Meet the Endocrinologist: Dr Scott MacKenzie, expert in adrenocortical biology

Scott MacKenzie is a lecturer at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow. Dr MacKenzie’s research focuses on adrenocortical production of the steroid hormones, aldosterone and cortisol, and investigates how genetic variability can affects their involvement in causing high blood pressure. In this interview, he tells us more about his research, career path and his role as an Adrenal and Cardiovascular Network convenor.

What inspired you into endocrinology, and why adrenocortical research in particular?

I got into endocrine research by chance. I was studying for an undergraduate degree in genetics at the University of Glasgow in the mid-90s and a lecturer happened to mention that any students interested in a summer research project should go and see John Connell. Everything came from that. Professor Connell, alongside Robert Fraser and Eleanor Davies, was particularly interested in aldosterone secretion by the adrenal gland and the genes that regulated it. At that time, there was also emerging evidence that other tissues including the brain were making aldosterone, so I was set to work on that through a Society for Endocrinology Summer Studentship. Unfortunately, the 8-week project went extremely smoothly, generating some nice data and giving me completely unrealistic expectations of scientific research! On the basis of this, I was then offered a PhD project in the same lab devoted to investigating extra-adrenal production of aldosterone in the rodent brain. I continued researching in this area, but over the years, I came to the conclusion that extra-adrenal production of aldosterone is unlikely to be of any physiological importance in humans. Fortunately, new questions were starting to be asked around adrenal secretion of aldosterone and I was able to apply the methods I had developed to that area. Now I am involved in projects that cover several aspects of this, with particular interest in how secretion can become dysregulated or excessive, as in primary aldosteronism (PA).

Tell us a little more about your current research?

I’m currently involved in various projects examining aspects of aldosterone secretion, which I think is an interesting and important field of endocrinology that has an impact on the cardiovascular health of large sections of the population. My current work includes aldosterone regulation by microRNA, analysis of common genetic polymorphisms that might predispose large sections of the population to PA (and therefore hypertension), and the identification of circulating biomarkers that might aid in the earlier and more accurate diagnosis of different forms of endocrine hypertension. The things I tend to be most proud of are the little bits of problem solving that arise in the course of lab work. I was quite pleased with a slightly obscure method I developed to confirm the unequal expression of two different forms of the highly similar CYP11B1 and CYP11B2 genes.

What do you think will be the next big or important breakthrough in adrenocortical research?

The discovery that the majority of aldosterone-producing adenomas contain mutations at one of just a few key genes encoding ion channels was really a big breakthrough that advanced our understanding of the pathophysiology underlying the majority of PA cases. At the same time, improvements in diagnostic testing for PA are revealing it to be far more common than we had previously thought. I think this will lead to a redefinition of PA to some extent, as we identify mechanisms that result in aldosterone hypersecretion under certain environmental circumstances or in certain sections of the population who are genetically predisposed to respond in this manner. Ultimately, this could result in better diagnosis and more targeted treatment for endocrine-related hypertension.

I’m currently very interested in the impact of environmental and physical stress on aldosterone secretion. The hypothalamic-pituitary-adrenal axis has long been thought to regulate aldosterone secretion in a very limited manner, but recent clinical studies suggest a sizeable minority of hypertensive individuals react to stress by producing high levels of aldosterone. Understanding what predisposes these people to respond in this manner is, I believe, of great importance and could have major implications for how we react to stressful situations in everyday life and its impact on our cardiovascular health.

What do you think are the biggest challenges faced by academic research?

I think the greatest challenge in current scientific research doesn’t apply to any one field but to us all. That is how we ensure that young researchers­­ coming through – particularly basic scientists – have a viable and stable career structure that enables them to progress and thrive in an academic environment. A lot of time, money and training is being invested in these people, but too many are being lost to science as they become disenchanted by successive short-term contracts and the uncertainty surrounding a career in scientific research. I think it is incumbent on older scientists to recognise just how much the career prospects and funding structures have altered in recent years, and to use whatever influence we have to push for greater early career support at institutional and national levels.

Are there any controversies in your research area? How do you think they will be resolved?

There are certainly controversial areas in my field; some may argue with my opinion that extra-adrenal aldosterone production in humans is of no importance. Others (if the comments on my recent grant proposal are anything to go by) will disagree with my assertion that stress is an important factor in aldosterone secretion. But, ultimately, any scientific disputes will be resolved as they have always been: by well-designed and well-executed experimental study.

What do you enjoy about being an Endocrine Network convenor, and how do you think it may benefit others?

I think that Endocrine Networks have tremendous potential to provide opportunities for researchers, particularly those in their early careers, by enabling them to gain supportive and informed advice from more senior members. I hope we are able to build a vibrant online community that is complemented by ‘real-life’ meetings, such as the Research Incubators at the SfE BES 2017 conference, which proved an excellent forum for researchers to get feedback on projects under development. Ultimately, the success of these initiatives depends on its participants, so I would urge all members in relevant areas of research to sign up to a network and get involved.

Do you have any words of wisdom for aspiring endocrinology researchers?

Although I think opportunities are harder to come by now than they were in ‘my day’, young researchers can still distinguish themselves from their peers in the same ways. That means taking every opportunity to make themselves known to prospective employers and supervisors (the dreaded ‘networking’) while at the same time not being too discouraged by the high number of rejections that almost inevitably follow. It also means exploiting opportunities that organisations like the Society for Endocrinology make available to them, such as Travel Grants, Early Career Grants and Career Development Workshops. Applying for these or getting involved with the Networks or the Early Career Steering Group can be an excellent way to develop your research and get your name known in endocrine circles.

