Picture this
Using comics to explain medicine
Bad science?
The dual-use dilemma
Wellcome News Editorial
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The Editor At the heart of our Strategic Plan are the five
In our challenge on ‘combating infectious
Wellcome News research challenges that will shape much
Wellcome Trust disease’, a Strategic Translation Award to
of our work over the coming decade. Each
Gibbs Building Professor Andrew Pollard at the University of
challenge is a theme that brings together
215 Euston Road Oxford will help to take a new vaccine
London NW1 2BE the many different activities of the Trust –
against meningitis B from preclinical studies
E wellcome.news@wellcome.ac.uk including research in biology and medicine,
to phase I clinical trials in humans.
the translation of research into healthcare
Editor Chrissie Giles
Meningitis B is the leading cause of bacterial
products, public engagement, history of
meningitis in the UK, causing 1500–2500
Writers Craig Brierley, Chrissie Giles, medicine and the ethics of research.
Mun-Keat Looi, Jen Middleton cases each year, and is also a major infectious
For both our Strategic Awards and
Design James Stride, Luis Olmos cause of death in childhood. Meanwhile,
Investigator Awards, we are asking
Professor Kaspar Althoefer at King’s College
Assistant Editor Tom Freeman applicants to consider how their research
London and colleagues are developing a way
Photography David Sayer will address one or more of these challenges.
to combat the emerging problem of
Publisher Hugh Blackbourn This is particularly important because each
counterfeit medicines. In low-to-middle-
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income countries, 10–30 per cent of
we fund should make a difference. For
through Wellcome Images (images.wellcome.ac.uk). medicines are fake, placing patients at
example, ‘maximising the health benefits of
The Wellcome Trust extreme risk. Professor Althoefer’s system
genetics and genomics’ makes clear that if
We are a global charity dedicated to achieving uses radio waves to detect signals from
extraordinary improvements in human and animal we and our partners are to be successful,
health. We support the brightest minds in medicines (or their imposters), even through
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biomedical research and the medical humanities. packaging.
Our breadth of support includes public important improvements in the lives and
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research to improve health. We are independent
health of patients and others.
development, ageing and chronic disease’
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www.wellcome.ac.uk we have awarded £3.8 million to a team at
or funding of a number of projects that
the University of Bristol to develop a new
This is an open access publication and, with the address our challenges directly. In the field
exception of images and illustrations, the content painkiller for the severe chronic pain
may, unless otherwise stated, be reproduced free of genetics, alongside the celebration of the
of charge in any format or medium, subject to the
associated with diabetes, for which there are
human genome sequencing’s ten-year
following constraints: content must be reproduced currently limited effective treatments. The
accurately; content must not be used in a anniversary in June came the launch of the
misleading context; the Wellcome Trust must be
new analgesic is based on galanin, a small
ambitious UK10K project. As its name
attributed as the original author and the title of the protein that is made by nerve cells and that
document specified in the attribution. The views suggests, UK10K will decode the genomes of
and opinions expressed by writers within Wellcome can reduce neuropathic pain.
10 000 people over the next three years and
News do not necessarily reflect those of the Finally, in our challenge on ‘connecting
Wellcome Trust or Editor. No responsibility is is expected to uncover many rare genetic
assumed by the publisher for any injury and/or environment, nutrition and health’, I was
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variants that are important in human
very pleased that we could announce £10m
products liability, negligence or otherwise, or from disease. The project will studying 4000
any use or operation of any methods, products, of funding, through the Insect Pollinators
instructions or ideas contained in the material
people from TwinsUK and the Avon
Initiative, for nine projects investigating the
herein. ISSN 1356-9112. First published by the Longitudinal Study of Parents and Children
Wellcome Trust, 2010. © The trustee of the decline of honeybees and other pollinating
Wellcome Trust. The Wellcome Trust is a charity – two extremely fruitful studies that the
insects in recent years. These projects will be
registered in England and Wales, no. 210183. Its Trust supports – as well as 6000 people with
sole trustee is The Wellcome Trust Limited, a exploring the causes and consequences of
company registered in England and Wales, no. extreme obesity, neurodevelopmental
2711000 (whose registered office is at 215 Euston
threats to these insect populations.
disease and other conditions.
Road, London NW1 2BE, UK).
In our challenge area of ‘understanding
PU-4737.3/14.5K/09-2010/JS
the brain’, two projects looking at stroke
Cover: Playing cards of Sir Henry Wellcome Postdoctoral
Fellows. See page 4. – the leading cause of adult disability in the
This document was printed on material
UK – aim to help us to understand and
made from 25 per cent post-consumer
reduce the devastating effects it can have on
50%
waste & 25 per cent pre-consumer waste. Sir Mark Walport
the lives of those affected. At the University Director of the Wellcome Trust
WellcomeNews | Issue 64
In this issue
Funding
20
News
Research
Malaria-carrying lizards 12
Dopamine and willpower 13
Blood donors’ views 17
18
Genes linked to diabetes 18
Features
Noticeboard 21
Sir Henry Wellcome Postdoctoral Fellows 4
Picture this: comics and medicine 10
The dual-use dilemma 14
Illuminating Florence Nightingale 20
12
10
WellcomeNews | Issue 64 | 1
News
Visions of new biomedical research centre Trust embarks on new
education strategy
We have recently completed our new
education strategy, which was agreed
at the Wellcome Trust Governors
meeting in June. The strategy will focus
on four key areas: playing a leading
role in science education; embedding
continuing professional development
for teachers; building our reputation as a
trusted deliverer of contemporary science
resources; and strengthening research and
development in primary science and the
transition to secondary school, informal
learning, and understanding the links
between neuroscience and learning.
