Medicine Southampton by University of Southampton

UNCOVERING OUR DNA Medicine, University of Southampton Our building blocks We set out over 50 years ago on a path to be a truly unique medical school – great minds do not think alike

Our today Every day somewhere on the planet, someone wakes up and embraces a new day, thanks to our work

Our tomorrow Our people are leading and inspiring the next generation, so more people can live healthier, better lives

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Why we get up each day “I feel intensely loyal to Southampton, as it gave me the opportunity to take a medical degree with no science credentials whatsoever. I came back to do my PhD and have had a career in medicine ever since. I have never regretted it for one second. “I am inspired by the fact that the country needs doctors and there are young people out there that are desperate to join the medical profession. “We get talented, enthusiastic, passionate young people coming in to Southampton Medical School, and I want to allow that passion and enthusiasm to flourish, so that they join the medical profession knowing exactly what they are going into, how they can contribute, and how they can innovate, drive it forwards and be the leaders of the future. I want them to feel that the medical curriculum in Southampton has empowered them to do that.” Dr Jane Wilkinson Associate Dean for Education BM 1989, PhD 1998 University of Southampton Graduate

CONTENTS

The building blocks of a unique medical school

Dealing with the difficult questions

We set out over 50 years ago on a path to be a truly unique medical school

Professor Diana Eccles talks about leading the Medical School through a pandemic and beyond

14 Our expertise changes lives Southampton medical research is changing the world for the better

Care starts with us Caring for our medical family

Nurturing next-generation researchers

Playing to our strengths Protecting frontline staff from COVID-19

Our building blocks

THE BUILDING BLOCKS OF A UNIQUE MEDICAL SCHOOL 1971 Southampton Medical School was opened by Health Secretary Sir Keith Joseph on the recommendation of the Royal Commission on Medical Education. There were 40 students in the first cohort.

1985 Professor of Human Genetics Pat Jacobs was appointed Director of the Wessex Regional Genetics Laboratory that leads genetics and genomics testing across South Central England.

2001 The Southampton Clinical Research Facility - an innovative partnership between the University and University Hospitals Southampton NHS Foundation Trust - was established. The centre takes the latest research from bench to bedside.

1989 Professor Stephen Holgate and colleagues were the first to use fibre-optic bronchoscopy to demonstrate the cellular mechanisms in asthma.

1986 Professor David Barker discovered the relationship between birth weight and a lifetime risk of chronic diseases, stimulating worldwide research into the effect of nutrition and growth in development on adult disease.

2002 Southampton’s pioneering BM6 widening participation programme was launched to increase access to medical education for students who have not previously had the opportunity to fulfil their academic potential.

2021 50th Anniversary of Southampton Medical School

2006 Research by the MRC Epidemiology Resource Centre revealed maternal vitamin D deficiency in pregnancy is linked with poor bone health in children. 2018 Southampton’s Centre for Cancer Immunology – the UK’s first centre dedicated to cancer immunology research – opened its doors. It brings together worldleading scientists to explore this exciting and promising area of cancer research.

2003 Spin-out company Synairgen was founded to drive forward Southampton research into developing novel therapies for respiratory disease. Synairgen became Synairgen plc when it floated on the AIM in 2004.

2003 Professor Cyrus Cooper was appointed Director of the MRC Epidemiology Resource Centre that leads research into the developmental origins of chronic disease.

See more about the work of the Centre for Cancer Immunology on page 12

Our building blocks

GREAT MINDS DO NOT THINK ALIKE “The creation of a new curriculum designed to meet the needs of medical practice for the rest of the century and beyond was perhaps our greatest challenge and our greatest opportunity. It was clear that tinkering with existing timetables would not make sufficient change: something more fundamental was needed.” Professor Jack Howell Dean of Medicine, 1978 Foundation Professor of Medicine

We were different from day one

Leading the way in best practice

In 1971, 40 young men and women arrived at the University of Southampton’s new medical school to begin a brand-new degree course. Their arrival was the culmination of several years of planning, preparation and hard work by a team of pioneering academics and clinicians whose innovations would eventually change the landscape of UK medical education.

Despite far-reaching changes in the external environment, Southampton has remained true to the principles of innovative medical education. We continue to instil the necessary understanding of the medical and behavioural sciences to underpin a sound grounding in clinical skills and an awareness of social and preventive medicine. These principles have been widely adopted and form the basis of best practice in medical education globally. In addition, these principles have informed Southampton’s approach to innovations in scientific training, including the individual research project for medical students, the four-year integrated biomedical PhD programme and the establishment of a Postdoctoral Association to nurture research careers in the biomedical and life sciences.