The Endocrine Networks are platforms for knowledge exchange and collaboration amongst basic and clinical researchers, clinical endocrinologists and endocrine nurses. The Networks enable members to discuss and find solutions to challenges within their specialist field.

To join an Endocrine Network login to the ‘My profile’ section of the Members’ Area and select ’Endocrine Networks’.

Meet the Endocrinologist: Professor Franks, expert in reproductive biology and medicine

Stephen Franks is Professor of Reproductive Endocrinology at Imperial College Faculty of Medicine and Consultant Endocrinologist at St Mary’s and Hammersmith Hospitals, London. Prof Franks’ clinical and laboratory research focuses on the hypothalamic-pituitary-ovarian axis, with a particular interest in polycystic ovary syndrome. In this interview, he tells us more about his research, current challenges in reproductive endocrinology and his role as a Reproductive Endocrinology and Biology Network convenor.

What inspired your passion for endocrinology, and reproductive endocrinology in particular?

As a young medical registrar with no experience of research, I was offered a research fellowship to study the physiology and pathology of prolactin (my supervisor and mentor was Howard Jacobs whose enthusiasm was contagious). It was an exciting time for prolactin research because measuring prolactin in blood was new. Radioimmunoassays for prolactin were problematic and I had to set one up from scratch that enabled us to show that hyperprolactinaemia was a common cause of amenorrhoea. The project got me hooked on endocrinology, and reproductive endocrinology in particular, so I carried on to train in internal medicine and endocrinology before finding the ideal clinical academic staff position, which I have held ever since.

Tell us a little more about your current position and work?

As Professor of Reproductive Endocrinology, my clinical practice focuses on reproductive endocrine problems with strong collaboration among my gynaecological colleagues. My main research goals for the last 30 years have focused on trying to unravel the complexities of both reproductive and metabolic problems of polycystic ovary syndrome (PCOS). This has involved clinic-based studies, epidemiological studies and lab-based studies, using human ovarian cells and animal models. My lab-based studies are jointly led with my colleague Professor Kate Hardy, a reproductive biologist.

Over the last decade, what do you think have been the most significant advances in reproductive endocrinology research or clinical practice?

There are many, including the discovery of the importance of the neuroendocrine signalling relay that impacts on gonadotropin secretion, notably the role of kisspeptin, neurokinin and dynorphin neurones. In the area of PCOS research, new data emerging from genome-wide association studies have given us clues to the genetic basis of this complex endocrine disorder.

What do you think has been the most surprising discovery in the field over the last decade?

Discovery, in the mouse at least, that anti-Mullerian hormone (AMH) has receptors in hypothalamic neurones, and can affect secretion of gonadotropin-releasing hormone (GnRH). For many years, it was thought that AMH was simply a local hormone, produced by the Sertoli cells of the testis, that played a key part in differentiation of the male reproductive tract. However, much more recently, AMH was also found to be synthesized and secreted by granulosa cells of the ovary, and has since been widely used as a clinical marker of ovarian follicular reserve. So, the report, by Dr Paolo Giacobini and colleagues in Lille, that this hormone has specific receptors in the mouse hypothalamus and that AMH has a profound effect on GnRH secretory activity was, to say the least, unexpected. The relevance of these findings to human physiology remains to be seen but perhaps we should not be too surprised, given that related gonadal growth factors, such as inhibins and activins, also have actions on the hypothalamic-pituitary axis.

What clinical advances do you think could make a difference for patients affected by reproductive health conditions in the near future?

I would hope that understanding more about the genetic basis of PCOS, particularly differences in genotype between individuals, will lead to more specific and effective ways of treating PCOS, rather than (the nevertheless important) management of symptoms.

What do you think are the main challenges faced by your clinical specialty?

There is a shortage of endocrinologists with a special interest in reproductive endocrinology. This is partly because not all endocrine training programmes offer sufficient experience of this sub-specialty.

Are there any major controversies in your practice area?

One good example is whether PCOS is a risk factor for cardiovascular events. Women with PCOS have risk markers for cardiovascular disease but do they actually have more heart attacks? We lack long-term, longitudinal studies on this, and therefore it would be wise to consider appropriate screening for cardiovascular risk factors in women with PCOS (including cholesterol, lipid and lipoprotein measurements), especially if they are obese. Despite the lack of definitive information about cardiovascular events in women with PCOS, it seems sensible to advise women with PCOS about the importance of diet and exercise to reduce the risk of cardiovascular disease.

What is the most unusual part of your work?

As a reproductive endocrinologist, much of my work and research centres around problems related to reproductive health and ovarian disorders. That naturally means that I have close links with my gynaecological colleagues and, for example, we ran a joint infertility clinic, albeit with a focus on induction of ovulation. Much of my research is laboratory based and, in that area, my long-term collaboration with my reproductive scientist colleague, Professor Kate Hardy, plays an important part. We jointly run our research group and the interaction between clinical and basic scientists is an important aspect in both research and training.

What do you enjoy about being a Reproductive Endocrinology and Biology Endocrine Network convenor, and how do you think the Network can benefit others?

