Category: Emma Kampouraki

By Emma Kampouraki

The ICM (Institute of Cellular Medicine) Christmas meeting took place last Monday, 18th December 2017 and was a great success indeed, more than any other Christmas meeting in these three years I have been around. What made it a success? The Christmas quiz of course!!! ICM staff had organised a great quiz for the festive period of Christmas with lots of questions and activities. They included photos of celebrities dressed like Santa, questions about Christmas traditions (some of which I had no clue about), Christmas movies, Christmas songs, an activity with logos and lots of nibbles and mulled wine.

This was the exact time I realised how much this whole quiz experience resembled my experience in science during the PhD. First of all, the idea of taking part in a quiz for some reason creates an unprecedented excitement. It drives you to the point where you try to remember previous quizzes you’ve participated in and predict the questions you’ll have to face in this one. It never works like that – admit it – but there is always a hope. At this very point, it reminds me of something…

And then the next stage comes… Teams formed, seated in circles, starting conspiring and ready to fight! It’s really like a race and the team with the most Christmas fans is meant to win. Slides and projector are sorted, questions start to appear one by one and we all look each other deep in the eyes, trying to guess who knows what. This is when you start having those thoughts that you don’t know anything and you should probably commit suicide for not remembering this and that, which are all so simple and easy otherwise. Ah, it reminds me of something…

But the thrill is about to begin when you know this detail from that popular movie and you are sure like hell, because you actually watched the movie, as tradition wants, last weekend.  You know you can’t scream but you know that you know it and all you can celebrate with is the mulled wine. You announce the answer with the speed of light and then glasses up and a big sip of well-deserved wine goes down, as waves of happiness flow inside you. It truly reminded me of something…

Nevertheless, it has its downs too, when you have absolutely no clue about what the question is about. When you don’t know the answer and it matters; that kind of thing. You are pissed with everyone, but can’t change much (no, phones ARE forbidden!) so you have to live with the loss. Yeah, I know, it hurts. And guess what; it reminds me of something once again.

You know what it reminds me of. It’s my PhD, your PhD, everyone’s PhD that has its successes and its difficulties, like all situations in life. You might ask why it reminds me of that and not anything else in life, right? Well, if you are “sailing” towards a PhD yourself, you know exactly how things get magnified during this era of your life. If not, “don’t try this at home” (just kidding!). If not, at least you know the sadness of not winning the chocolates at the end of the quiz as well as the absolute madness when you actually end up winning and you feel like hero.

For the sake of my story, my team won this quiz and we got the delicious choco candies. Let’s see what happens with my PhD now…

By Emma Kampouraki

Professor Sir John Burn has been appointed the new chairman of the Newcastle upon Tyne NHS Trust a week ago. Immediately after reading the news, I felt that great satisfaction flowing inside me, like I’ve always wanted to see this happening. Then, I remembered. The first day I met him after an honorary lecture he gave in a meeting. I was impressed!

I have met loads of successful people so far in my life. And I consider myself lucky for that. I always take some time to observe them before I talk to them. While introducing myself, I look them deeply in the eyes and try to understand what they might be thinking. However, I’ve never managed to read their minds as they end up saying exactly the opposite to what I was thinking.

I’ve spent a few hours trying to understand what makes them so successful and influential at the same time. I know their secret now; among being clever and hardworking and lots of others, they also have good “people” skills!

Communication
This may be the biggest asset in someone’s life, both personal and professional. Studies show that when a person is speaking, over half of what people understand is coming from body language and particularly the expressions of the face. Another 40% or so comes from voice and tone, with the actual words falling under the remaining one tenth. Without wanting to underestimate words, the picture always counted more anyway. And the picture we are making, while smiling, speaking passionately or transmitting our best energy to the audience is what impresses and convinces people about the real truth. Successful people have a unique way of communication; full of experience, knowledge and expertise without pretending to be robots and forgetting to be humans.

Trust
In order to convince your audience, you definitely need to present your logic and data upon which you based your conclusions. Or, you can simply allow your audience to trust you. Those two are linked, of course, but the latter required a lot more effort. Trust is something we achieve, it’s never given for free. It’s always connected to sincere people that present facts as objectively as possible and never fall under promises they can’t keep. If you say, it’s worth the money I’ll spend on it, you have to prove me wrong when I say I am not paying. Or vice versa.

Patience
People make mistakes. Those who know that, also know that mistakes, excluding only but a few, can be reversible one way or another. As always, you need time to assess what is right or wrong though. And this is where patience fits. All you have to do is concentrate, think clearly, act slowly and give it some time to “cook”. Like you do with your delicious cake. Or employees. Or PhD students.