Changing the medical profession by thinking differently Dean Professor Donald Acheson rewrote the rule book for medical training, for example, patient contact came early, and still does at Southampton. “Thanks to the recruitment of an inspired team of colleagues, and improvisation on a grand scale, we were not only able to reach our target class size of 130 students by 1976, but also to achieve a formidable series of educational innovations.” Sir Donald Acheson Foundation Dean, 1968

Find out more: www.southampton.ac.uk/medicine/research

CHANGING THE WAY WE THINK Southampton research is having a significant impact on the fight to prevent and reduce infection around the world. From influencing national guidelines, to trialling novel vaccines, we are driving forward solutions to one of the greatest challenges facing society. Our academics have a long history of working with clinical colleagues and industry to explore ways to reduce the impact of infection and improve the life of millions of people, and never was this more important than now, during the global COVID-19 pandemic. Key areas where our work is internationally recognised include: Developing and trialling vaccinations We are a major centre for investigating the use of vaccines. We carry out large clinical trials, ‘first-in-human’ trials, human challenge trials and we explore the epidemiology of infection. The first trials of the AstraZeneca COVID-19 vaccine were predominantly carried out in Southampton, and we are now leading a range of COVID-19 vaccine trials including new dose schedules and patient groups for the licenced vaccines, and early stage trials of novel vaccines. As well as COVID-19, our trials in meningitis are noted worldwide.

Human challenge trials use controlled infections to examine how humans respond to the infections and how vaccines can be directed to prevent them. These trials also investigate how infectious diseases develop and how we can stop that spread. We did the world’s first human challenge with the whooping cough bacteria and we proved that whooping cough is a worldwide problem, which is probably much more common than thought. Our researchers are exploring the epidemiology of infection, looking at bugs that are infecting the population and trying to spot patterns so that vaccines can be targeted much better in conditions such as: chlamydia, sore throat and pneumonia. We are also investigating hepatitis C and tuberculosis to establish new ways of treating them and using vaccines to prevent them. Antimicrobial resistance For the past 25 years our researchers have been at the international forefront exploring alternative strategies to prescribing antibiotics.

Our work is already having an impact, including: Ò NICE adopting our recommendations into their national guidelines for doctors to ‘wait and see’ before prescribing antibiotics. Ò Demonstrating controlled human infection with genetically modified commensals can induce effective immunity against meningitis. Ò Our work with colleagues in physics, optoelectronics and electronic engineering investigating new systems for rapidly diagnosing infectious diseases that allow doctors to make very accurate diagnoses and target infections more efficiently. Ò Developing near-patient tests, such as throat swabs and finger-print blood tests, that can show if bacteria are present. Ò Developing a score-predictor test – FEVERPAIN – that has been adopted into NICE guidelines, to assess whether a patient is likely to benefit from antibiotics or not. Ò Providing better symptom relief through the use of non-antibiotic therapies. Ò Preventing infection by using digital interventions to alter behaviour. Ò Investigating the use of ultrasound to rapidly clean rooms and instruments to prevent infection and reduce antimicrobial resistance.

They have led tests and trials into delayed prescribing, near patient tests, prevention of infection and use of herbal medicine for symptom relief.

Our today

DEALING WITH THE DIFFICULT QUESTIONS Diana’s first 18 months as Dean of Medicine were a rollercoaster ride, then just as things were settling down COVID-19 hit and she had to respond rapidly, working with staff and students, colleagues across the University, the City of Southampton, University Hospital Southampton and industry to steer a course through a global pandemic. Here she shares her passion for medicine, her drive for the future and her vision for Medicine at Southampton.

“It is good to challenge yourself. The first 18 months were a bit like taking off in a plane, it was a steep learning curve...” 8

How did you get into medicine? I have wanted to be a doctor since I was about eight-years-old, I didn’t have any doctor relatives or role models, but like many aspiring doctors, I wanted to help people. I have never regretted it for a moment. I joined Manchester Medical School, coincidently at the same time as Southampton Medical School was being established. Why did you come to Southampton? I was specialising in oncology in Edinburgh and had spent a few years looking after young people with end stage cancer. This inspired me to explore research into inherited cancer risk with potential to prevent cancer. This took me into the new field of cancer genetics. It was while I was at a national genetics conference that I met clinicians and scientists from Southampton. They told me about a research job in cancer genetics, I applied and not long afterwards I moved to Southampton.

Over the next 12 years, Diana was at the clinical edge of delivering discoveries in cancer genetics, working as an NHS consultant, and maintaining a strong research profile. Then in 2004, she transferred to the University of Southampton, led the Clinical Trials Unit from 2009, became Head of Cancer Sciences five years later, and now Dean of Medicine in 2018. How have you found your first few years as Dean? The first 18 months were a bit like taking off in a plane. It was a steep learning curve, but it started levelling out just as COVID-19 hit. Everybody was learning at the same time, none of us had experienced anything like it before. We already had great networks with the hospital, industry and across the University, and COVID-19 has cemented these relationships and epitomised our role as a Civic University. We were able to rapidly refocus our research and adapt our education.