The network facilitates interdisciplinary research through meetings in reproductive endocrinology and biology, using joint sponsorship from the Society for Endocrinology and the Society for Reproduction & Fertility (SRF), by providing a platform for collaborative research. Andy Childs and I (together with Kate Hardy) are currently putting together a programme of international speakers for a meeting on growth factor signaling in the ovary, to which the Society has contributed a meeting grant. An important feature of our Network is that it also involves input (both intellectual and financial) from the SRF, and we shall also be seeking involvement from them. Also, in planning, is another meeting of ReproSouth (again, jointly with SRF), an informal event where students and post-docs (from the Midlands and Wales, as well as London and the South) are encouraged to present work in progress (scheduled for June, this year). Ahead of our next Network meeting at SfE BES 2018 in November we will be canvassing topics for collaborative research across centres in the UK.

Further details on the ReproSouth meetings can be obtained from Stephen Franks and Andy Childs directly.

Do you have any words of wisdom for young endocrinologists out there?

Whether you are planning a career in academic endocrinology, clinical practice or related pathways, there is no substitute for the experience and excitement of being involved in a research project. My own experience of being introduced to research as a very junior physician is that it opened up a completely new way of thinking. So, whether you stay in research or not, it allows you to approach problems in a unique way. And, despite the trials and tribulations, the rewards of a career in academic endocrinology are many, including the privilege of being part of a national and international “family” of colleagues and friends.

The Endocrine Networks are platforms for knowledge exchange and collaboration amongst basic and clinical researchers, clinical endocrinologists and endocrine nurses. The Networks enable members to discuss and find solutions to challenges within their specialist field.

To join an Endocrine Network login to the ‘My profile’ section of the Members’ Area and select ’Endocrine Networks’.

 

 

The conference that stirred my scientific passions (and got me a cool mug!)

What to expect from SfE BES as an Early Career researcher / medical trainee

Scientific conferences are not just an unparalleled opportunity to dive deeper into what’s going on in your specialty. Much more importantly, they are where the little things – the random encounters, the unexpected conversations that can lead to career turning points happen. Do you remember, or can you imagine, the nervous expectation, the excitement -perhaps a tinge of bewilderment- of being there for the first time?

Matthew Sinton, PhD student in Cardiovascular Science at the University of Edinburgh attended his first ever scientific conference, SfE BES, in November 2017. Read how the experience saw him equipped with a sense of purpose, and a taster of what the endocrinology community can do for his career (and could do for yours too, if you’re an SfE BES newbie!).

Amongst the multitude of questions whirling around in my head when I started my PhD, there was one I never realised would be so important: which societies should I join? The first one recommended by my supervisor was the Society for Endocrinology, so I did my due diligence – I found out what the role of the Society was, and how it could support me throughout my PhD and my career beyond.

One of the first opportunities that I came across was the Society for Endocrinology BES Registration Grant, which is available to trainee scientists, as well as others trainees and students, and covers the cost of conference registration. The aim of the grant is to enable those who are still choosing their career paths, or are new to the field of endocrinology, to attend and hear the latest basic and clinical research in the field, and to network with both peers and experts. A few weeks after a straightforward, painless application process, I received an email confirming my award of the grant. While I was delighted about it, I also felt a little nervous – this was my first ever conference but I wasn’t presenting anything, and although I knew a few people who were also attending, they would be busy with poster presentations and meetings. How could I make use of all that spare time to wander around by myself?

As I made my way, on the train from Edinburgh to Harrogate (where the conference was being held), still feeling somewhat apprehensive, I read the conference programme again, and got my notebook out so that I could make a list of things that I would like to see. As I put this list together, a feeling of excitement overtook my nerves – there were such a range of different topics, including engaging with the media, cancer metabolism, food taxation, and alternative career paths. Thinking about opportunities for people at my same career stage, I also made a note to check out the Early Career Lounge.

Once in Harrogate, and too early to check into my hotel, I headed straight to the convention centre. I quickly registered and made my way to the main exhibition hall to see all the posters and exhibition stands. It was still very quiet, so I joined the coffee queue, with the intention of enjoying my caffeine kick whilst looking at the posters in more detail. To my surprise, however, a collaborator who I had not yet had the opportunity to meet in person, joined the queue behind me, and we got chatting. This chance encounter made me feel far more at ease, and afterwards I took the time to wander around. I stopped to check the posters I thought I would be most interested in, then headed to my first talk of choice, on engaging with the media, by Giles Yeo. Like most of the talks that I attended during the conference, it was insightful and engaging, and I really enjoyed being able to listen to experts in their respective fields discussing science and endocrinology from so many different perspectives.

The first evening of the conference I went to the Early Career Quiz, where I had been assigned a seat with people from my home institute, including other postgraduates and PIs. Although I’d seen the other postgraduates around the university, I’d never had the chance to talk to them, so this was a brilliant opportunity to get to know each other better and find out about the projects that everyone was working on. To our (brief) dismay, we didn’t do that well in the quiz, finishing slap-bang in the middle, but it didn’t matter – the evening was so much fun! That night I went back to my hotel feeling exhausted, but still managed to spare some energy to plan my next day.

The following morning, after a quick breakfast and a coffee, I walked back to the convention centre and went straight to the Early Career Lounge, to find out more about the Society and what was on offer in terms of career development. Whilst I want to stay in academia after I finish my PhD, I’m realistic enough to know how competitive it is, and that I need to develop additional skills away from the bench. At the Lounge I spoke with Matt Grant, the Society Careers and Engagement Officer. We chatted for quite a while, about opportunities within the Society, and about what I thought the Society could do to further support people at my career stage. At the end of our chat, I was feeling excited about the various events that I could attend, and Matt promised to email me with any opportunities that arose (which he did). The icing on the cake was, of course, the free Society for Endocrinology mug that I got after our chat…!

