Trustee’s Report (continued) Review of Past and Future Activities
Research published in Nature in April 2011 described a new approach to mapping the function of individual neurons and their connections in unprecedented detail. This technique was developed at University College London and has been used to study the visual cortex – the part of the brain that processes information from the eye. Applied to other parts of the brain, this technique could produce the data needed to develop a computer model capable of explaining how our neural networks generate thoughts, sensations and movements.
The London Pain Consortium, funded by a Wellcome Trust Strategic Award, showed for the first time that a molecule called CXCL5 is over-expressed in the skin of volunteers exposed to UVB radiation. In rats, this significantly reduced sensitivity to pain caused by UVB radiation, suggesting it could be a target for new pain relief drugs.
In August 2011, scientists at the University of Bristol identified how a nerve cell in the brain protects itself from damage during stroke. They published their research, funded by the Trust and the MRC, in the Journal of Neuroscience and showed that the CA3 nerve cell protects itself from damage during stroke by removing glutamate receptors from its surface (high levels of glutamate cause brain damage in stroke). This natural protection mechanism might suggest new strategies to protect other nerve cell types.
The brain is as fascinating to artists and their audiences as it is to scientists. A play about a man whose experimental surgery for epilepsy in 1953 left him unable to form new memories won a Fringe First award at the 2011 Edinburgh Festival and wide praise in the press. Part-funded by the Trust, 2401 Objects was created by theatre company Analogue in collaboration with leading neuroscientists.
Research challenge 3: combating infectious diseases Infectious disease research continues to deliver better treatments, more accurate diagnostic tests and new strategies to battle the challenge of drug resistance. For example, strains of typhoid are becoming resistant to the standard antibiotic treatment, chloramphenicol. A newer drug, gatifloxacin, works on resistant strains but was withdrawn in North America following claims it could cause irregular blood sugar metabolism in older obese people.
Researchers from the Wellcome Trust’s Major Overseas Programme in Vietnam and colleagues tested gatifloxacin in a different population: young adults in Katmandu, Nepal. The findings were published in April 2011 in the Lancet and showed that gatifloxacin worked in cases where there was resistance to chloramphenicol, had fewer side-effects and was cheaper to use than chloramphenicol. Blood sugar levels returned to normal once treatment ended. The researchers submitted the evidence to the World Health Organisation (WHO) arguing that gatifloxacin should be retained in young populations not at risk of diabetes.
Another study has led the WHO to revise its guidelines for severe malaria. In 2006, the South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT), part-funded by the Trust, showed that artesunate, a new drug derived from a Chinese herb, lowered the death rate from malaria more than quinine, the standard treatment. That trial was conducted in Asia and most of the patients studied were adults. In Africa, however, severe malaria is still treated with injected quinine and continues to kill 1 million young children every year.
The new study was called the African Quinine versus Artesunate Malaria Trial (AQUAMAT). Funded entirely by the Wellcome Trust, it was the largest malaria trial ever carried out and compared artesunate with quinine in this vulnerable population. The results, published online in the Lancet in November 2010, showed that treatment with artesunate reduced the number of deaths compared to quinine. In April 2011, the WHO announced that in light of this evidence, it was revising its treatment guidelines to recommend artesunate as the first-line treatment in the management of severe malaria in African children.
Trials of two new tuberculosis tests being developed with support from the Trust – the microscopic observation drug susceptibility (MODS) test and the GeneXpert MTB/RIF test – have shown that they are effective in rapidly diagnosing the infection at the point of care. The WHO endorsed the MODS test for use in resource-poor settings, while the GeneXpert test is recommended for diagnosing tuberculosis and resistance to rifampicin, one of a combination of drugs widely used to treat it.
14 | Annual Report 2011
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