What keeps you at Southampton? Medicine at Southampton has a rich history and tradition. From conception, it was a really innovative medical school pioneering the early clinical contact adopted by many other medical schools, and it has continued to have that pioneering ethos through its research led education. We are proud of the exemplary “pluripotent” doctors we produce, ready to take on whatever role in medicine they choose. What gets you up in the morning? It is the people and the possibilities that inspire me to come to work every morning. I believe that together we can enable Southampton to continue as one of the most innovative medical schools in the world. We are already impacting on healthcare nationally and globally. We have the first dedicated Centre for Cancer Immunology research, one of the best genomic centres in the UK and we are carrying out groundbreaking work into antibiotic resistance. We are also leading

“It is the people and the possibilities that inspire me to come to work every morning. I believe that together we can enable Southampton to continue as one of the most innovative medical schools in the world.” research into novel approaches to prevention and treatments for cancer, respiratory diseases, blindness, musculoskeletal disease and Alzheimers. What is your vision for the future? Our students are the future of medical care, they will be working in ways that are completely different to how we worked, and our training needs to reflect this future for them. Key to our education is the strong partnership with our colleagues in hospital trusts and community

Find out more: www.southampton.ac.uk/med-dean

settings and great opportunities for our students working with our exceptional research teams. Southampton is renowned for its interdisciplinary research and Medicine is at the core of this ethos. Strengthening this collaborative working is vital if we are to meet future healthcare challenges. We have to effectively and efficiently support our researchers’ and educators’ work to improve their ability to deliver fantastic healthcare innovation for the future. How are you preparing your students to be part of that future? We ensure our students are well-rounded, resilient individuals, able to deal with the rewarding but demanding job of being a doctor. We provide pastoral care that is highly valued by our students, preparing them to work in what can often be a stressful environment, but also make sure they can seek out support when they need it. To be able to care for their patients, they need to be able to look after themselves.

Our Pagetoday title

KATE GEOGHEGAN’S BM5 JOURNEY

Accepted I was so elated and excited to be offered a place. My experience I loved the community I built at Southampton, I made wonderful friends both on and off my course, and the societies I joined and helped run made me feel a real part of the University. Lows The degree was hard and at times isolating, but I had so much love and support from my friends and colleagues. I also knew that as much as I loved medicine, I was more than just my degree. We gain a lot from failures as well as successes. Graduation Because of the COVID-19 pandemic, my graduation wasn’t quite what I planned. I graduated early by email in April 2020 and the very next day I signed up to be an interim junior doctor and started working in the NHS.

My Interview I felt very welcome at my Southampton interview. The two doctors were genuinely interested in me and in the future I was working towards. Learning Southampton offers an integrated spiral curriculum which provides a range of different teaching styles and subjects. This is really important and reflects Medicine as a profession. Highs I met my greatest friends at Southampton, loved going on my medical placements and felt such a sense of community with my fellow medical students. I’m a doctor Throughout my time at medical school I grew into a confident, kind doctor. Starting work as a junior doctor was always going to be scary but COVID-19 made it even more daunting. However, I am working with a fantastic, supportive team, and the focus Southampton put on communication skills and challenging parts of medicine has been really helpful.

CARE STARTS WITH US You are patient zero. At Southampton, we care about our medical family first - our students. To ensure that they can progress into the world of work and do their best for their patients.

Temi Alawoya - BM6 Temitayo Alawoya had always wanted to go into medicine and signed up to Southampton’s BM6 widening participation programme because it included a foundation year. The flexibility of the course allowed her to juggle her studies, her job as a healthcare assistant and her training as a pole vaulter in the GB junior squad. She said: “It was amazing. The benefits of the BM6 course are financial, emotional and educational support amongst other things. BM6 has a small cohort where you can build connections easily, you are more than just another student in a packed lecture hall as your lecturers will know you by name.

Find out more: www.southampton.ac.uk/medicine

Lissie Rolf – MSc Genomic Medicine

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Lissie Rolf’s MSc in Genomic Medicine helped her get her longed-for job on the Scientist Training Programme.

Postgraduate research students

Working in a molecular pathology laboratory, Lissie had twice applied but failed to get on the programme, but after gaining her MSc she was delighted to be accepted on her third attempt.

Postgraduate taught students

278 30% University of Southampton students are from outside of the UK

“The knowledge and experience I gained from my MSc definitely helped me improve my application, and I am convinced it was down to having the extra experience from my MSc.

“Now that I have finished medical school, I can confirm the BM6 family - built back in 2014 when I started medicine - is still very much a family now. I am both proud and honoured to have been part of the BM6 programme.”

“I chose the MSc in Genomic Medicine as I wanted to learn more about how genomic medicine could be used in patient care. It was inspiring to see the wide-reaching applications of genomic medicine including research, patient care and public health.