I would encourage anyone to apply for the Society for Endocrinology BES Registration Grant and attend this conference, as it really is a fantastic experience. I learned about areas of science that I would otherwise have missed, and met people that I would not normally have the opportunity to meet, including those from the institute that I’m based at! I’m really looking forward to staying involved with the Society, throughout my PhD and beyond!

 

Do you want to know more about Matthew’s unusual career path? Read how quitting his first PhD led him to refocus his career on endocrinology here.

Meet the Endocrinologist: Dr Carel le Roux, Consultant in Metabolic Medicine and Obesity Update speaker

Meet Dr le Roux, Consultant in Metabolic Medicine at Imperial College London and Chair of Experimental Pathology at University College Dublin. During his career, he successfully established an independent research group and has been an important influencer in the field of metabolic medicine. His research focuses on diabetes and obesity, specifically the increased morbidity and mortality associated with these conditions.

Dr le Roux will be speaking at Obesity Update 2018, in the debate ‘Will metabolic surgery replace pharmacotherapy for the treatment of type 2 diabetes?’ Ahead of the event, we interviewed him to find out more about his career path, research interests and his position in the upcoming debate.  

 Q: Tell us more about your background and career highlights so far?

I am a metabolic medicine physician with an interest in obesity; specifically in how bariatric surgery and pharmacotherapy can improve patient outcomes.  I graduated from the University of Pretoria and completed my specialist training in Metabolic Medicine at St Bartholomew’s Hospital and Imperial College. I was awarded a Wellcome Clinical Research Fellowship and completed my PhD at Imperial College. I then received an NIHR Clinician Scientist Award, which enabled me to set up the Imperial Weight Centre, and was then offered a Chair at the Diabetes Complications Research Centre at University College Dublin. The proudest moment of my career was receiving the President of Ireland Young Research Award at Áras an Uachtaráin.

Q: What are you currently working on?

My research investigates using a combined approach of bariatric surgery with pharmacotherapy to reverse the complications of diabetes. We are aiming to treat people with diabetic complications, e.g. diabetic kidney, renal, neural or cardiovascular disease, with both surgery and medication to put these symptoms into remission and stop the development of the disease.

Q: What most excites you about your work and the contribution you can make?

I am most excited about the opportunity to hear what obese patients report about their disease, and applying this knowledge together with basic and clinical science to pursue these symptoms and understand the mechanisms of obesity. I am also excited about the progress we have made in the field; for example, the discovery that obesity is a subcortical brain disease opens up new treatment options, while also reducing the discrimination that patients suffer.

Q: The theme of the 2018 Obesity Update debate is whether surgery is more effective than pharmacotherapy in the treatment of type 2 diabetes. Can you tell us why there is a difference of opinion on this?

Until recently, bariatric surgery – that is gastric by-pass or sleeve surgery – was not considered to be a viable treatment for patients with type 2 diabetes. However, a systematic review of 11 randomised controlled trials, published in 2013, showed that those who undergo surgery do better and outperform patients on pharmacotherapy for weight loss, glycaemic and blood pressure control. This, of course, has great implications for type 2 diabetes patients.

Given the aforementioned trials and their results the question becomes: should every type 2 diabetes patient be offered surgery as a treatment? However, the issue here is not really whether or not we should use surgery – but if and when bariatric surgery is the best strategy to follow.

Q: You will argue that surgery cannot replace pharmacotherapy but, if surgery is so successful, why not?

The main issue is that not all patients with diabetes are the same – the risks of morbidity or diabetic complications are extremely varied and thus, their treatment options should accommodate these differences and find a balance between the risks and gains of bariatric surgery vs. pharmacotherapy.

Although the risks associated with surgery are very low, they still aren’t as low as those associated with medication. Considering this, patients at high risk of diabetic complications for whom best medical treatment is not sufficient may hugely benefit from surgery. On the other hand, for those patients who respond positively to pharmacotherapy there is little value in offering surgery as well.

Additionally, we must not forget that pharmacotherapy is constantly improving. Due to such advances, if we had a randomised controlled trial today that compared outcomes between surgery and medical care, it would be very difficult to imagine that surgery would have any additional benefits beyond best medical care when it comes to mortality. We’d love to say that if you have an operation you’re going to live longer but we simply don’t have that evidence. However, we do have evidence to say that using drugs, such as a sodium-glucose co-transport inhibitor or a GLP-1 analogue, will help diabetes patients to live longer.

Q: In your opinion, when would bariatric surgery be appropriate?

We should offer surgery when it adds value to the patients – helping them to lose weight, and achieve better glycaemic and blood pressure control – and to facilitate the work of diabetologists that treat these patients. It’s not about surgery against medicine, it’s about how surgery can make medicine better. This is precisely what’s done in cancer therapy – we use surgery to control the disease, then chemo or radiotherapy to keep it in remission. We don’t expect surgery to be sufficient on its own – after surgery we still follow the patient and make sure to control all the other consequences of the surgery.

In summary, the model should shift to actually using surgery as an add-on therapy to pharmacotherapy. This way, the benefit of using surgery is that patients need much lower doses of medication. It may allow someone who needs insulin to control type 2 diabetes to move on to requiring only metformin or other oral medications. That would be a massive improvement for the patient’s quality of life. Taking it a step further, a patient with fully controlled diabetes on oral medication could use surgery to put diabetes into remission, and then use a lower dose of metformin to keep the diabetes in remission.

