Skip to main content

The future of health

Discover how Bath researchers are finding new ways to tackle global health challenges.

Health is a concern that touches all our lives – whether we’re suffering from an illness or simply hoping to keep our bodies in top condition.

In the UK, one in two of us will be diagnosed with cancer at some point in our lifetime; an estimated 1.13 billion people worldwide have high blood pressure; and 463 million people worldwide are estimated to be living with diabetes. With the average age of the global population on the rise, our health is more important than ever before.

It’s also an area that invites innovative research, whether that’s using 3D printers to create orthopaedic implants or looking inside cells to work out what’s going wrong. Read on to find out about how researchers from across the University are helping to shape the future of health, from cancer treatment through to personally tailored surgical techniques.

3D printing parts for knee surgery

Osteoarthritis is the most common type of arthritis, with the knee joint often affected.

Line drawing of human knee anatomy

Currently the main treatment is a knee replacement, but this is only available to those with end-stage disease – meaning sufferers face up to 20 years of pain and impaired mobility.

The need for a replacement can be delayed by a high tibial osteotomy (HTO), a procedure where a surgeon makes an incision into the shin bone to realign the joint then stabilises it with a metal plate. In their current form, HTOs are lengthy, complex procedures, and also carry a risk to structures such as ligaments within the knee.

TOKA – a new treatment created by Professor Richie Gill from our Department of Mechanical Engineering and Centre for Therapeutic Innovation and ORTHOSCAPE, a medtech company based at the University's Innovation Centre – aims to change this. It uses CT scans to create a computerised 3D model of the patient’s anatomy, which acts as a digital guide for the procedure. Crucially, it’s also used to design and 3D-print a plate that precisely fits the recipient.

This tailored technology has been tested on 25 patients at the Rizzoli Orthopaedic Centre in Bologna, Italy, with incredibly promising results. “The doctors have said that the surgery is much better,” Richie explains. “The alignment they achieve is excellent, they can do the surgery in less than 30 minutes and, most importantly, all the patients have recovered quickly.”

The project is about to enter a randomised clinical trial in the UK, and the team are hopeful that TOKA will be widely available in the next few years. “The Italian patients all now, within six months of their surgery, want their other knee done with the same technology,” says Richie. “That’s a remarkable result, because the pain of the recent surgery usually makes people wait at least a year before considering further operations!”

Optimising your caffeine fix

If a cup of coffee is the first thing you reach for when you roll out of bed, you’re not alone. However, according to our experts, you’re not doing your metabolism any favours.

Research overseen by Professor James Betts from our Centre for Nutrition, Exercise & Metabolism compared blood sugar levels of three groups of participants. The control group had a normal night’s sleep followed by breakfast; a second had broken sleep and then breakfast; and a third also had a bad night’s sleep but were given a cup of strong black coffee 30 minutes before their breakfast. Glucose levels in the latter group spiked by around 50%.

“Put simply, our blood sugar control is impaired when the first thing our bodies come into contact with is coffee, especially after a night of disrupted sleep,” explains James. “We might improve this by eating first and then drinking coffee later if we feel we still need it. Knowing this can have important health benefits for us all.”

Line drawing of a moka pot and coffee berries

Skin cancer treatments with fewer side effects

Non-melanoma skin cancers are one of the most common cancers, and cases have rocketed since the 1990s.

They originate when DNA in stem cells of the epidermis – the outermost, protective layer of the skin – is damaged by the Sun’s radiation. Stem cells create copies of themselves through cell division, but also replenish mature cells as they die off. Issues arise when the balance between these two processes goes awry and stem cells divide more often than they should.

“Most of the work in our cells is done by proteins, and the instructions for how to make proteins come from genes,” says Dr Gernot Walko from the Department of Biology and Biochemistry and Cancer Research at Bath. “The process by which the information in a gene is turned into a functional protein is called gene expression. Only a fraction of the genes in a cell are expressed at any one time.”

He continues: “YAP/TAZ work in the cell’s nucleus, where they interact with many other proteins to promote the expression of genes that allow cells to divide. The problem comes when YAP/ TAZ are more active than they should be, enabling normal cells to become cancer cells.”

Gernot’s team – including PhD scholar Jodie Bojko, who is supported by alumnus Raoul Hughes (BSc Business Administration 1987) and his wife Catherine – are working on identifying the proteins that interact with YAP/TAZ specifically in cancer cells to cause this harmful overactivity. He continues: “We hope to identify proteins where drugs already exist or are in development, which can be used to treat YAP/ TAZ-driven tumours.”

Targeting these proteins rather than YAP/TAZ directly also means that their normal function of repairing and renewing the skin won’t be inhibited. These treatments could offer hope for a cure for various YAP/TAZ-driven cancers that avoids many of the unpleasant side effects of current therapies.

Timing is everything

From speeding up Spice identification to keeping chemotherapy running on schedule.

Use of the human-made street drug Spice has risen steeply in recent years – particularly among homeless people and in prisons. It’s also potentially deadly, causing psychosis, seizures and even strokes.

At present, testing for Spice takes days, which makes treating overdoses particularly difficult. “There is no way of knowing if Spice has been taken if someone presents with psychosis or intoxication symptoms that could also be due to other reasons,” says Dr Chris Pudney from our Department of Biology & Biochemistry.

Chris and his team are working to create a machine that uses saliva samples to give results in just five minutes. They developed a successful prototype in 2019 and were recently awarded a research grant of £1.3 million to turn this into a portable device – which they hope will be in use in just a few years’ time. Chris is positive about the impact that on-the-spot Spice testing will have: “Our ultimate aim is to save both money and lives.”