Empathy
This is the last, but maybe the most important. It defines the connection you cultivate with the people that surround you. Empathy can be demonstrated when you show pure interest in others’ lives. For that, you can be as open-minded as it takes. A detail from a conversation you had last week, that concert ticket they wanted and you found it, the name of their pet or even the last time they said they needed your help. (Try not to freak them out with the last time they popped into the loo.) These little moments are all important to them, as it is your children for you. They show you care.

I hope it’s clearer now what the title was about. People skills make us inspiring. Success is mainly demonstrated by loving your whole life as it is today. Don’t forget to be human, kind and have a bit of humour as well. It might not be necessary, but it helps making each and every day special.

By Emma Kampouraki

Research has been constantly criticised in recent years. It seems rather odd that while increasing efforts have been made to upgrade the regulatory framework as well as the level of research, we are facing more than ever research outputs and publications of low quality or even results of trials that still remain unpublished. However, there are some simple steps that could improve the published research outputs.

1. Reducing publication bias
First and foremost, research results, positive or negative, should be published without reservation. I often hear early-career scientists complaining about being constantly rejected by journals for their negative results that lack significance. Rarely will I find a well-known researcher publishing studies that failed to prove the hypothesis. Whole books have indeed been written about the publication bias.
Equally, protocols that failed because of not easily predictable parameters should also be reported so that similar attempts are avoided. One reason for this is failure to critically assess the prior literature and another is the unspecified statistical assumptions in the analysis of studies. A statistician should be consulted to calculate sample sizes that are required for the target power of study and to set the relevant assumptions from the beginning.
Negative results and unsuccessful protocols should be seen as equally important and we should always allow them to influence our decisions to conduct further research based on previous failed attempts, the same way as positive results urge further study.

2. Maintaining transparency in research publishing
Peer-review is powerful precisely because it is made by peers; scientists that know how to recognise high-quality research and well documented research results. Most journals today publish work that has been peer-reviewed by at least two reviewers. Selecting a journal in which low quality studies with obvious pitfalls have been published is all but good practice.
Moreover, transparency is well maintained when study protocols and data analysis plans are published well in advance. These should be in accordance with the published results when the study is completed and any reasons for deviation from the initial plan should be well justified. Most researchers should be happy to make the complete set of data publicly available, for the purposes of not only transparency but also meta-analyses. Study funders should grant access to detailed clinical data in response to legitimate requests from both researchers and regulators. These data-sharing initiatives are increasing more and more lately and should be supported.

3. Clinical trial results
Randomised clinical trials are a special category, as they are considered the gold standard in biomedical research. In reality, not all questions are answered with a clinical trial that includes an intervention. Observational studies are very powerful especially when they are well designed and bias is reduced. It is required by law that all trial protocols are pre-published at clinicaltrials.gov. Other details such as recruitment goals, data analysis plan and sources of funding are recorded as well. Funders and researchers should stick to their commitment to publish the (positive or negative) results within a timeframe after completion to inform next steps that might already be in progress (e.g. research funding applications for similar study).

4. Systematic reviews
Last but not least, systematic reviews are an incredibly powerful tool to assess the quality of existing evidence and identify gaps in current knowledge. Every large trial should be supported by a systematic review that justify its planning and of course its cost. Otherwise, there is a great risk that the particular study may not add much to the problem and therefore it won’t be cost-effective. Systematic reviews should be reproducible, peer-reviewed and according to the Cochrane standards.

Each and every new generation of researchers should feel the responsibility to maintain the quality of research that the scientific community demands. It is now more essential than ever that we provide powerful and undoubtable evidence simply because we rely a lot on it to make informed decisions in clinical practice and patient management. We are all involved so we should care!

By Emma Kampouraki

Differences in the genetic material we carry make us who we are. Individual variability is important when prescribing drugs, as we can now genotype a person in less than a few hours. We can then use this information to inform drug prescription. Genotype-informed prescription is more than virtual reality nowadays. Both FDA (US Food and Drug Administration) and EMA (European Medicines Agency) recommend the use of genetic information to drive the decision of treatment and prevent patients from serious mistakes in the prescription of “useless” drugs. Although ethical concerns don’t facilitate the establishment of genotyping in clinical practice, it is common sense that it is also unethical not to use all the existing data for a more informed and safe process of drug therapy. Trial and error is still in place in most drug schemes, however moving on to a more individualised approach has the advantages of costing less and resulting in more effective treatments, increasing patient satisfaction and compliance at the same time.

The first FDA-approved genetically-guided therapy was for the treatment of HER2 (human epidermal growth factor) positive metastatic breast cancers in 1998. The case of trastuzumab (Herceptin®) paved the way for the co-development of gene-based therapies with tests to detect the drug targets, in order to identify the right therapies for the right patients. Simultaneously with the approval of trastuzumab, a laboratory technique for detection of HER2 protein overexpression in breast cancer cells (Dako North America, Inc. for HercepTest).