Q: How do you think this debate be resolved?

I think we will all agree that more surgery should be offered to patients; and that we need to use this combined treatment model more frequently in patients with diabetes, especially for those that would benefit most. However, it is how this cohort of patients will be defined that will provoke further debate.

Q: What do you enjoy doing in your spare time?

I have recently started sailing Flying Fifteens and am currently training to qualify for the World Championships in 2019.

Q: Who do you admire most and why?

Rodin – as a sculpture artist he was able to communicate very complex concepts using the human body, but he did so in a simplistic way that influenced how people thought, thus moving civilization forward.

Obesity Update 2018, an event sponsored by the Society for Endocrinology and the Association for the Study of Obesity, will be held in London, 1 February 2018. Register now to attend.

Conference delegate SOS – help get our research proposals off the ground!

SfE BES is all about bringing endocrine professionals together to share knowledge and spark future collaborations. This year, for the first time, delegates are invited to hear specific research proposals and contribute their insights, data or resources to really help get these fledgling projects off the ground.

Here, Dr Kate Lines, from the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, talks about her proposal to be presented at an Endocrine Network Research Incubator Meeting to further understanding of pancreatic neuroendocrine tumours. To complete her project, she needs SfE BES 2017 delegates to provide more patient samples!

My research mainly focuses on learning more about how pancreatic islet cell tumours (pancreatic neuroendocrine tumours) grow, and using this information to develop new therapies. One specific area that has begun to interest me recently is inflammation. Inflammation is a process in which the body sends cells of the immune system (or white blood cells) to specific areas to defend against foreign substances. It has now been shown that many tumours can hijack this system by releasing chemicals to lure in white blood cells. Once the white blood cells reach the tumour they are encouraged to secrete small proteins (cytokines), which help make the perfect environment for the tumour to grow. The perfect growth environment is different for different tumours, therefore the specific white blood cells and cytokines needed by each tumour is also different. Currently, not much is known about which white blood cells and cytokines are most important for supporting pancreatic neuroendocrine tumours.

I submitted a proposal for the Endocrine Neoplasia Syndromes Network Research Incubator Meeting at SfE BES 2017 that suggests examining the area around dissected tissue from pancreatic neuroendocrine tumours for these specific cells and cytokines. Once we have this information we can use it to either help diagnose the tumours (as the cytokines can be detected in the blood), or target them with specific drugs to try to make the environment less ideal for the tumour to grow. However, the trouble with pancreatic endocrine tumours is that although they can be deadly, they are also rare. This is the main stumbling block for the proposed study, as our hospital alone doesn’t have enough samples for us to be confident that the specific cells and cytokines we see are representative of those occurring in all patients.

The Endocrine Neoplasia Syndromes Network Research Incubator Meeting provides a rare opportunity for us to try to access these samples from different hospitals in different locations, which ultimately could provide a set of samples that is truly representative of all the pancreatic neuroendocrine patients in the UK. Not only could the members help by providing samples for this study, but as our work continues they could also provide further samples, such as blood, for future work stemming from this proposal. I therefore hope that the other members of the network will be as interested in this area as I am and would like to provide us with lots of patient samples to investigate. In addition, as an early career researcher it is rare to get the chance to present new ideas to my peers. I am therefore looking forward to what I hope will be an exciting and stimulating discussion on a new area of research for me.

The Endocrine Network Research Incubator Meetings will take place on Tuesday 7 and Wednesday 8 November, 07:45–08:30, come along to the Endocrine Network Meeting most relevant to your research interests and read the full scientific programme for SfE BES 2017 for more details.

To join an Endocrine Network login to the ‘My profile’ section of the ‘Members’ Area and select Endocrine Networks.

Meet the Endocrinologists: Rowan Hardy and Louise Hunter

On the countdown to SfE BES 2017 we interviewed Dr Rowan Hardy (left) and Dr Louise Hunter (middle right), both members of the Early Career Steering Group. Dr Hardy is an Arthritis Research UK Career Development Fellow at the University of Birmingham, and his research focuses on the role of steroid metabolism in chronic inflammatory disease. Dr Hunter, MRC Clinical Research Training Fellow at the University of Manchester, specialises on the interaction between the body clock and the action of stress hormones.

In this interview, Rowan and Louise tell us about their careers in endocrinology and reveal their upcoming highlights for this year’s SfE BES conference in Harrogate, 6-8 November.

Q: Would you tell us a bit more about your career so far? How did you become interested in endocrinology?

Rowan: Since my degree I have always had a passion for endocrinology and immunology. In my first post-doctoral position I developed collaborations between leading endocrinologists and rheumatologists at the University of Birmingham. Through these connections I got to combine my interests by studying the role of glucocorticoid metabolism in tissue biopsies from patients with rheumatoid arthritis.

Louise: I’ve been interested in stress hormone biology for over ten years, since doing an intercalated BSc in Pharmacology whilst at medical school. Choosing endocrinology as my clinical career was the natural way forward.

Q: How are you getting involved with SfE BES 2017?

R: At this year’s conference I will be contributing to the public engagement event, where I will be speed-networking with local teenagers to promote science and a career in endocrinology. I will also be presenting my research as an oral communication in the Bone, Calcium and Neoplasia session, as well as supporting my PhD student who is also delivering her first presentation at SfE BES.

L: At SfE BES 2017 I will be speaking about clinical academic opportunities in endocrinology, and chairing the Early Career symposium on alternative career pathways for endocrine scientists and clinicians, as well as another session on endocrinology and behaviour.

