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Glaucoma is the commonest cause of irreversible blindness world-wide and, in many parts of the world, surgery to create a new drainage channel is the only practical treatment. The commonest cause of surgical failure is scarring, and the use of injections of cytotoxic agents prevents scarring but has many complications. Our research identified how convenient single 5-minute treatments with cytotoxic drugs work and led us to carry out pilot and randomised trials, which showed they reduced post-operative scarring. Combined with other refinements of surgical technique (named the Moorfields Safer Surgery System) this has improved outcomes of glaucoma surgery world-wide.
The most frequent surgical procedure undertaken in the NHS is cataract surgery and it improves vision and quality of life (QoL). In the 1990's there were long waiting times for cataract surgery with rationing most frequently restricting surgery on the 2nd eye. A randomised controlled trial undertaken at the University of Bristol (UoB) demonstrated clear QoL benefits from 2nd eye cataract surgery, followed by a population study quantifying population requirements for 1st and 2nd eye surgery and the surgical backlog. Government policy, announced in `Action on Cataracts — Good Practice Guidance, 2000', advised that the volume cataract surgery, including on the 2nd eye, should be increased. This policy ensured timely access to surgery becoming routine practice in the NHS, thus improving the lives of thousands of people. Second-eye surgery rates rose from ~25% of operations to 35-40%, with overall increases in operations for patients needing surgery (e.g. in England up from 201,682 operations in 1998-1999 to 332,625 in 2009-2010) and reduced waiting times. These improvements were sustained through to the end of the 2000's. The research has become highly relevant again as the NHS enters another period of constrained expenditure.
Research by Professor Parmjit Jat (first at the Ludwig Institute for Cancer Research, then part of UCL; later at the UCL Institute of Neurology) established and applied the critically important scientific concept of conditional immortalisation to a wide variety of cell lines, enabling cells to be grown indefinitely in vitro but differentiate upon altering the growth conditions. Two companies were established in partnership with Jat to exploit this research, ReNeuron (now worth £63.5m and publicly traded on the London AIM market) and XCellSyz (now part of Lonza AG). More than 20 patents based on Professor Jat's work have been issued. Reagents based on his research have been evaluated, licensed and used by 17 companies worldwide: Amgen, Amylin, Boehringer Mannheim, Cell Genesys, Chiron, Eli Lilly, Genentech Inc., Genetics Institute, Immunex, Johnson & Johnson, Medarex, Novartis, Ortho Pharm., Pfizer Inc., Regeneron, ReNeuron, Takeda, EMD Serono, and XCellSyZ/Cambrex Bioscience/Lonza.
Seven patients with avascular necrosis of the femoral head and bone cysts have been treated successfully with skeletal stem cell therapy, developed by Southampton researchers, resulting in an improved quality of life. This unique multi-disciplinary approach linking nano-bioengineering and stem cell research could revolutionise treatment for the 4,000 patients requiring surgery each year in the UK and reduce a huge financial burden on the NHS. The work has been granted three patents and the team are in discussions on development of the next generation of orthopaedic implants with industry.
Neural stem cells offer enormous therapeutic potential for stroke but they require regulatory approval. Researchers at King's College London (KCL) devised a technology to immortalise stem cells, generated clinical-grade neural stem cell lines and demonstrated efficacy in an animal model of stroke. KCL research underpins the first approvals in the UK for a therapeutic stem cell product. This led to an industry-sponsored clinical trial of a stem cell therapeutic that has demonstrated vital improvement in all the first five stroke patients treated. KCL research has made a significant impact by considerably reducing the timetable for delivering potential therapies which will affect the life sciences industry and the process now in place acts as a model for other technology developments in this area.