More immediately, we will be publishing
the findings of an investigation into pupil
Impression of UKCMRI seen from Eurostar Terminal. Justin Piperger/Wadsworth3d. Inset: UKCMRI entrance atrium. Glowfrog and parent attitudes to assessment at Key
Stage 2 (age 11). This innovative study
These are the latest artist impressions of how one of the biggest centres for biomedical
incorporated children aged 10 and 11 into
research in Europe will look. The designs and a video fly-through for the UK Centre for
the research team, providing fresh insights
Medical Research and Innovation (UKCMRI), at St Pancras in London, were released
into children’s views of assessment. We will
alongside the Centre’s scientific vision and research strategy. UKCMRI, to be headed by
also publish the outcomes of a seminar,
Nobel Laureate Sir Paul Nurse, is founded by the Wellcome Trust, the Medical Research
held in July, marking 21 years since the
Council, Cancer Research UK and University College London. www.ukcmri.ac.uk
National Curriculum was introduced.
These reports are timely, given that the
new UK government is currently outlining
Wellcome Collection reaches 1 million visitor milestone its proposals to revise the curriculum and
school assessment in England.
On 20 July 2007 Wellcome Collection A summer of related events included
opened to the public. Just three years later, sessions on the science of healthy skin
one million people have passed through (audio recording available at www.
its doors. Yaphet Berihoun, a student and wellcomecollection.org), the history
Pacific Health Summit held
regular user of the Wellcome Library, was and cultural significance of tattoos and in the UK
the milestone visitor and received a goodie the ‘Skin: Exposed’ symposium, which
bag to mark the event. explored nakedness in different periods,
Wellcome Collection’s latest temporary cultures and contexts.
exhibition, Skin, wrapped up in September. High Society, which opens in November,
will look at mind-altering drugs in history
and culture. The exhibition will explore
everything from apothecary to laboratory
studies, self-experimentation, collective
intoxication and the drugs trade. An
accompanying series of events will include Sir Mark Walport addresses the Summit.
a two-day symposium and discussion In June the Pacific Health Summit, the
events curated by cultural historian Mike world’s most prestigious health policy
Jay. Also in November, free Friday-night summit, came to London for the first time.
extravaganza ‘Hand’ will celebrate the The annual meeting brings together key
functional organ that allows us to make, leaders from science, industry, health
touch and hold. systems and government to discuss how
Finally, a new app for the iPhone and scientific advances and appropriate policy
iPod Touch gives you your very own can be combined to make dramatic health
multimedia Medical London guide in your improvements around the globe. This year’s
pocket. Produced in association with City topic was maternal and newborn child
Stories Walks, the free app ‘Blood, Guts, health. The Summit was co-presented by the
Brains and Babies’ leads you through the Wellcome Trust, the Fred Hutchinson
streets of London, bringing together film, Cancer Research Center, the Bill & Melinda
audio and photographs from our archives. Gates Foundation and the National Bureau
Download the app from iTunes, or find the of Asian Research.
Yaphet Berihoun, Wellcome Collection’s 1 millionth visitor. app and more at www.citystorieswalks.com. www.pacifichealthsummit.org
2 | WellcomeNews | Issue 64
Meetings explore medical futures Making history
A new book charts
As the drug development industry looks A separate workshop at the Trust looked
the history of the
for alternative ways to find new medicines, at hospital-associated infections, such
Trust, from Sir
‘open source’ partnerships between as MRSA and Clostridium difficile, and
Henry Wellcome’s
academics and pharmaceutical companies the patient pathway. Some 40 delegates,
interest in medicine
are increasingly common. But challenges including scientists, healthcare workers,
and the challenges
remain. These were explored in a two-day industry representatives, policy makers
of establishing a
Frontiers meeting hosted at the Trust and and patients, highlighted the many facets
medical research
attended by representatives from both of the problem, such as detection and
charity, to the shaping of the
public and private sectors. The conclusions surveillance, hospital design and disease
organisation it is today. Written by
include the development of a cross-sector transmission. Among the conclusions
former Trust Director Peter Williams,
working group for the identification and were the need for standard operating
The Story of the Wellcome Trust is
validation of drug targets, and agreement procedures, new diagnostics and a national
published by Quiller Press and priced
on the need for common repositories surveillance database.
at £16.95.
for drug targets, failed drugs and key
www.countrybooksdirect.com
compounds.
WellcomeNews | Issue 64 | 3
Carving a niche
In 2006, the Wellcome Trust launched
the Sir Henry Wellcome Postdoctoral
Fellowships, which give newly
qualified postdoctoral
researchers £250 000 to pursue
research questions and establish
an independent research career.
Chrissie Giles caught up with some of
these pioneering postdocs to hear how
they’re getting on.
You’ve got your BSc, maybe an MSc too. UK. Every year since, up to 20 researchers of disease, including cancer, blindness
A year or four chained to the laboratory each receive £250 000 over four years to and stroke. The ultimate aim of his work is
bench, the long days of experiments and launch their independent research careers. to identify the molecules that affect how
even longer nights of thesis writing behind Fellows can divide their time between blood vessels behave and try to use them to
you and you’ve earned your PhD. So what different institutions across the world, design drugs to combat these diseases.
now? For many researchers, the next step is giving them the chance to get experience He had planned to split his four-year
to find a postdoctoral position in a lab. in the best labs for their field, gain Fellowship between working on two
But not all postdocs are the same. In independence and make contacts. models: zebrafish and mouse. However,
2006, the Wellcome Trust introduced a We spoke to some of the current Fellows when the zebrafish work proved
scheme unlike any other available in the to find out about their experiences and particularly promising early on, his plans
research so far, and the best ways to changed. “The flexibility of the award
secure one of these Fellowships. Inspired? allows me to stick with this model for now
It’s not too late to apply for this year’s and then pick up the mouse later on in my
competition; visit www.wellcome.ac.uk/ career,” he says.
shwpf for details. He appreciates the greater autonomy
4 | WellcomeNews | Issue 64
in the position I’m in currently, looking number of places including Qatar,
at future jobs, without my mentor, Steve Kenya, Zimbabwe and Thailand.