Q: What brings you to SfE BES 2017? Any particular sessions you are looking forward to?

R: I have attended this event regularly since 2006, when I began my PhD. In all that time, whilst I immensely enjoyed the science, the social and networking opportunities at the conference are always fantastic.  I am really interested in how altered steroid metabolism contributes to inflammatory bone loss, and therefore sessions featuring eminent speakers, such as Jan Tuckermann and Eugene McCloskey, on the actions of glucocorticoid on bone, are of particular interest to me. I would strongly recommend everyone to attend the plenary sessions – these are great opportunities to see the progression of truly innovative research within endocrinology.

L: This is my fifth time at SfE BES, and I would say my favourite elements are the opportunities to be exposed to a great mix of cutting-edge science and clinical talk. I’m especially looking forward to Marian Joëls’ plenary talk on the action of corticosteroids in the brain. As a clinical trainee, I find the ‘How do I…’ sessions particularly useful – they are practical and focus on questions which crop up in routine endocrine practice, rather than rare conditions that trainees may not often encounter. For example, Andrew Toogood’s session back in 2015, on managing men who take anabolic steroids, included useful tips which I’ve found helpful in my practice.

Q: What are your future plans for your work and career?

R: I wish to combine the expertise I have developed in murine models and working with patient biopsies to develop novel therapeutic approaches for preventing complications, such as muscle wasting and systemic bone loss in chronic inflammatory disease. Within the next three years I intend to apply for a Senior Fellowship.

L: In the long-term, I’m aiming to become a clinician scientist, and I’d like my work to combine nuclear hormone research with clinical endocrinology.

Q: Who do you most admire professionally, and why?

R: I most admire Professor Georg Schett. He is a world-leading rheumatologist, investigating the pathogenesis of cartilage and bone destruction in inflammatory diseases that have shaped much of the field I currently work in.

L: For my intercalated BSc project, I had the opportunity to go to the Netherlands, and spend time with Ron de Kloet’s group in Leiden. My supervisor there, Menno Kruk, was an inspiration. He’d devoted his career to understanding the neurobiology of aggression, and his passion for the field was infectious.

Q: What do you think will be the next major breakthrough in your field?

R: Understanding how local pre-receptor steroid metabolism contributes to the dysregulation of adaptive immunity and chronic inflammatory disease.

L: In circadian biology, there’s enormous potential for the application of recent research findings to clinical practice. The idea that we could use drugs, vaccines, and other interventions more intelligently, simply by administering them at the right time of day, is very exciting.

Q: Any words of wisdom fot those starting out in your field?

R: Attend SfE BES, take an interest in any of the talks taking place at the conference, and when a speaker really inspires you, take the time to speak with them after their session.

L: Don’t be afraid to approach people and ask for help or advice, even if they hold eminent positions and you’ve never met them before! I’ve found that if you’re keen and have ambition, most people are only too pleased to help.

Both Dr Hardy and Dr Hunter will be presenting at SfE BES 2017, 6-8 November, in Harrogate.  Dr Hardy’s talk ‘Glucocorticoids activation by 11beta-hydroxysteroid dehydrogenase type 1 protects against inflammatory bone loss in a murine model of chronic inflammation’ will take place on Wednesday 8 November, 16.15-16.45. Dr Hunter’s ‘Clinical academic opportunities in Endocrinology’ will be on Monday 6 November, 12.45-13.00.

Find more details about all sessions in the scientific programme, and discover more Early Career activities at SfE BES 2017 on their dedicated event webpage.

Meet the Endocrinologist: Professor Julia Buckingham

Meet Professor Julia Buckingham, Vice-Chancellor and President of Brunel University London and 2017 Society for Endocrinology Jubilee Medal winner. Professor Buckingham’s work focuses on the mechanisms controlling the hypothalamo-pituitary-adrenocortical (HPA) axis. Her outstanding work together with her contribution to the Society, of which she was President from 2009 to 2012, has led to her being awarded this medal, to be presented the annual conference, SfE BES 2017, in Harrogate, 6-8 November 2017. In this interview, Professor Buckingham tells us about her journey in endocrinology.

Q: Can you tell us more about your career path and research interests? 

I developed my passion for endocrinology as an undergraduate student at Sheffield University, where I was inspired by my amazing teachers.  My love for pharmacology, triggered by a short spell in the pharmaceutical industry, came later, before I started my PhD.  Since then I have worked in both endocrinology and pharmacology and have remained firmly wedded to academia. Throughout my career I have combined research and education, and I passionately believe that the two are symbiotic. In fact, I get very cross with people who are ‘too posh to teach’ – we all have a responsibility for the next generation, just as previous generations did for us.  I have had enormous fun over the years working with my research group (and contributing a little bit, I hope!) to our knowledge and understanding of the HPA axis.  I have also been privileged to work with the broader academic community – research funders, publishers, learned societies, particularly the Society for Endocrinology.  Looking back on my career, I think I have probably always been interested in leadership roles, although I didn’t think about it in those terms.  My previous role as Pro-Rector for Education at Imperial College London opened my eyes to the broader issues facing higher education in the UK and internationally, and that led to my current role as Vice-Chancellor of Brunel University London.

Q: What specifically are you presenting at your Jubilee Medal Lecture at SfE BES 2017?

At the conference I will be talking about the complex relationship between the host-defence system and the HPA axis. I will specifically focus on the role of a family of receptors, which were first identified as targets for formylated bacterial peptides, and which contribute to the pathological response to infection.

