Science meets reality – Professor Nancy Rothwell, President and Vice-Chancellor and Professor of Physiology, The University of Manchester.
Scientists are, quite rightly, very focused on their academic field and often deeply buried in the scientific literature (which is always much too vast to fully grasp,) in the ongoing experiments (which so often don’t work), the latest results (never as you expect them to be) and the next publication (which always seems just out of reach).
But we all need to take some time to lift our heads from the endless papers and bench work to look at the wider picture. This may be to view the bigger scientific world, to engage with those outside our own speciality, or even with non-scientists and to think about the context in which we do our work.
It’s helpful if, like me, you work in an area of direct human relevance. For the last 20 years or so I have worked on stroke and related brain disorders. These are incredibly common and have a massive impact on the patients, on the people around them and on society. Stroke is the greatest cause of disability in the western world and the third highest cause of death after cancer and heart disease-and it’s getting worse.
Even after 20 years it remains quite arresting to meet with the survivors of stroke and their friends and families and to hear just what they have gone through-and so often, how they have overcome remarkable difficulties.
I experienced this, and much more at the launch of a remarkable series of events last week called ‘Science, Stroke, Art’ at Manchester Town Hall. I was involved in the planning, but did little apart from throw in a few ideas. Frankly it was a bit of an experiment and I wasn’t sure if it would work.
The event was a collaboration between the University of Manchester and the Stroke Association, which supports those who have suffered stroke and their families and friends and also funds research, including our own. It brought together colleagues in the University from biology, medicine, communication and drama. But the real person behind its success was Chris Larkin from the Stroke Association.
A main driver for me was what really worries me about stroke. It’s a massive disease burden, but gets almost no publicity or profile and very little funding (the research spend per patient is a tiny fraction of diseases like cancer). I think that’s because there is a perception that only very old people get strokes, many think that after a stroke there is really no hope and we have failed to find really effective treatments, so there is little prospect (and hence little investment) for new treatments.
So the event was designed to illustrate how these perceptions are wrong.
In ‘TED’ style talks we heard from truly inspirational and remarkably talented people who have suffered major strokes but have continued not only a normal life but ones with major impact on others.
Professor Tony Rudd, National Clinical Director for Stroke, NHS England, highlighted just how far we have come in the treatment of stroke and how survival rates have improved dramatically.
Andy McCann a performance coach, Pieter Egriega a musician, songwriter and artist and Mark Ware a multi-media artist all spoke about the experience of their major strokes and gave fantastic performances. The acclaimed Manchester poet Mike Garry spoke about his father’s stroke at the age of 40 and was accompanied by two stroke survivors, Mary and Steve who read their amazing poems.
I spoke about our research on inflammation and how we believe it contributes to stroke and the damage that it causes. Though I felt like a pretty poor speaker after these inspirational people.
Everyone has had some form of inflammation – whether in an infected cut or in-growing toenail or more seriously in arthritis, inflammatory bowel disease or skin problems such as psoriasis.
We are now beginning to realise that inflammation, a great body defence to infection, is also a big player in many common diseases like cancer, diabetes and diseases of the brain like stroke. We are realizing that our own defence systemscan become killers if they are activated too much, in the wrong place or for too long.
We’ve found a particular molecule, called interleukin-1 (IL-1) that we think is a major culprit in causing damage after a stroke. IL-1 is one of the ‘master controllers’ of inflammation, it’s what gives us a fever and makes us feel so terrible when we have flu or other infections.
IL-1 is produced in the brain and in other parts of the body (particularly white blood cells) after a stroke and can cause brain damage in several ways.
Interestingly we all have a naturally occurring blocker of IL-1 in our bodies. Its technical name is IL-1 receptor antagonist, but it’s been produced as a drug to treat rheumatism, called Anakinra. We have found that Anakinra can reduce damage caused by stroke in experimental settings. We’ve done a small study in stroke patients and we’ve also shown that it can get into the brain. We are just completing a clinical study of Anakinra in patients with bleeding in the brain and we are just starting a study in stroke patients, supported by the Stroke Association.
It would be wrong to give false hope – we just don’t know yet if Anakinra will work, though the signs are good. Time will tell. We are also now looking at how we can try to speed up recovery in the brain after a stroke.
But the most important thing about this public event for me was that we heard about hope. That is hope for survivors of stroke, hope for future prevention and hope for future treatment. It was humbling to see the difficulties that some had overcome, often after suffering a stroke at a scarily young age.
I was also personally inspired by the bringing together of science and arts. I have long held the view (perhaps as a once aspiring artist) that science and arts share more common features than differences – both rely on creativity, inspiration, imagination, intuition – and a lot of hard work.
I speak at many, many events. None has had such an impression on me or has made me want our research to go ten times faster.
See which other events are taking place this month www.sciencestrokeart.co.uk
President and Vice-Chancellor and Professor of Physiology
University of Manchester