Watson at the University of Birmingham. Most recently, he’s been working
He’s helped with job negotiations, putting with researchers from Karachi,
together offers etc. You have tons of Pakistan to develop evidence-based
questions, so it’s vital you choose someone recommendations on how to help
you feel comfortable with.” injecting drug users there.1
“The travel was one of the
Dr Tim Hallett big draws for me,” he says.
Like Shane, Dr Tim Hallett received one of “The field I’m in is very
the inaugural Fellowships. Currently based international and there are
in Seattle at the University of Washington, groups working all over the
he’s studying interventions to stop the world that I’d always wanted
spread of HIV and how these could be to work with. The Fellowship
tailored for different populations and let me do that.
different epidemics. “It was quite a big step,
“So far, my Fellowship’s been really, particularly as I’ve got two children
really busy, but productive,” he says. “The who came with me – but they’re
best thing has been being able to switch enjoying their holiday out here!”
focus and follow my nose a bit – following
up developments in the field, for instance, Dr Marie-Jo Brion In a paper
as they arise.” Travel has played a large part in Dr Marie- recently
An example of this is the ‘test and treat’ Jo Brion’s Fellowship. Her PhD involved published in
looking at the factors that influence Pediatrics,2 Marie-Jo
childhood blood pressure in the ALSPAC and colleagues showed that
cohort, made up of children born to over while socioeconomic predictors of
14 000 mothers living in the Bristol area maternal smoking in pregnancy differed
in the early 1990s. For her Fellowship she’s between ALSPAC and Pelotas, there was
expanded this work by also looking at a remarkable consistency in the association
second cohort, consisting of 5000 children
born in the Brazilian city of Pelotas in “It’s about taking forward the
1993. She is comparing both groups to try conventional approaches for
to understand what factors are involved in
different aspects of child health.
studying health and disease
While it’s not new to compare and trying to improve it and
populations, researchers tended to use get more reliable answers”
similar populations, with most research
coming from cohorts based in high- between maternal smoking and child
income countries, Marie-Jo says. For her behavioural problems, strengthening the
Fellowship, she’s comparing high- and likelihood that these problems are due to
middle-income groups. intrauterine effects of fetal exposure to
“When you compare two cohorts tobacco smoke.
that are as dissimilar as ALSPAC and Around halfway through her Fellowship,
Pelotas you get a better idea of whether she’s already spent six months working
something is causing a
debate, when a group working on HIV particular condition or
said that to stop the disease they should not,” she says. “We can
treat everyone who had the infection. compare and contrast,
“This created an enormous debate in the for example, predictors
international research community,” Tim of maternal smoking
says. “I switched focus for a little while to in pregnancy and then
work on that, and published a paper quite use this to explore how
quickly to add to the discussion. That was maternal smoking relates
really satisfying.” to aspects of child health
He’s been part of many collaborations in both populations.
as part of his Fellowship. As well as These comparisons can
keeping close links with Imperial College then give us a better idea
London, where he did his PhD, he’s of whether biological
also worked with agencies including intrauterine factors are A meeting of Sir Henry Wellcome Postdoctoral Fellows at the Trust.
UNAIDS, the US Centers for Disease likely to be driving these associations, or in Brazil and 12 months at the University
Control and Prevention and the World if it’s more likely to be due to wider social, of Western Australia’s Centre for Genetic
Health Organization. He’s travelled to a psychological or environmental factors.” Epidemiology and Biostatistics. Here,
WellcomeNews | Issue 64 | 5
This year’s Fellows
Congratulations to the 2010 Sir Henry
Wellcome Postdoctoral Fellows:
to her for the Fellowship. will give you the best opportunity to • Daniel Fazakerley, University of Dundee
– Use of proteomics and systems biology
“I’m looking to use genetic information develop an independent research career
to dissect the molecular adaptability of
as proxies for maternal exposures in in the future. If you want a chance to metabolism in muscle and fat cells.
become one of the top three people in the • Demis Hassabis, University College London
“Four years of research world in your field, then you need to be a – Understanding the episodic memory
system and its critical role in future thinking.
funding, a generous competitive researcher.”
• Nerea Irigoyen, University of Cambridge –
Marie-Jo agrees about finding a unique
amount of travel and question: “I tried to think of a project
Ribosomal frame-shifting and read-through
in virus gene expression.
opportunities to work that pushed the boundaries a little bit.
• Benjamin Judkewitz, London School of
abroad. It’s a gift – if you It was exciting and interesting to try and Hygiene and Tropical Medicine – Optofluidic
microscopy for portable low-cost malaria
come up with things that might extend
can get it, go for it!” conventional approaches and improve the
diagnostics.
way we’re able to get answers.” • Line Löken, University of Oxford – Feelings
pregnancy,” Marie-Jo says. For example, of pain and pleasure: delineating hedonic
“It is a big jump from PhD,” she says, “but sensation in the brain.
there are genetic variants related to
a big learning curve, which is excellent. It’s • Andrew MacAskill, University College
whether or not mums stop smoking during
great knowing that how things turn out London – Spine-specific targeting of ion
pregnancy, and how effectively people’s channels in striatal neurons.
is, by and large, a function of what you do
bodies break down the ethanol in alcohol.