Q:  What are you particularly looking forward to at SfE BES 2017?

The programme is fantastic as always, and it is difficult to choose.  I always try to go to the plenary lectures and I am particularly looking forward to brushing up my knowledge of POMC processing.

However, the most interesting insights you can get at these events often come from talking to people who are presenting posters, so I would urge everyone to spend time doing that.

Finally, I look forward to catching up with old friends and colleagues, of course.

Q: What has been your career highlight so far?

My research team would say it is seeing new data – and they would go to great lengths to wind me up by telling me they’re not sure how an experiment has gone because they haven’t worked the results out yet! But if you ask me, the greatest highlights are always when seeing someone in my team do well and progress to the next stage of their career, and as Vice-Chancellor, seeing the pride and joy of parents from across the globe when their sons and daughters collect their degrees at graduation.

Q: What are your future plans for your work and career?

I am very focused on my work at Brunel at the moment and I haven’t given much thought as to what comes next.  Theoretically it should be retirement, but I can’t imagine that – when my time at Brunel comes to an end I shall be looking to do something else!

Q: Who do you most admire professionally?

That’s a very difficult question as I have met so many hugely impressive people in different walks of life – it would be unfair to pick one.

Q: Any words of wisdom for aspiring endocrinologists out there?

Follow your passions, keep an open mind and don’t let a hypercritical referee’s report get you down.

Q: What do you think will be the next major breakthrough in your field?

If I knew the answer to that I would be working on it now!

 

You can attend Professor Buckingham’s lecture, ‘Bacteria, steroids and formyl peptide receptors – more twists to the inflammatory response’, at SfE BES 2017 on Wednesday 8 November, 16.15-16.45. See more details in the scientific programme.

Meet the Endocrinologist: Interview with Prof David Hodson

Meet Professor David Hodson, Society for Endocrinology Starling Medal winner for 2017. Prof Hodson is based at the University of Birmingham, where his work investigates how failure of pancreatic beta cell function contributes to type-2 diabetes. He is particularly interested in using multidisciplinary and innovative approaches to answer these research questions, which has earned him this award, to be presented the annual conference, SfE BES 2017, in Harrogate, 6-8 November 2017. Learn more about his endocrine journey in this exclusive interview.

Q:  Tell us a little about your career so far and how you ended up in Birmingham

I originally trained as a Veterinary Surgeon at the University of Bristol, where I studied for a PhD in reproductive neuroendocrinology. Tempted by warmer climes, I then migrated to the South of France to join Patrice Mollard’s lab at the CNRS Montpellier, France. This was an exciting time when Patrice had just discovered pituitary networks, and I was lucky enough to be involved in some of the seminal work that followed. This period cemented my passion for microscopy and method development. I then took up a post as a Non-Clinical Lecturer at Imperial College London in Guy Rutter’s Section, applying optical approaches to the study of islet biology and generally learning how to survive in academia. I moved to the University of Birmingham 18 months ago through their Birmingham Fellows Scheme, convinced that the availability of world-class imaging/metabolomics and abundance of young talent would help me to push my research to the next level. Now a Professorial Research Fellow, I am tasked with the exciting role of expanding diabetes research, as well as further developing our imaging capability. This despite my initial reservations about the city following the BAFTA award-winning “Peaky Blinders”!

 Q: What more specifically are you presenting at your Medal Lecture at SfE BES 2017?

It is becoming increasingly clear that, rather like society, beta cells are not equal. In fact, a small number of beta cells may be responsible for driving insulin release, as well as proliferation/renewal, similar to how just a few individuals own most of the world’s wealth. Or alternatively, how you are only ever six people away from knowing Kevin Bacon (of “Tremors” or “Footloose” fame). This is a really hot topic that challenges our understanding of how beta cells may fail (or respond to treatment) during type 2 diabetes. Therefore, I’ll talk about the recent questions that have arisen in terms of beta cell diversity, the tools we have developed to try and understand this and how this has changed our viewpoint of beta cell function under normal and diabetic conditions. There will be lots of colour, movies and practically no text.

Q: What are you particularly looking forward to at SfE BES 2017?

 My first SfE BES conference was last year and I’m a convert! It will be great to see how endocrinology is progressing in the UK and to catch up with colleagues whilst discussing research in a friendly, informal and supportive environment. In particular, I am looking forward to the “Tissue Engineering for Regenerative Medicine in Endocrinology” symposium. This holds promise not only for diabetes treatment, but also for many endocrine disorders. I’m also looking forward to the social programme. I’d be lying if I said that food and alcohol didn’t play an important role in any conference attendance!

Q: What has been your career highlight so far?

To be honest, I’m relatively new to this and the lab has been working across so many disciplines/topics that it’s difficult to pinpoint a particular highlight. I’m very appreciative that I’ve got excellent collaborators and we are just pleased to be involved in any output that falls under the ‘team science’ banner. Having said that, getting to see Wrestlemania 33 at the same time as ENDO 2017 this year in Florida has to be pretty good, right? Does this count as a career highlight?

Q: What do you think are the biggest challenges in your particular research area right now?

Our biggest challenge remains how to translate our basic findings on beta cell function from the bench to the bedside. We are amassing detailed knowledge regarding the mechanisms underlying insulin secretion, especially in the ‘omics era, but need to strive to harness this for therapeutic potential. On the flip side, lack of understanding about basic mechanisms will hold back progress on all fronts, so we should not make this the only criteria for our research.