Temi is currently a doctor in the Midlands gaining extensive experience in various medical and surgical jobs. She has always wanted to become a neurosurgeon and believes her degree at Southampton should give her the first step on the path to reaching her goal.

“The high-quality teaching I received and the hands-on workshops gave me so much more confidence. In the future I would love to get onto the Higher Specialist Scientist Training Programme and become a consultant clinical scientist in the NHS.”

“At my interview I was really given the opportunity to talk. I felt the interviewers really cared about my character and who I am, not just about my grades.”

“The course content is delivered by inspirational academics who are passionate about the subject. It has the right balance of clinical experience, theory and research and I have learned knowledge and skills in all core areas of allergy and leadership.”

David Hendry BMBS (BM5), 2021

Ekaterina Khaleva MSc Allergy, 2019

Our today

HOPE IS NOT ENOUGH Meet Belle - the first patient to undergo an immunotherapy clinical trial at Southampton for neuroblastoma (a childhood cancer that affects the nerve cells). Two-year-old Belle Farnhill was celebrating her birthday in her grannie’s garden when her parents Jane and Chris noticed she wasn’t herself – not interested in playing with her friends, going on the bouncy castle or eating. Diagnosis Assuming she was coming down with something, they took her to the doctor’s and eventually to Poole Hospital where a chest x-ray showed a shadow on Belle’s lung. After a series of tests, Belle was diagnosed with the most aggressive form of neuroblastoma – neuroblastoma n-myc positive – which typically has a very poor prognosis as the tumour grows very quickly. Belle’s tumour was on her adrenal gland, just above the kidneys, taking up most of her abdomen and pushing on her organs. The cancer was at stage three/four and she was given just a 20 per cent chance of survival.

Pioneering immunotherapy trial Parents Jane and Chris were told about the possibility of Belle being the first patient in Southampton to go on a new immunotherapy trial*, which had just been set up to test whether a new antibody treatment - a form of immunotherapy - could offer improved outcomes for patients with neuroblastoma. It could give Belle the potential for a much better long-term prognosis and even the possibility of a cure. Chris said: “We were told that immunotherapy would basically run around Belle’s body and catch and destroy any of these escapee cancer cells, thereby reducing the chances of the cancer coming back. If there’s the chance you have missed even just one cell, it has to be worth doing. It’s amazing.” Jane added: “Chemotherapy is so harsh - it was terrifying to see. Immunotherapy was much gentler and easier for Belle to cope with.”

Life-saving treatment

Immunotherapy provided the family with vital hope: if the cancer should ever come back, the immune system’s memory would be programmed to produce the right antibody to destroy the cancer cells.

Belle underwent intensive treatment straight away, including five rounds of high-dosage chemotherapy and three weeks of radiotherapy. Thankfully, the treatment worked and the cancer went into remission, but Belle still needed multiple operations.

Belle’s prognosis improved with every step. Her check-ups became less and less frequent and now aged 11 she is still in full remission with the chances of the tumour coming back very low.

The chances of Belle’s tumour being completely cured were still very low, with a high chance of it growing back once the treatment had finished.

Jane said: “I feel proud to feel like we are part of the cancer immunology research at Southampton that the new Centre for Cancer Immunology will continue to progress. Cancer immunotherapy is such a massive breakthrough in the cancer world – it’s a huge thing to be part of.”

Find out more: www.southampton.ac.uk/youreit

Over £27 million Building on this unrivalled expertise, we have raised over £27m to open the country’s first dedicated Centre for Cancer Immunology.

* The trial that Belle was on was the European SIOPEN High Risk Neuroblastoma trial, set up to test whether a new antibody treatment, a form of immunotherapy, could help treat neuroblastoma. The antibody, which specifically targets the GD2 molecule on neuroblastoma, had already shown promise in another trial, and the trial that Belle took part in was looking to see whether the antibody was best given on its own, or with another type of immunotherapy, called IL-2. Belle was the first patient to be treated with the antibody on the trial in Southampton, led by Dr Juliet Gray.

“We are starting to see unprecedented success. Our new vaccines and antibodies direct special immune cells against cancers. These ‘killer’ cells can control and shrink cancer and give long-lasting protection.” Professor Peter Johnson Professor of Medical Oncology, University of Southampton; Chief Clinician, Cancer Research UK

Our today

OUR EXPERTISE CHANGES LIVES Southampton medical research is changing the world for the better, leading to novel treatments, improving the healthcare of millions of people, and enhancing the quality of life.

Developing treatment for Alzheimer’s Disease

Reducing the impact of malnutrition

Globally 50 million people have dementia and the World Health Organization predicts that will rise to 82 million people in 2030. Alzheimer’s Disease is the most common cause of dementia, affecting 20 per cent of people over the age of 80, and currently there are no modifying or preventative treatments for the disease.