with your time, how well you liaise with • John Perry, University of Exeter – Identifying
You can use these genetic variants as a low-frequency and rare genetic variation
people and how well you work.” involved in type 2 diabetes using next-
means to tease out to what extent mothers’
“I have very warm and fuzzy feelings generation sequencing data.
smoking or drinking in pregnancy
for the Wellcome Trust for giving me this • Sridharan Rajagopalan, University of Oxford
might biologically affect components of
opportunity and for filling this gap in the – Proteases as next-generation therapeutics
development in children. for influenza A.
market,” Tim laughs. “What would I say
“It’s about taking forward the • Oliver Ratmann, Imperial College London
to prospective applicants? Well, you’ve
conventional approaches for studying – Unravelling the dynamics of rapidly
got nothing to lose by applying. It’s one of evolving infectious diseases in humans with
health and disease and trying to improve it
those really rare opportunities: four years approximate Bayesian computations.
and get more reliable answers,” she says.
of research funding, a generous amount of • Anthony Roberts, University of Leeds –
travel and opportunities to work abroad. It’s Mechanisms regulating movement and force
Do it yourself generation by cytoplasmic dynein.
a gift – if you can get it, go for it!”
So what do these researchers think is the • Aleksandra Watson, University of Cambridge
secret to securing one of these prestigious – The structural basis of the interactions of
References the NuRD co-repressor complex.
Fellowships? Shane is emphatic about
1S
trathdee SA et al. HIV and risk environment for injecting • Elton Zeqiraj, University of Dundee – A
getting the right people behind you. “The drug users: the past, present, and future. Lancet structural and biochemical approach to
most important thing to do is to identify 2010;376(9737):268–84.
understand the molecular mechanism of
the key people in the field doing what you 2B
rion M-J et al. Maternal smoking and child psychological glycogen synthesis.
want to do, then approach them about problems: disentangling causal and noncausal effect.
• Kaixin Zhou, University of Dundee –
Pediatrics 2010;126(1):e57–65.
being sponsors for your application,” he Heritability and pharmacogenetics in patients
For more information on the scheme and to watch some with type 2 diabetes.
says. “Finding the best people is critical.” of the current Fellows, including Marie-Jo Brion, talk about
their experiences, visit www.wellcome.ac.uk/shwpf
6 | WellcomeNews | Issue 64
Funding
Trust partnership to fund African genomics studies UK researchers gear up
for 10 000 genomes
Scheme for global health Ethicists meet to consider UK10K will draw on a twins database.
8 | WellcomeNews | Issue 64
Recent biomedical Trust renews support for
sciences awards Centres
Among the new awards made through
our Neuroscience and Mental Health
funding stream is one to Professor
Phil Maguire, a psychiatrist at King’s
College London who will be researching
psychosis at an early outreach clinic
in south London. He will investigate
why individuals develop the condition
using a combination of neuroimaging
methods.
Prof. Andrew Wilkie has been
Kidney anatomy. Medical Art Service, Munich
awarded a programme grant through
our Molecules, Genes and Cells stream Prof. Dario Alessi from the University
to explore the consequences of ‘selfish of Dundee will use a project grant A participant in the Avon Longitudinal Study of Parents
and Children being tested.
mutations’, which confer a growth awarded through the Physiological
Our Strategic Award Committee recently
advantage to cells in the testes that Sciences stream to investigate a kidney
renewed funding for a number of our
produce sperm. He and colleagues at protein that’s targeted in the first-line
best-known Centres. The Wellcome Trust
the University of Oxford will investigate treatment for high blood pressure. His
Centre for Cell Biology at the University
whether these mutations are more work, in conjunction with researchers
of Edinburgh was awarded £5 million over
common than thought and whether in Mexico, should improve our
five years to continue its work into the
they contribute to cancers and other understanding of hypertension, which
molecular principles that underlie cellular
complex diseases in the offspring. could ultimately lead to new treatments.
function. Professor David Tollervey will
replace Prof. Adrian Bird as Director there
in 2011.
The Wellcome Trust–Cancer Research
‘I’m a Scientist’ celebrates best year yet UK Gurdon Institute, Cambridge, which
promotes research at the interface of
developmental biology and cancer
biology, was awarded £10m funding
over five years. Researchers there study
normal animal development, including
cell differentiation, morphogenesis and
cell proliferation, and aim to understand
how cancers may develop when these
processes fail.
We awarded just under £8m over five
Science’s answer to The X Factor – ‘I’m a years to the Wellcome Trust Centre for
Scientist, Get Me Out of Here!’ – took place Neuroimaging at University College
in June, bigger and better than before. For London and its Director, Prof. Ray
two weeks, over 5000 students from 150 Dolan. Plans include the development
schools read about the work of the 100 of a model-based framework to better
scientists involved, asked them questions address fundamental questions in systems
and joined them in live online chats. They neuroscience and the breakdowns in
then voted for the scientist they wanted function that characterise common
to win, with those with the fewest votes neurological and neuropsychiatric
evicted, until a single winner from each of disorders.
20 zones was crowned. With the Medical Research Council’s
The event inspired everyone who took Molecular and Cellular Medicine Board,
part: students formed fan clubs, scientists we approved the renewal of core funding
stayed up all night making videos, and one and shows them that their opinion for the Avon Longitudinal Study of
participant even responded to questions matters. The fact that the event is real – real Parents and Children, at a total of £6m
from the toilet queue at Glastonbury. scientists, real science, real prize money – over three years. Running for nearly 20
Sophia Collins, co-producer of the event, makes it a far more vivid experience.” years, the study has collected, among
said: “I think the reason ‘I’m a Scientist’ The event will run again next year, with other information, genome-wide data
is so successful is because it makes young core funding from the same Welcome Trust from over 20 000 mothers, children and
people feel empowered – by letting them Society Award. The team is also looking to fathers.
vote and having their vote count, it gives run similar events in other countries and is
them a reason to engage with the science, seeking local partners. imascientist.org.uk
WellcomeNews | Issue 64 | 9
Picture this
In June, the Wellcome Trust sponsored the first ever
conference on comics and medicine at the Institute of English
Studies in London. Mun-Keat Looi, science writer and comic
aficionado, went along to see out how the graphic medium is
helping doctors and patients alike.