Q: What are your future plans for your work & career?

Honestly, I haven’t really thought that far ahead. I’m content following up the avenues created by current research and just having fun doing what we’re doing. Maybe become a Vice-Chancellor? The pension seems decent.

Q: Who do you most admire professionally?

I have to admit that I most admire my postdocs, students and technicians. The fact that they have chosen to research diabetes with relatively little reward and in tough academic times really speaks volumes about their motivation and personalities. They do it because they love to do it. I am lucky to have such good people.

Q: Any words of wisdom for aspiring endocrinologists out there?

Endocrinology is bound by shared mechanisms and concepts. Therefore, as a basic or clinical researcher, don’t be afraid to apply thinking from one field to another field, as well as take risks with the research. The outcome and impact can be quite dramatic compared to the high-throughput, predictable science that the funding climate seems to encourage. If someone asks you what is the point of doing this, then it’s generally a positive thing!

Q: What do you think will be the next major breakthrough in your field?

There is a realisation that current drugs are difficult to improve upon. Certainly, pharma pipelines, profits and innovation are all shrinking as the list of FDA requirements rightly grows (e.g. concerning cardiovascular safety margins). Therefore, directed or personalised treatment may represent the next breakthrough in the field, for example through production of unimolecular agonists where a few licensed drugs are ‘bolted’ together or matching patient genotype to drug efficacy.

You can hear Prof Hodson’s Society for Endocrinology Starling Medal lecture, “Next generation tools to understand endocrine function in health and disease” on Monday 6 November, 18:00-18:30, and see the full scientific programme for SfE BES 2017.

 

Meet the Endocrinologists: Miriam Asia & Andrea Mason

Miriam Asia (right) and Andrea Mason (left), Clinical Nurse Specialists (CNS) in endocrinology at Queen Elizabeth Hospital Birmingham (QEHB) tell us about their work in endocrine nursing and what they are looking forward to at SfE BES 2017, 6-8 November in Harrogate.

Q: Tell us a little about yourself and where you work

Miriam: As an endocrine specialist nurse, I run the adrenal nurse-led clinic, post-traumatic brain injury endocrine screening clinic and support the young adult clinic. I have also completed the Non-Medical Prescribing course at Masters Level and I am planning to start a masters in endocrinology.

Andrea: I currently look after three nurse-led clinics; late effects of cancer treatment (transition clinic from children’s to adult services), pituitary and a new clinic that monitors patients who have developed immune-related adverse events in response to immune check-point inhibitor treatment. I have a particular interest in the quality of life issues surrounding endocrine conditions.

 Q: What inspired you to work in endocrinology?

Miriam: I only knew about endocrinology through nursing textbooks but now, being able to see endocrine patients, reviewing them in clinic and working with them through their endocrine journey makes me realise even more how fascinating and exciting endocrinology is. Especially when I see the difference it makes to our patients during and following treatment.

Andrea: During my nurse training I developed a keen interest in cancer nursing and worked in oncology for many years until an opportunity for me to branch out into endocrinology as a Clinical Nurse Specialist arose. This position was to cover maternity leave and I knew little about endocrinology, so I had to learn on the job quickly! During my first week, I attended the Society’s Endocrine Nurse Update and was totally blown away by the specialty. The journey had started; I spent evenings studying after work trying to get to grips with the basics.

 Q: What are you looking forward to at SfE BES 2017?

Miriam: As well as the plenaries and nurses’ sessions, I am also looking forward to the ‘Meet the Expert’ and ‘How Do I…’ sessions, especially those relevant to my clinical practice.

Andrea: This is my second SfE BES and I am looking forward to the nurses’ sessions, particularly those on opiate-induced endocrinopathy, and development of endocrinopathy following metastatic melanoma treatment. I also enjoy meeting and networking with other endocrine nurses.

Q: What are your career highlights so far?

Miriam: I recently completed a sky dive (see photo right), with some of my CNS colleagues, in support of our QEHB charity for the Young Adult Clinic!

Andrea: Highlights in my nursing career, include working as an Endocrine Nurse Specialist and successfully completing the Non-Medical Prescribing course at Masters Level.

Q: Who do you most admire professionally and why?

Miriam: My endocrine colleagues – nurses and doctors – at QEHB who work with such competence and dedication to look after our endocrine patients

Andrea: I have had an inspiring and passionate Endocrine Lead Nurse to guide me throughout the last five years and support my development. I have also had the support and patience from a caring team of endocrinologists.

Q: What advice would you give to someone starting out in endocrine nursing?

Miriam: Although endocrine nursing is a challenging specialist role that requires a lot of reading and studying, it is rewarding in the end.

Andrea: It does take time to understand the speciality and additional studying is required but when you understand the basics of the endocrine system, it is all very logical. I would say to any nurse…. go for it!

Q: What are your future career aspirations?

Miriam: To complete my masters in endocrinology and become more confident and competent in dealing with complex endocrine cases as a result. I also hope to see more nurse consultants and nurse led clinics being set up.

Andrea: My future plans are to remain in my current position and I am looking to complete a master’s degree in endocrinology.

Don’t miss the dedicated Nurses’ Lounge at SfE BES 2017, giving nurses the opportunity to meet and network in their own space. This is especially beneficial when you are travelling on your own, or if you are a first-time attendee, as there is nearly always somebody there to chat to. At designated break times there is at least one member of the Nurse Committee on hand for you to get to know.

Follow the links to find out more about SfE BES 2017, view the scientific program and register online.