, or HDL).  They are used to treat high cholesterol, and to lower the risk of stroke, heart attack, or other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors. In this study, mice treated with Atorvastatin had similar physiology to the mice treated with oat beta glucan (reduced body weight and percentage body fat).

The takehome message is to take porridge regularly to reduce your risk of cardiovascular disease whilst also protecting your gut microbiota.

Reference

Paul M. Ryan, Lis E. London, Trent C. Bjorndahl, Rupasri Mandal, Kiera Murphy, Gerald F. Fitzgerald, Fergus Shanahan, R. Paul Ross. David S. Wishart, Noel M. Caplice and Catherine Stanton (2017) Microbiome and metabolome modifying effects of several cardiovascular disease interventions in apo-E-/- mice Microbiome DOI 10.1186/s40168-017-0246-x

New Study Highlights Need for a Weight Loss Surgery Strategy

Data from a recent study carried out by the ESPRIT (Evidence to Support Prevention, Implementation and Translation) research group led by Professor Patricia Kearney at the Department of Epidemiology and Public Health, University College Cork (UCC), estimate that current weight loss surgery (bariatric surgery) provision in Ireland meets less than 0.1% of the need.

Bariatric surgery is an intervention for patients with severe obesity. The study, funded by Prof Kearney’s Health Research Board Research Leader Award and published in the journal Surgery of Obesity and Related Disorders, estimates the number of older Irish adults who are potentially eligible for and likely to benefit from weight loss surgery.  It calls for a strategy to develop and expand the provision of bariatric care.

The prevalence of severe obesity and type 2 diabetes (T2D) is rising, which poses a major challenge for public health in Ireland. While public health strategies focus on the prevention of obesity and lifestyle interventions, the treatment of morbid obesity needs to be recognised as a fundamental aspect in tackling the obesity epidemic. Bariatric surgery is a treatment option as it improves life-expectancy and increases the odds of diabetes remission, leading to a reduction in direct healthcare expenditure. However, bariatric surgical procedures are not commonly performed in Ireland. Only two public bariatric centres exist nationally and between them fewer than 50 procedures are performed annually, meeting less than 0.1% of the need for service provision.

The findings of the study show that 7.97% of older Irish adults are potentially eligible for bariatric surgery according to recent guidelines. This represents approximately 92,500 adults in Ireland.  It is estimated that 12% of these adults have T2D and related complications. The study suggests that focusing the provision of bariatric surgery on this population cohort would potentially improve both patient outcomes and reduce healthcare expenditure. Dr Francis Finucane, Consultant in endocrinology at Galway University Hospital, states that “It is important that this intervention becomes an accessible treatment option for those in greatest need. We sought to estimate the number of people potentially eligible for bariatric surgery in Ireland based on established clinical criteria and then to refine the number of potentially eligible patients by identifying those who suffer from diseases with high morbidity, mortality and healthcare cost, that respond best to bariatric surgery.”

Data for the study was collected from a cross-sectional analysis of the first wave (2009-2011) of The Irish Longitudinal Study on Ageing (TILDA) to estimate the proportion of people eligible for bariatric surgery. TILDA is a nationally representative cohort study of community-dwelling adults aged 50 years and over.

Ms Kate O’Neill from the Department of Epidemiology and Public Health, UCC states that “Our findings ought to be considered by policy-makers and should be used to guide resource allocation. One strategy to limit the budget impact is to focus on the patients with T2D and related complications. The provision of bariatric surgery to those in greatest need has the potential to improve both patient outcomes and reduce direct healthcare expenditure quickly.”