“Chemotherapy day units operate with extremely limited resources and under tight schedules, so the design of that schedule is crucial for the most efficient use of resources,” explains Dr Melih Çelik from our School of Management.

His team compared the actual running times for over 200 patients’ drug infusions to the estimates used by doctors when setting the schedules. They found that the two often failed to match up, with shorter infusion durations being underestimated, and longer ones being overestimated.

“To overcome the inefficiencies in patient appointment scheduling due to this mismatch, we built a simpler approach that provides ‘near-best’ schedules in only a few minutes,” adds Melih. The result is an algorithm that improves patient waiting times by 80% and reduces nurse overtime by over 30% compared to current practice.

Pacemakers that listen to your breathing

Of course, you know that exercise affects your heart rate, but did you know that even breathing has an impact?

Line drawing of human lungs

When you inhale, your heart beats slightly faster, slowing down again when you exhale. However, conventional pacemakers keep the heart beating at a fixed rate.

Professor Alain Nogaret from our Department of Physics is using artificial nerve cells – otherwise known as neurons – to create a ‘smart’ bionic pacemaker, which will help the heart to beat in a more natural rhythm by listening to signals from the body. This will enable the cardiac muscle to work more efficiently, addressing the symptoms of heart failure.

The artificial neurons are created by studying the signals sent by nerve cells in the brain. These parameters are then programmed to a silicon chip, which will replicate what nerve cells do naturally. “This allows us to resynchronise the heart rate to biological rhythms – in particular to respiration and blood pressure, but also oxygen and carbon dioxide concentration in the blood,” says Alain. “As a result, the heart saves energy and as it works more efficiently it is able to repair itself.”

Amazingly, the pacemaker has been shown in the lab to improve cardiac output by 17%, and to actually reverse the decay of cells in the heart muscle, says Alain. This is particularly promising because there is currently no cure available for heart failure, a condition that can ultimately prove fatal. Human studies are set to take place later this year in New Zealand. Alain continues: “We have proven the principle and, beyond any doubt, that restoring heart natural rate variability has major benefits for heart failure.”

Targeting the causes of Parkinson's

Tragically, around 10 million cases of dementia are diagnosed worldwide each year.

A team led by Professor Jody Mason from our Department of Biology & Biochemistry have discovered a series of protein structures that are highly relevant to the onset of Parkinson’s disease.

The protein – alpha-synuclein (αS) – is abundant in all human brains, and the scientists are examining how they can form toxic deposits. These kill cells, causing dementia symptoms – and preventing their formation could help to keep brain cells healthier for longer. “Sometimes, when these proteins are produced, instead of getting to the right structure, they go rogue, ’misfolding’ and ending up in the wrong place,” says Jody. “Rather like plates stacking, they grow into very long toxic chains, which we call αS fibres.”

He is carrying out research to identify proteins that can bind to αS and prevent this toxic misfolding from occurring. The team are doing so by introducing millions of peptides – microscopic proteins just 10 amino acids (the building block of proteins) long – to αS inside living cells, and observing whether fibres form. This will also allow them to check if the peptides kill off cells – an obviously undesirable side effect.

“We’ve also been making step by step changes to the amino acids within the peptides; this involves going through the molecule to establish which of the 10 amino acids are talking to the target,” Jody explains. “If you can do that, then you can start to rationally design the peptide’s sequence to make it more effective and drug-like.” It’s hoped that this research will lead to future treatments for a disease that currently has no cure.

Using liver cells to cure diabetes

Type I diabetes is an autoimmune disease where the body destroys the insulin-producing beta cells found in the pancreas. In some cases, it can be cured by a transplant of beta cells, but a shortage of organ donors is a major hurdle.

Sebastian Wild, a Biochemistry PhD student in the Centre for Therapeutic Innovation, is aiming to address this by developing a method of converting liver cells – which are plentiful, as the liver can regenerate – into pancreatic beta cells.

Sebastian, whose studentship is supported by alumnus Nick Hynes (Executive MBA 1991), says: “It is a privilege to work on a project with such a clear medical application and obvious benefit to people’s lives.”

Line drawing of a human liver

Giving feeling back to amputees

While advances in prostheses have changed the lives of thousands of individuals with limb differences, they still do not yet relay sensory information to the user.

Without that sensation of touch, how can you tell how much pressure you’re exerting or how tightly you need to grip something? This challenge in prothesis development leaves many users frustrated, relying on their remaining limb and risking painful ‘overuse syndrome’.

Using electrical currents to stimulate nerves can produce a ‘feeling’ that is perceived as originating from the prosthesis, but so far, the method requires electrodes to be implanted into the arm. Not only is this invasive – and has the potential for infection – it also means that users aren’t able to test out the system before committing to it.

Electrical & Electronic Engineering PhD student Leen Jabban is developing a non-invasive system by attaching electrodes to the skin around the arm to target specific nerves. So far, she has achieved sensation in the ‘hand’ through electrical currents to the forearm, and is working on localising the stimulation.

“I aim to create a simple, cheap system that a user could fit themselves,” says Leen, whose scholarship is supported by alumnus Eur Ing Dr Brian Nicholson QC (PhD Electrical & Electronic Engineering 1998; Hon DEng 2018), Tony Best (Hon DEng 2013), and the Esther Parkin Trust. She is also the recipient of an Alumni Fund grant. “I’d like my research to be available to as many people as possible, so even those in the remotest parts of the world can access technology to help them live easier and healthier lives.”

Support research at Bath

Make a donation today

This article was written by Emma Davies for BA2 Issue 29, published in September 2021.