Later, the cases of olaparib (Lynparza®) and rucaparib (Rubraca®) prove the increasing need for more targeted therapies and the outstanding interest of medicines regulatory agencies to cover this need as soon as possible. Recent findings show that tumours rely on poly (ADP-ribose) polymerase (PARP)-mediated DNA repair for their survival. Both olaparib and rucaparib are inhibitors of the PARP enzymes responsible for DNA damage repair. In 2014, olaparib was the first drug in its category to be approved for ovarian cancer with mutations in BRCA gene, with only mild to moderate adverse effects to date. In fact, the clinical trial data that convinced the EMA in 2014 for the efficacy of olaparib were not as convincing for the FDA for various reasons. A few months later, olaparib was granted approval in the US. Further testing on humans confirmed the increased progression-free survival for patients with BRCA mutations on olaparib. Two years later, in 2016, rucaparib became the second drug with accelerated approval for treatment of patients with BRCA mutations. In addition, the need for a reliable genetic test to identify patients eligible to receive the treatment was also covered by the FDA. The FoundationFocus CDxBRCA test is the first FDA-approved next-generation sequencing (NGS)-based companion diagnostic, which detects alterations in BRCA genes in the tumour tissue of ovarian cancer patients.

Between the two decades of cancer treatment genotype-based approvals, the first oral anticoagulant warfarin, used for the prevention and treatment of strokes, thrombosis and atrial fibrillation among others, was shown to be influenced by genetic variation, as well. Genetic testing prior to prescription along with genotype-guided dosing of warfarin was recommended, changing the way we perceive drug dosing. Warfarin is one of the most commonly prescribed drugs, with more than 2 million people are treated with warfarin every year in the US, hence the importance of such advancement is great, as it affects the clinical management of millions of people worldwide.

The list of drugs that receive approval and are specifically designed for variant genotypic characteristics is fast growing. It is our responsibility to educate health professionals and most of all patients. Now, more than ever, we need to find the best way to use and protect genetic information, while at the same time proving its power to change clinical practice forever.

By Emma Kampouraki

Obesity, dwarfism and intellectual disability. Can you guess what they have in common? I couldn’t either before the 17th May when “pint of science” brought all three topics in one evening and explained “how genes run and ruin our lives”. Three local scientists, mainly PhD students, gave three wonderful presentations explaining the interaction between genetics and environment in the context of various diseases. Diseases we still struggle to fight in the 21st century.

Obesity, a modern pandemic, is the result of multiple factors such as exercise, quality of mitochondria, DNA mutations in mitochondria, nuclear DNA mutations and diet. Various myths around obesity and weight loss were refuted, starting from calorie-restricted diets that stress the cells and end up in the accumulation of fat instead of weight loss. Mitochondria are the energy-producing organelles of our cells. We inherit our mother’s mitochondria and therefore any mutations she carries are very likely to be passed on to the offspring. This is the idea behind three-parent babies, so that mitochondrial dysfunctions, such as the ones causing obesity, are not passed on to the next generations. Another factor is the problematic communication between nuclear and mitochondrial DNA that collaborate for the production of energy. Finally, exercise is important to maintain energy balance but is not enough to compensate for the genetic predisposition that obese people might have.

The second talk was related to people with deformities, such as hip dysplasia and osteoarthritis caused by dwarfism. The latter is a very rare disease and it‘s hard to study in humans therefore scientists use mice. Two mutations are responsible for funny-shaped proteins, stressed cells and skeletal abnormalities, however the main observation is their difference in autophagy activity. Autophagy is the mechanism for controlled cell death when the cells cannot get rid of defective proteins. This study is ongoing at the moment, but it helped us gain some insight in mechanisms that are involved in many physiological functions and when disrupted they have detrimental effects on development.

At the end, the almost exclusively female audience really enjoyed the talk titled “Should we mate with old men?”. In this talk, we explored the importance of age of both men and women in reproduction. The prevalence of Down syndrome increases exponentially when the mother is older than 45-50 years old. However, paternal age is also a risk factor for intellectual disability, with men passing one more mutation for every year older (i.e. 40 mutations at the age of 40). Freezing sperm is popular in the media nowadays, but we are not there yet. It is unknown why the consequence of mating with old men is intellectual disability, but it is possibly because brain function depends on numerous genes therefore there is a higher chance that it will be affected.

As you may have realised already, “pint of science” is an annual celebration of scientific development, with scientists organising informative sessions that aim to give the public a better understanding of the human body and resolve its mysteries with evidence. Join us next year to find more about the wonderful world of science!