Malnutrition affects more than three million people each year in the UK, with about 30 per cent of patients aged 65 and over who are admitted to hospital being malnourished or at risk of malnutrition.

Southampton research into using the immune system to combat Alzheimer’s Disease has changed the way the disease is perceived, the theories behind what causes it, and the development of new therapeutic approaches. It has led to the development of more than 30 novel immunotherapy approaches by the pharmaceutical industry.

“Our recent clinical research has shown that the development of new drugs can stimulate the immune system to ‘attack’ and clear amyloid plaques in the early stages of the disease, leading to improved brain function and slowing down the progression of Alzheimer’s Disease.” Professor Clive Holmes Professor of Biological Psychiatry

Research at Southampton has highlighted the impact of this economic burden, improved the identification and management of malnutrition, and developed volunteer-led interventions to address malnutrition among older people. We have developed a new tool – the Malnutrition Universal Screening Tool (MUST) – which is being used in more than 80 per cent of hospitals and care homes in England; saving millions of pounds for the NHS; and attracting significant international interest.

“The Southampton-validated MUST tool is now integral to the UK’s health policy framework and has been incorporated into NICE clinical guidance. It is commonly used by UK clinicians to screen more than 10,000 patients each month, and about 210 people every month are using an online version to screen themselves for malnutrition.” Professor Helen Roberts Professor of Medicine for Older People

Find out more: www.southampton.ac.uk/med-ref

Improving the treatment of eye disease

Breathing new life into the treatment of respiratory illnesses

Age-related macular degeneration (AMD) is the commonest cause of blindness in the elderly in the developed world. It usually affects central vision in people over the age of 55. The current main treatment in the UK is injections of ranibizumab or aflibercept - drugs which block the growth of the fragile blood vessels in the eye, however they cost circa £500 per patient, per injection.

Respiratory diseases kill one in four people in the UK and cost the NHS £2.6bn each year. According to Asthma UK, 5.2 million people receive treatment for asthma - with 500,000 suffering severe symptoms because available treatments cannot control the disease.

Southampton research is paving the way for the routine use of the more cost-effective bevacizumab to treat nearly 400,000 AMD patients in the UK every year. Bevacizumab has the same mechanism of action as ranibizumab but costs just £60 per patient, per injection - potentially saving the NHS about £500 million per year.

“The use of bevacizumab is changing practice in the UK and abroad and is also being used by the NHS for the first time to treat a rare, juvenile form of macular degeneration - Sorsby Fundus Dystrophy - to prevent these patients from going blind in their thirties and forties.” Professor Andrew Lotery Professor of Ophthalmology

Research at Southampton has enabled significant advances in the understanding of respiratory diseases, for which the lack of available treatments has had global health repercussions for many years. This research has led to the creation of a spin-out company - Synairgen that has discovered and developed inhaled interferon beta to prevent or minimise the severity of - acute asthma and chronic obstructive pulmonary disease (COPD) attacks that can cause hospitalisation or even death. The ability of SARS CoV-2 to also evade the induction of interferon beta has provided a further indication for inhaled interferon beta with substantial clinical benefit observed in a Phase II clinical trial. “Our research is being turned into world-changing drugs for treating asthma, COPD and COVID-19. We made a breakthrough in the search for a therapy by establishing a direct link between lower respiratory tract infections and lung disease by showing that disease-linked deficiency in interferon production by the airway epithelium could be restored by adding back this critical first line of anti-viral defence.” Professor Sir Stephen Holgate Medical Research Council Clinical Professor of Immunopharmacology

Our today

Integrating genetics and epigenetics to give children a healthy future Genomic imprinting disorders (IDs) affect one in 3,000 children worldwide and can have a major impact on their growth, metabolism, development, behaviour, cancer risk and overall quality of life. They are congenital conditions involving imprinted genes, whose expression is regulated by the parent from whom they are inherited. Southampton’s groundbreaking research is fundamentally advancing our understanding of human development by investigating disorders of children caused by genetic changes in their mothers. It is also helping to diagnose IDs earlier and mitigate their impact through appropriate treatment and surveillance, as well as providing key tools for health professionals to recognise, diagnose and treat patients with these rare disorders.

Enabling innovative hip replacements through stem cell research Advances in medical care are enabling more of us to live longer. However, this raises its own challenges, with the rise in fracture-related healthcare costing the UK taxpayer billions of pounds every year. Southampton’s pioneering skeletal stem cell research is helping reduce that cost, by combining bone grown from a patient’s own stem cells with a 3D printed hip implant, resulting in the first augmented 3D-printed hip replacement in a UK patient. Since then more than 20 patients have benefited from the technique, a spin-out company - Renovos Biologics Limited – has been created, and the work is inspiring students to follow careers in bioengineering and biomedical science.

“By embedding early diagnosis of imprinting disorders as a standard practice, the research has enabled patients and their families to access personalised treatment that maximises their health and well-being.”