Comics and medicine may seem like strange combination fosters connections between
bedfellows. The former you may dismiss new information and existing knowledge.
as a frivolous medium for children, while Comic artist and former journalist Brian For the 2010 Glasgow West End Festival,
the latter is a critically important, serious Fies says comics have the capacity for the Wellcome Trust Centre for Molecular
Parasitology produced a comic to raise
endeavour. But graphic stories are hugely powerful visual metaphors and universality. awareness of the parasitic disease
trypanosomiasis.
popular among all age groups and are today The spare and stylised use of text and art
seen as a legitimate form of literature. And allows readers to project themselves into
not just fiction: graphic novels have dealt the story. ‘mundane’ topic of communication skills –
with all kinds of medical and scientific “These powerful images illustrate the which medical science students rarely take
subjects: substance abuse, depression, HIV, patient’s and family member’s experience seriously – ‘come alive’.
diabetes, epilepsy, mental illness. in a way that standard clinical reportage Reading graphic stories may enhance
‘Graphic pathographies’ provide could never achieve with such economy,” students’ observational and interpretive
powerful, personal insights into medical says Dr Michael Green, a physician and skills, as well as raising awareness of broader
conditions. The visual format can bioethicist at Penn State University. social and political issues associated with
communicate the personal experience of Green runs a course for fourth-year medicine. The comic series Depresso by
conditions such as depression and help medical students at Penn State College of Nottingham-based artist Brick, for example,
to destigmatise and demystify an illness. Medicine. This uses comics to enhance has been used to train student mental
As Paul Gravett, a writer and lecturer on observational and communication skills health workers and is recommended by GPs
comics says, creating autobiography and and improve understanding of patients’ to patients.
first-person fiction allows graphic novelists experience of illness. The novel approach M K Cserwiec, a nurse and graphic
to explore aspects of coping with illness, as helps students to consider discrete artist, has found that the graphic medium
patient, professional, carer and relative. elements more efficiently than if they’d can circumnavigate the professional
Researchers have found how combining been assigned a whole book to read. detachment that comes from wearing a
pictures and text enhances understanding. Further evidence comes from Professor ‘white coat’. She has asked caregivers to
The activities of reading and viewing Keith Stevenson, Stella Williams and Dr draw their experience of an illness from
activate different information-processing Paula Nunes of the University of the West the point of view of a professional and
systems within the brain, and the Indies, who have used cartoons to make the a patient. Those drawn from a patient
10 | WellcomeNews | Issue 64
perspective were full of emotion and
empathy, but that was lost when taking on
a professional capacity.
Obstacles remain in challenging people’s
preconceptions and biases against comics:
presenting comic-form information may
seem flippant to some.
But challenging these preconceptions
has its benefits. As Fies said: “It gives people
information they didn’t have before in a
way they hadn’t seen before. That a comic
could do that come as a surprise to people.”
For a longer version of this article see:
www.wellcome.ac.uk/comics
References
Green MJ, Myers KR. Graphic medicine: use of comics in
medical education and patient care. BMJ 2010;340:574–7.
WellcomeNews | Issue 64 | 11
Research
Researchers probe lizard malaria parasites Poverty linked to mental
health disorders, review
finds
Over the last 20 years, researchers
have been debating whether common
mental disorders, such as depression
and anxiety, are linked to poverty in
low- and middle-income countries.
Now, a systematic review funded by
the UK Department for International
Development has strengthened
evidence for such a link, and added
weight to calls to include mental
health on the agenda of development
agencies and international targets
such as the Millennium Development
Goals.
Researchers, including Wellcome
Ameiva ameiva lizard. Dario Sanches
Trust Senior Research Fellow Professor
Trust-funded researchers in Brazil have malaria in humans), which provoke a Vikram Patel from the London School
published the first description of the violent reaction in the host, often leading of Hygiene and Tropical Medicine,
malaria species Plasmodium carmelinoi, to disease and the death of both organisms. looked at 115 studies, most of which
which infects the Ameiva ameiva lizards The researchers have encountered a wide reported positive associations between
common in South and Central America. variety of malarial parasites in a range a range of poverty indicators and
Professor Ralph Lainson, who led the of lizard species and have yet to find any common mental disorders. Some
research, says that as the parasite does evidence of disease. factors, notably education, food
not cause disease to its hosts, this suggests
that the two have an ancient and well- Lainson R et al. Plasmodium carmelinoi n. sp.
(Haemosporida: Plasmodiidae) of the lizard Ameiva
balanced relationship. This contrasts ameiva (Squamata: Teiidae) in Amazonian Brazil. Parasite
to other Plasmodium species (such as P. 2010;17:129–32.
12 | WellcomeNews | Issue 64
Impulsive, weak-willed, or just too much dopamine?
and learning through – when levels of dopamine in the brain
reinforcement, make us were boosted by L-dopa.
more likely to opt for The findings may help to explain why
instant gratification, people affected by conditions such as
rather than waiting for a attention deficit hyperactivity disorder
more beneficial reward. tend to show extremely impulsive
Professor Ray Dolan and behaviour. Similarly, this highlights
colleagues tested 14 why such behaviour is a potential
healthy volunteers given negative side-effect of L-dopa, used to
either a placebo or a small help to alleviate the symptoms of
dose of L-dopa, a Parkinson’s disease
dopamine-like drug.
stockcam/iStockphoto
Subjects were asked to Pine A et al. Dopamine, time and impulsivity in humans.
