In the first of a series on researchers at the frontlines of health and medicine across Scotland, here is an overview from an event showcasing the top talent across academia. From the ‘dark matter’ of the genome, our gut immune system, and Parkinson’s research to problematic periods, endometriosis and training new doctors – here are six women working at the forefront of Scotland’s health and medicines challenges.

Biomedical and health science researchers from across Scotland’s universities came together last week at the Academy of Medical Sciences’ event in Edinburgh to share snippets of their work tackling some of the nation’s most pressing health challenges.

Parkinson’s disease

healthandcare.scot heard from Dr Esther Sammler, an expert in the biological processes which underpin the disease.

Dr Sammler is both a Senior Clinical Academic Fellow at the University of Dundee and a Consultant Neurologist in Ninewells Hospital. She says that while there are increasing numbers of Parkinson’s diagnoses, we are yet to properly understand how the condition develops – in part due to a lack of research funding.

Dr Sammler is exploring the neurological systems involved in Parkinson’s and collaborating internationally to look for particular biomarkers which could be critical to assessing new therapeutics in clinical trials.

Genomics

Professor Wendy Bickmore is also invested in the underlying biological signals which influence disease development.

Director of the University of Edinburgh’s Human Genetics Unit, Professor Bickmore says her work is focused on the “dark matter of the genome”. She is an expert in the structure of chromosomes and how they contribute to the development and progression of diseases.

Particularly looking at the link between genetic signals and diseases, Professor Bickmore investigates the biological ‘switches’ that allow processes to be activated or deactivated in the body. She say Scotland’s Rare Diseases Plan – including its rare medicines approval pathway – is a great development.

However, Professor Bickmore highlighted the need for more genomics and genome sequencing work across Scotland, which she says receives more prominence and investment down south.

Immunity and bowel diseases

One researcher at the event, Dr Mahima Swamy, takes a particular interest in immune cells and cellular responses in the body.

Dr Swamy is an expert in intestinal immunity and inflammatory bowel diseases and is the University of Dundee’s Principal Investigator and Sir Henry Dale Fellow in the Protein Phosphorylation and Ubiquitylation Unit. This looks at how proteins in our gut lining are expressed and altered, and what their role is in “controlling infection, stress or transformation” of the gut lining.

Currently, Dr Swamy is investigating how the immune system response in reaction to incoming infections is expressed in the gut, particularly given the “huge difference between blood immune cells and gut immune cells”.

One condition she is interested in better understanding is coeliac’s disease, an auto-immune response to gluten which sees the gut lining deteriorate – causing a range of poor health outcomes.

Women’s health

“We need to smash the stigma around periods to make advances in research and healthcare… There are still so many people who suffer in silence,” shared Dr Jackie Maybin.

While many agreed women’s health has been historically “underfunded and under-researched”, Dr Maybin shared her perspective as a specialist in this area.

Dr Maybin is a Senior Clinical Research Fellow in Obstetrics and Gynaecology at the University of Edinburgh. An expert in problematic periods, she is keen to find better treatments for heavy periods and explained that part of the challenge is the stigma that remains around discussing menstruation.

In August 2021, the Scottish government published its Women’s Health Plan including a commitment to improving health outcomes for women and girls and reducing inequalities in areas that are stigmatised disregarded or dismissed as ‘women’s problems.’

Focused on reducing pain from menstruation, Dr Maybin says current treatments – often pills or intrauterine systems that release hormones – can come with a host of unwanted side effects. Dr Maybin aims to better understand the cause of heavy menstrual bleeding and the underlying repair processes in the womb lining.

Her team have thus far identified a link between low oxygen levels in the womb lining and repair processes required to prevent prolonged bleeding.

Dr Maybin is also exploring the effect of long COVID on the menstrual cycle, collecting tissue biopsies from Scots currently living with the condition.

Another researcher at the Academy of Medical Sciences event, Professor Philippa Saunders, is an expert in reproductive and endometrial disorders.

Professor Saunders is Chair of Reproductive Steroids at the University of Edinburgh and explained that one area she is investigating is the link between diet, supplements, and pain among women with endometriosis.

Again, she says a lot more research is needed in this area of women’s health in Scotland and globally. Professor Saunder’s team also recently helped discover a novel group of wound-responsive endometrial fibroblasts that contribute to endometrial repair, which are important for understanding the development of endometriosis.

Professor Anna Glasier was appointed as Scotland’s Women’s Health Champion in January, to drive forward actions within the Women’s Health Plan, including specialist services for menstrual health, endometriosis and PCOS.

NHS workforce crisis

Beyond biomedical research, the Academy invited Professor of Respiratory Medicine, Moira Whyte to join the event who – although a lung disease expert – discussed her concerns about Scotland’s workforce crisis.

While a ‘record’ pay offer is on the table for NHS Scotland staff, this does not include doctors. Professor Whyte says, “Scotland needs more doctors” and must develop new training pathways.

She said particularly among higher level roles like consultants and GP services, shortages are at an alarming level and collaborative work to address the problem is essential.

Professor Whyte suggested creating an allied health professional-to-doctor training course to be delivered across Scotland, praising the ScotGEM programme for presenting a new route into medicine.

More widely, Scotland’s Nursing and Midwifery unions have called for the workforce crisis across NHS to be addressed, rejecting offers that ignore underlying workforce pressures.

A more in-depth look at the work of these women will follow on healthandcare.scot, as profiles of some the Scottish researchers are still to come.

Read more: Auditor General: Difficult choices for Scotland's NHS; Phage therapy approved for resistant infections; Radiotherapy optional for older breast cancer patients

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