“The ability to grow bone at the point of injury, alongside a 3D printed hip implant, offers real opportunities for improved recovery and quality of life for patients.”

Professor Karen Temple Professor of Medical Genetics Professor Deborah Mackay Professor of Medical Epigenetics

Professor Richard Oreffo Professor of Musculoskeletal Science

Find out more: www.southampton.ac.uk/medicine/pgr

Matt Loxham BBSRC David Phillips Fellow and NIHR Southampton Biomedical Research Centre Senior Research Fellow

Diana Garay Baquero

NURTURING NEXTGENERATION RESEARCHERS Diana came to Southampton from Colombia to take her PhD and has stayed to work as an early career researcher exploring tuberculosis and helping to forge links back in her home country. “I have remained at Southampton because it gave me the opportunity to keep progressing my academic career and provided support to build and maintain my international collaborations. It offers high-quality research, multidisciplinary projects, and support to international students. The groups I have been working with have a great emphasis on collaboration, teamwork and personal/academic balance, which has helped me to build nurturing academic and personal relationships. “During my PhD I developed a wide range of technical skills that have helped to develop my current career as a research fellow working on unconventional T-cell responses in tuberculosis. I am also involved in a joint project with a research centre back home in Colombia to extend the 3D-cell culture system developed at the University to study leishmaniasis. “I would like to keep building a strong international collaboration that allows me to develop multidisciplinary projects that can contribute to improving our understanding and treatment of infectious diseases such as tuberculosis and leishmaniasis.”

My Research Every day we inhale billions of air pollution particles and we are only beginning to understand the effects these particles can have on our health, and the mechanisms by which these effects occur. Throughout my time at Southampton I have been able to develop my research into the effects of inhaling these particles from underground railways, ships and ports. Southampton’s strengths Southampton is very good at pushing interdisciplinary research and collaboration, making it easy to work with people across different disciplines. This has been vital for my work. There’s lots of opportunities to collaborate with people elsewhere across the University and very good integration between the scientists and the clinicians through the University and the Hospital Trust.

Why Southampton? I came to Southampton to do an integrated PhD in Respiratory Biology as I had heard it was one of the best places in the UK for asthma and airways disease research. Since then I have worked as a postdoctoral researcher, a BBSRC Future Leader Fellow, and an NIHR Southampton Biomedical Research Centre Senior Research Fellow. Most Notable Achievement I am proud of setting up my own research group as there are only a small number of other groups in the UK doing similar work. It is also very rewarding to supervise my own PhD students and see them develop. They have won prizes at conferences and published their own papers.

Our today

PARTNERSHIPS PLAYING TO OUR STRENGTHS Medicine at Southampton has extensive, long-standing partnerships with industry resulting in much of its research being translated into the clinic, and the creation of a number of spin-out companies. Our academics engage in significant collaboration across the healthcare spectrum and are often preferred partners because of their history of delivery.

Paul Elkington demonstrates the PerSO hood on YouTube

Protecting frontline staff from COVID-19 As the global COVID-19 pandemic hit, an interdisciplinary team of scientists at Southampton worked with industry experts to create a pioneering respirator hood that would help protect frontline healthcare workers from the coronavirus threat. Professor Paul Elkington, a consultant and professor in respiratory medicine, initiated the project with colleague Professor Hywel Morgan, from Electronics and Computer Science, and academics in Engineering. They designed PerSO – a fabric hood that covers the wearer’s head and has a plastic visor to protect their face – in collaboration with the NIHR Southampton

Biomedical Research Centre and clinicians at University Hospital Southampton (UHS). PerSO, which delivers clean air through a High Efficiency Particulate Air (HEPA) filter with belt-mounted fan pack, can be worn continuously for eight to nine hours, and is reusable after appropriate cleaning. The prototype was developed by the team in just a week, tested on UHS health staff on wards, and manufactured at scale within a month. It was then made open-source (available) to be manufactured around the world.

Paul said: “Frontline medical staff were constantly at risk of being exposed to COVID-19 infection. Our aim was to minimise the risk of infection for medical staff by rapidly developing something simple yet effective that could provide further protection and resolve some of the supply chain issues associated with disposable personal protective equipment. The HEPA-filtered air removes more than 99.95 per cent of particulate matter and the face mask protects from splashes and accidental touching, so we believe this will significantly reduce the risk of infection.”