J Neurosci 2010 [Epub ahead of print].
Scientists at the Wellcome Trust Centre make a number of choices consisting of
for Neuroimaging at University College either a ‘smaller, sooner’ option (for
London have shed light on the brain example receiving £15 in two weeks) or
processes that underlie our willpower a ‘larger, later’ option (such as receiving
and impulsive action. The study shows £57 in six months). The researchers
that increased levels of dopamine, found that every subject was more Research reveals brain cells’
a chemical in the brain involved likely to behave more impulsively –
in mediating reward, motivation choosing the smaller, sooner option
role in breathing
WellcomeNews | Issue 64 | 13
WellcomeNews | Issue 61 | 13
dem10/iStockphoto
14 | WellcomeNews | Issue 64
defence and offence.” Protecting freedom convention, nationally implemented,
In the USA, the biodefence industry One of the difficulties is finding a way to attempting to prevent the misuse of their
has grown tenfold in the wake of the prevent hostile misuse of science, without work. And they’ve got some responsibility
anthrax letter bombs in 2001 – ironically, impeding scientific progress and the for maintaining and developing the
expanding the pool of potential terrorists. freedom to publish. convention. For instance, they should
“So there are now ten times as many Policy makers and biosecurity experts make sure that their students are educated
people who could defect, or become have advocated downstream regulation, about these dangers and what might be
deranged in some way, and decide they such as export controls and laboratory done.”
have a grudge they want to follow,” says security requirements, to prevent On a practical level, engaging the
Dr Douglas. Indeed, the perpetrator dangerous agents and technologies from scientists is essential. “Without scientists
of the 2001 anthrax attacks was later falling into the hands of possible hostile involved I don’t think there are going to
revealed to have been a scientist users. But, says Dr Rappert, they generally be effective or sensible policies,” says Dr
employed in the US government’s Rappert. “Oversight and codes of conduct
biodefence laboratories. While biosecurity experts can’t be put in place by security and
Sceptics counter that we still
are increasingly concerned, policy people who have no connection to
don’t really know how to make how life science research is practised. So
a pathogen dangerous or to scientists have tended to until scientists are aware of this problem,
disseminate it widely, and that see the threat as remote or and thinking about it, it’s difficult to see
to do so requires state-of-the-art
outside their responsibility anything meaningful being done.”
technology. However, Dr Douglas
points out that what is state-of-the- haven’t thought deeply about the wider Culture change
art now probably won’t be in ten implications of scientists conducting and The need to think about their work in
or 20 years time. “Amateur biologists publishing work. terms its potential for harm is likely to
could make weaponised agents in a garage The problem is compounded by the fact be counterintuitive for many scientists,
or basement lab. You could argue there that many scientists have tended to believe who see their research as something of
are enough crazy people in the world, and that knowledge in itself is intrinsically immense value for society – a means of
it’s only a matter of time before someone valuable and ethically neutral, and that enhancing health and lives.
does.” how it is used is the responsibility of Getting them to think about the
A few high-profile cases have illustrated politicians. possible ways that the new knowledge
how easy it could be to create such agents.
In 2001, scientists accidentally created a
highly virulent mousepox strain, simply
by inserting one extra gene into the viral
genome – and published the information,
albeit with a warning to scientists to be
aware of the potential consequences of
research. And in 2006 a Guardian reporter
purchased a 78-nucleotide sequence of
DNA based on the smallpox genome from
a commercial company with alarming
ease – bearing in mind the fact that the
full-genome smallpox sequence is readily
available on the internet.
Those cases can be disregarded to
some extent. The mousepox strain was
eventually shown to be less virulent than
at first feared, and reconstructing the
185 000-base-pair smallpox genome from
such a small sequence would be extremely
challenging, if not impossible. DNY59/iStockphoto Krakozawr/iStockphoto
However, Dr Brian Rappert at the
However, ethics work by the researchers they generate could be misused is not
University of Exeter believes that the
funded by the Trust Enhancement Award something that can happen overnight.
more problematic issue is the general
has concluded differently. “The question “We’re looking for cultural change,” says
development, proliferation of knowledge
is, what can you reasonably ask of a Dr Judi Sture at the University of Bradford,
and expertise in science, which open up
scientist?” says Professor Malcolm Dando who is overseeing the development of an
huge new possibilities, and are widely
at the University of Bradford. ethical framework with which to approach
published in journals and on the internet.
“It’s not reasonable to ask people to the dual-use dilemma. “We want to see the
“Basic blue skies research, which is so
have responsibility for things that are community of life scientists undertaking
needed for public health issues, is the same
way outside their control. But you can the transformation that medics undertook
kind of proliferation that security people
reasonably suggest to them that they after WWII. As I understand it, it’s very
look at and think, ‘oh dear’,” he says.
should be aware of the possibility of difficult now for a medical student to
misuse, and that there is an international graduate without being aware that there
WellcomeNews | Issue 64 | 15
Rowena Dugdale
are ethical issues in almost everything they says Professor Dando. 2011 Review Conference of the Biological
do. And that they have a responsibility To this end, the group have developed and Toxin Weapons Convention. “We’re
to think about these things and to act in an online educational module resource, in hoping that the state parties will agree that
an ethical way. It’s going to go through a collaboration with Japanese colleagues. It scientists should have a legal obligation to
process of professionalisation and become can be incorporated into life science and train young scientists in these issues, and
part of professional identity.” associated teaching modules and is freely show that they’ve thought about them
To set the ball rolling, in 2004 Professor available online (see below). in relation to their work. That’s the holy
Dando and Dr Rappert began delivering The Bradford group has also developed a grail,” says Dr Simon Whitby at Bradford.