Find out more: www.southampton.ac.uk/medicine/enterprise

Leading the way in treating respiratory illnesses

shown that patients on SNG001 are significantly more likely to recover than those on placebo. Our Phase III clinical trial is seeking to establish its Southampton’s pioneering work developing effectiveness against COVID-19 with the treatments for COVID-19 has been used as an aim of seeking emergency approval for inhaled international case study for translating other potential COVID-19 treatments into clinical trials. interferon beta.” Tom Wilkinson, Professor of Respiratory Medicine, has been collaborating for a number of years with University spin-out Synairgen to explore the use of interferon beta (IFN-beta) to treat asthma and chronic obstructive pulmonary disease (COPD) patients. When the pandemic struck, their partnership enabled them to pivot their efforts to see if IFN-beta could be used to treat seriously ill COVID-19 patients. Within three months, they had delivered a Phase II clinical trial and were liaising with regulators about Phase III testing. Their experience is now helping develop other drugs through the Accelerating COVID-19 Research and Development (ACCORD) platform. Tom said: “There were clear signals that COVID-19 patients who had a depressed interferon response were doing badly and dying, it was obvious we should trial this exciting treatment in patients infected with SARS-CoV-2. “Even before the pandemic, the World Health Organization identified respiratory infections as a leading global unmet need. They are a major cause of illness and early death and our work established a new approach to developing antiviral drug treatments.” Richard Marsden, Chief Executive Officer of Synairgen, added: “With the University and other UK researchers, we have already been developing the use of SNG001, an inhaled formulation of IFN-beta in the lungs. We have

Helping couples with fertility problems Couples with fertility problems are being given help to increase their chances of becoming pregnant, thanks to research led by Medicine and Electronics and Computer Science at Southampton. Our academics have developed a small, implantable battery-less sensor that can be placed inside the womb to help understand and improve fertility. The device measures the temperature, oxygen and pH levels, informing doctors if the womb environment is right to accept a fertilised embryo. This research led to the creation of a spin-out company – Verso Biosense – which has become a leader in real time and accurate intra-uterine monitoring to optimise fertility treatment and uterine health. It is translating the research into the first insertable, wireless device that can measure the key uterine parameters in vivo. Professor Ying Cheong, a Professor of Reproductive Medicine, an Honorary Consultant in Reproductive Medicine and Surgery, and Cofounder of Verso Biosense said: “The environment that the womb provides to the embryo is crucial for successful implantations in In Vitro Fertilisation (IVF). In many cases where couples have problems becoming pregnant, the womb is likely to be the key cause. Our technology continuously monitors the three key parameters that determine whether an embryo can develop.”

Stemming from world-class research Southampton research is helping improve people’s lives with a pioneering new technology that can potentially transform orthopaedic surgery. Thanks to advances in medical care, people are living longer and staying more active, but this leads to a range of healthcare challenges including an increase in age-related diseases and a rise in the risk of trauma, injury and disease. University of Southampton spin-out, Renovas is commercialising its world-class research, which is drawn from more than 50 years of expertise in skeletal stem cells, translational orthopaedic research and materials for tissue repair, to meet the need for new regenerative therapies. The company has developed Nanoclay gel technology that allows a significantly lower dose (100 times lower than comparable treatments) of a powerful regenerative therapeutic agent to be precisely delivered to exactly where it is needed, delivering bone-forming agents safely and cost-effectively. Early trials are demonstrating that it is contributing to improved bone healing. Dr Jonathan Dawson, EPSRC Research Fellow in Medicine said: “This technology offers a step change in the safety, efficacy and ease of use, and reduces the adverse effects and complications that patients can experience with current orthopaedic interventions by repairing and replacing diseased or damaged tissues. It allows patients to return to normal life sooner. We are already engaging with some external partners, and are keen to interact with more, to work together and develop this treatment further.”

Our tomorrow

OUR SPHERE OF INFLUENCE Our medical breakthroughs, discoveries and innovative educational methods have a tangible impact on the world, delivering lasting improvements in human health and wellbeing. Professor John Holloway A collaboration with the University of Bergen and the Norwegian Research Council is studying the effects of exposures in parents and grandparents on asthma, allergies and lung function in their children.

Professor Mary Barker With colleagues in Hamilton and Edmonton, Canada, we are using innovations in behavioural science to develop user-led interventions to improve diet and nutritional status in marginalised and disadvantaged families.

THE NHS: PARTNERS TOGETHER We have a close partnership with University Hospital Southampton and other NHS providers across the South. Our students are trained through real-world situations, meeting patients right from the very start, and our researchers collaborate with clinicians to deliver developments that are revolutionising healthcare.

Professor James Batchelor Our partnership with Professor Antonio Ribeiro at Universidade Federal de Minas Gerais, in Brazil, is translating and scaling up telehealth platforms to support clinical centres in rural communities diagnose, manage and control hypertension and diabetes.

Dr Marta Polak The Systems Immunology Group has been successfully collaborating with CIDEIM centre in Cali, and the University of Antioquia, Medellin, in Colombia, exchanging knowledge and transferring next-generation sequencing technologies to investigate immune regulation in infectious diseases such as malaria and leishmaniasis.