interactive workshops, which they have Master’s-level distance learning module, to There are signs that things are changing.
since taken to 13 countries, including be rolled out in October 2010, which offers In a significant development in the USA,
Argentina, Uganda and Japan, to engage students two hours of lectures on the dual- the National Science Advisory Board for
scientists with the issue. “As we went to use dilemma per week, and a seminar and Biosecurity recently recommended that
all these seminars, we were becoming discussion group requiring them to think all federally funded institutions should
more and more wide-eyed at the fact that about a range of ethical dilemmas, such as be required to provide ethics education,
we could hardly find anybody who knew whether they would undertake or publish including biosecurity and the dual-use
anything at all about how their work could a piece of work, based on ethical analysis dilemma.
potentially be misused,” says Professor using the principles and underlying ethical However, the researchers believe that
Dando. themes developed within the Bradford ultimately the spur to get scientists deeply
They realised they needed to start group’s framework. engaged with the possible misuse of their
earlier, by educating science PhD students The group will be presenting its work will be when they actually see it
on the dual-use dilemma. “People with educational module and ethical happen, in an event such as a bioterrorist
advanced degrees should have some more framework, along with findings from attack. Says Professor Dando: “It’s down
meaningful training or education and at international surveys exploring existing to what Macmillan said: ‘Events, dear boy,
least have thought about these things,” thinking on the dual-use dilemma, at the events’!”
16 | WellcomeNews | Issue 64
Research
More openness could boost blood banking, Researchers find new
research suggests role for matrix molecule in
one UK blood centre as part of a
memory
wider programme of work about
Once regarded as an inert scaffold or ‘glue’,
blood banking and biobanking.
the extracellular matrix – the molecules
She found that donors often don’t
that surround and support animal cells
appreciate the complex issues
– has been shown to have crucial roles
surrounding blood donation.
in the function of organisms. Now, an
There was a lack of knowledge
international team of researchers has
and understanding of how their
identified a new role for an extracellular
contribution would be used – few
matrix molecule in memory and learning.
knew, for example, that just 8
Hyaluronic acid is a key part of the
per cent of blood donations in
extracellular matrix. The team, co-led
England and Wales are used in
by Wellcome Trust Senior Research
emergencies. Dr Busby found
Fellow Professor Dmitri Rusakov from
an implicit trust in the National
the University College London Institute
Blood Service to use the blood
of Neurology, looked at the role of this
and blood products as they saw
molecule in the activity of synapses in the
fit, though there was a strong
brain. They studied slices of mouse and rat
emphasis on the voluntary act of
hippocampus, a brain region involved in
giving blood and contributing
memory and learning.
to the NHS, a service many were
The researchers conclude that
grateful for.
hyaluronic acid regulates a particular kind
She calls for blood services to
of calcium channel found in nerve cells,
be more open about how blood is
and so affects use-dependent changes
used and processed, and for this
in the strength of synaptic connections
to be better communicated to the
(plasticity) – in particular, long-term
public. Though such information
potentiation, a mechanism thought
NHS Blood and Transplant is openly available, little effort
to underlie learning and memory. The
is made to emphasise this. She
The act of giving blood is associated with researchers also showed that removing
suggests that a more open discussion could
notions of community and contributing hyaluronic acid from the brains of mice
help modern blood services in the long
to the greater good. But blood services impaired their ability to learn to fear a
run as traditional aspects of blood banking
today are an increasingly complex business particular stimulus, further linking this
fail to attract the donations needed to
clouded by issues such as the use of molecule to memory and/or learning.
sustain demand.
blood for research as well as the clinic,
distribution and contamination. Kochlamazashvili G et al. The extracellular matrix molecule
Wynne Busby H. Trust, nostalgia and narrative accounts
Dr Helen Busby from the University of blood banking in England in the 21st century. Health
hyaluronic acid regulates hippocampal synaptic plasticity
by modulating postsynaptic L-type Ca(2+) channels. Neuron
of Nottingham interviewed 26 donors at 2010;14:369–82. 2010;67:116–28.
WellcomeNews | Issue 64 | 17
Research
High-fat maternal diet linked to birth defects Round-up
More genes linked to diabetes
An international consortium of
scientists, led by researchers from the
Wellcome Trust Centre for Human
Genetics at Oxford, has identified
12 new genes associated with type 2
diabetes in the largest ever genetic
study of the condition. Though the
individual effect of each of the 12
regions is small, the findings bring
the total number of genetic regions
known to be associated with type 2
diabetes to 38. This could ultimately
Shyman/iStockphoto
have a substantial impact on our
understanding of the biology of
Pregnant mothers who eat a high-fat palate. The offspring of a control group
diabetes, and on the development of
diet before and during pregnancy could of mice, also lacking Cited2 but fed on
therapies.
be putting their unborn child at risk of a balanced diet, were normal. Further
Voight B et al. Nat Genet 2010;42(7):579–89.
congenital heart disease, according to analysis showed that these factors affect
researchers at the Wellcome Trust Centre the expression of another gene called
for Human Genetics in Oxford. Their study Pitx2, required for heart development and
suggests that a mother’s diet may interact the body’s natural asymmetry.
with the genes of their offspring. “We are excited by this as it suggests
The researchers studied mice lacking that congenital heart defects may be
a gene called Cited2, deficiency in which preventable by measures such as altering
leads to heart defects. The mice were fed maternal diet,” said Dr Jamie Bentham,
on a high-fat diet before and throughout one of the researchers.
pregnancy, resulting in offspring with
double the average risk of atrial isomerism Bentham J et al. Maternal high-fat diet interacts with
– a serious heart defect – and a more than embryonic Cited2 genotype to reduce Pitx2c expression
and enhance penetrance of left-right patterning defects.
seven-fold increase in the risk of cleft Hum Mol Genet 2010 [Epub ahead of print].