Find out more: www.southampton.ac.uk/med-international

“Partnership between research and industry is vital within the UK clinical research community. The University of Southampton is renowned for its collaborative approach that enables effective translation of research from bench to clinic.”

PARTNERSHIPS 29 Industrial collaborations and partnerships

Richard Marsden Chief Executive Officer, Synairgen plc

11 Spin-out companies 3 Enterprise units 100+ Partnerships with other universities

Highly successful BMInternational undergraduate programme in partnership with IMU Malaysia and UBD Brunei. Students transfer to Southampton and complete a Bachelor of Medicine degree.

OUR ALUMNI Our alumni community is spread across 93 countries.

Professor Keith Godfrey Our collaboration with academics in New Zealand and Singapore is conducting cutting-edge research to advance understanding of the interaction between environmental factors, genetic and epigenetic processes, and their influence on health and the risk of disease across the lifecourse.

Professor Nuala McGrath The Couples HEalth Research and Intervention Studies (CHERISH) team design and evaluate couples-focused interventions to address HIV, diabetes and other health conditions in subSaharan Africa, with partners in Cape Town and Pietermaritzburg, South Africa.

Our tomorrow: public engagement

Building a culture of equity Medicine at Southampton is actively building a culture of equity, not only supporting staff and students, but also ensuring that our learning and research meets the needs of all people through engagement with patients and the public.

Meet the scientist A programme that gives secondary school students the opportunity to talk informally with research scientists to explore or challenge their views of science and scientists. Following the pause of face-to-face visits, a series of videos has been recorded to continue to bring the world of science to school students. The project is run by LifeLab.

Patient voices are vital to clinical research The Southampton Clinical Trials Unit invites public contributors to sit on its trial management groups to ensure patient voices are represented in clinical research, to influence how trials are run and to make sure information is understandable to everyone.

Stem Cell Mountain Combining the fun of a pinball machine with key biological concepts, Stem Cell Mountain brings to life the complex idea of stem cell potential. The hands-on exhibit has engaged Glastonbury and Bestival festival goers, science aficionados at the top Science Festivals and visitors to Winchester Science Centre.

Online Escape Rooms LifeLab has developed interactive online escape rooms to engage young people with the science behind the health messages: Escape Climate Change, Escape Coronavirus and the Medical Summer School Escape Room.

Over 11,500 students from schools across the south coast have participated in the LifeLab programme since opening in 2014

Find out more: www.southampton.ac.uk/med-engage

THE MOST RELIABLE WAY TO PREDICT THE FUTURE IS TO CREATE IT LifeLab’s mission is to empower children and young people through scientific discovery to make positive lifestyle choices for their physical and mental health, wellbeing and resilience - now and in the future and for their future children. LifeLab is a unique initiative created by the University of Southampton in collaboration with the National Institute for Health Research Southampton Biomedical Research Centre and University Hospital Southampton. Providing educational programmes and resources which enable young people, through their own scientific discovery, to learn first-hand how their behaviours create the foundations for better health for themselves and for future generations, captured by the phrase: Change the beginning and you change the whole story. Since 2017, LifeLab has worked in partnership with the Royal Society for Public Health (RSPH) being awarded the ‘Centre of excellence’ Hygeia award in 2019. LifeLab delivers the RSPH Young Health Champions qualification. This is an Ofqual-regulated qualification, which trains young people up to become ambassadors for healthy lifestyle choices. De-mystifying health messages “Experiencing LifeLab has had a massive impact on our students. Having the opportunity to discover for themselves what impact their choices now can have on them in the future in the inspiring setting of the LifeLab Facility, and then allowing them the space to make those decisions for themselves, will undoubtedly mean our students are empowered to make better choices. “Every year, a group of our students has the opportunity to become health ambassadors through the RSPH Young Health Champions scheme. This qualification gives them the chance to produce health campaigns for their community on a diverse range of subjects giving them the skills and confidence to be influencers among their peers in promoting healthier choices. Nicky Wood Science teacher, Thornden School, Hampshire

Our legacy for the future “Within these pages we proudly reflect on the significant achievements of our interdisciplinary approach at Southampton. The focus here has been on the Faculty of Medicine, but this approach pervades the University. Our excellence and collaboration in education, research and enterprise are the three strands that make up the unique Southampton approach to our triple helix of excellence. The approach as you will have seen in this document has already delivered real-world solutions that directly impact health, nationally and globally. Building on this past success, our vision for the future is very ambitious. The transformation of the Faculty of Medicine will support diverse disciplines within our organisation to work together to address health challenges highlighted by the public, NHS, and our key partners across the region and beyond. We will educate and train tomorrow’s doctors, researchers, educators, and entrepreneurs to be future leaders who will improve the health of the population in the 21st century.” Professor Mark E. Smith Vice-Chancellor

Find out more: www.southampton.ac.uk/medicine deanmed@soton.ac.uk +44 (0)23 8120 6581

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