18 | WellcomeNews | Issue 64
Protein shape change
ensures pick-up in right
places Q&A: Cora Araújo
We often have a skewed perception of
how we look, particularly when it comes
to weight. This can be particularly acute
in teenagers, already uncomfortable with
the rapid changes in their bodies. With
funding from the Wellcome Trust, Dr
Cora Araújo and colleagues studied this
in a group of over 4400 teenagers from
the Pelotas birth cohort in Brazil.
WellcomeNews | Issue 64 | 19
Illuminating
the Lady with
the Lamp
Few figures in medical history have been as fascinating and
enduring as Florence Nightingale, who died 100 years ago this
August. The Wellcome Library’s Ross MacFarlane guides us
through some of the items in the Library’s collection that shed
light on her life, and how it’s been viewed ever since.
Around the Wellcome Library’s main form of pie chart (below). mirrored in the visual representations the
Reading Room runs a frieze containing the Our collections also cast a more Library holds. Lithographs, prints and
names of some of the most famous figures disparaging light on Nightingale. For paintings, all putting a positive spin on her
in medical history. Installed in 1962, it example, the letter book of Sir John Hall, activities in the Crimea, show how she was
names 29 men but only one woman. The Head of Medical Services during the objectified and romanticised.
woman in question – Florence Nightingale Crimean War, paints a less than flattering Ever since Lytton Strachey’s revisionist
– would perhaps see this imbalance as apt, portrait. Hall writes to his superiors account of Nightingale in his classic
as she was often characterised as a lone defending the Army Medical Services from Eminent Victorians (1910), her life has been
female bringing care to the wounded, while interpreted and reinterpreted
arguing with the male authority figures of by each generation.
the British Army. Understandably, given the
In the year that marks the centenary of range and scale of the sources
her death, it’s particularly worthwhile to described above, many of these
note that the Library’s materials offer a biographies – such as Mark
great insight into not only her pioneering Bostridge’s Florence Nightingale:
life but also how she was judged by her The Woman and her Legend
contemporaries and reinterpreted by later (2008) – have used our
generations. resources and, on publication,
Our collections include a sizeable amount have gone on to find a space in
of Nightingale correspondence: hundreds our collections.
of manuscript letters, spanning the whole Perhaps we can leave the last
of her life and many aspects of her career, her criticisms, also arguing that her word to Nightingale herself, through her
including her attempts to become a nurse, intervention deprived the Army of good own voice in a recording made in 1890 to
her famous service during the Crimean War nurses who were working in the Crimea raise money for the impoverished veterans
and subsequent work reforming nursing, before her arrival. Hall pulls no punches in of the Charge of the Light Brigade (you
through to her concerns with sanitation, accusing Nightingale of arrogance and you can hear it at
cottage hospitals and medical statistics. being an interfering busybody desperate for catalogue.wellcome.ac.uk/
The last of these topics is illustrated by power – a “petticoat imperium”. record=b1590740~S3):
her lengthy correspondence with William However, the romanticised “When I am no longer a memory, just a name, I
Farr, one of the leading epidemiologists of representations of Nightingale – often in hope my voice may perpetuate the great work
the 19th century, who collaborated with object form – of the late 19th century are of my life. God bless my dear old comrades of
Balaclava and bring them safe to shore.”
Nightingale in providing statistical
evidence for sanitary reform. She became
the first female member of the Royal Florence Nightingale Museum
Statistical Society in 1858 – in no small part
2010 has also seen the reopening of the Florence Nightingale Museum, following a
owing to her graphical representation of
£1.4 million redevelopment supported by the Wellcome Trust, Guy’s and St Thomas’
statistics, mostly notably the polar area
Charity and Garfield Weston Foundation. www.florence-nightingale.co.uk
diagram (or Nightingale rose diagram), a
20 | WellcomeNews | Issue 64
Seeding A £200 million funding initiative to facilitate
early-stage small-molecule drug discovery.
20–26
Malaria Experimental Genetics
July
Advanced Course GC
A gene map of the malaria-causing Plasmodium
20–23
falciparum genome. The Genomics of Common
GC: Event takes place at the Wellcome
March Diseases 2011
Trust Genome Campus, Hinxton, Cambs.
Conference GC
For information on Wellcome Trust Conferences, see 23–27
www.wellcome.ac.uk/conferences.
Genomic Disorders 2011: The 23–29
For information on Advanced Courses
and Open door Workshops, see genomics of rare diseases Human Genome Analysis: Genetic
www.wellcome.ac.uk/advancedcourses.
Conference GC analysis of multifactorial diseases
Advanced Course GC
30–1 Apr
January 2011 Cellular Cytoskeletal Motor Proteins
Conference GC August
23–28
Genomics and Clinical April 7–22
Microbiology Drosophila Genetics and
Advanced Course GC 10–21 Genomics
Computational Molecular Evolution
Advanced Course GC
Advanced Course GC
WellcomeNews | Issue 64 | 21
OPEN TUESDAY–SUNDAY (UNTIL 18.00)
LATE-NIGHT THURSDAY (UNTIL 22.00)
www.wellcomecollection.org
A CALL TO UPDATE
HENRY WELLCOME’S
CURIOUS COLLECTION.
PLEASE GIVE US A
‘THING’ NO BIGGER
THAN YOUR HEAD OR
COME FOR A SNOOP!
See online for details: www.wellcomecollection.org/things