Dr Ali Abbara is Senior Clinical Lecturer in Endocrinology at Imperial College London. His work, mainly in the field of reproductive neuroendocrinology, focuses on studying the potential of kisspeptin in IVF treatment. Dr Abbara is also a Society Media Ambassador, and regularly helps national and international journalists to accurately frame their hormone-related stories in the media. In this interview, Dr Abbara tells us more about his research, career, and role as Media Ambassador.
What inspired you into neuroendocrinology?
I was attracted to endocrinology as a specialty as it’s very much a thinking person’s specialty. In many ways, endocrinology operates at the higher echelons of Bloom’s taxonomy, being more about mechanism and comprehension, than retention of facts. In school, I was interested in maths and physics; these subjects, consonant with endocrinology, are based on understanding key principles, from which it is possible to decipher more ranging factual information. Neuroendocrinology is an interesting subspecialty for research, and it encompasses a fair degree of complexity. Deciphering the underlying principles that exist within this complexity is both challenging and stimulating.
Can you tell us a little about your work?
As part of my research, I have led clinical trials evaluating the potential of the novel reproductive hormone, kisspeptin, to safely mature oocytes during IVF treatment, and avoid a dangerous complication called ‘ovarian hyperstimulation syndrome’ (OHSS). Kisspeptin acts in the hypothalamus to stimulate the release of endogenous GnRH. Our trials have shown that kisspeptin is safer than current IVF treatments, even in women at markedly increased risk of OHSS. This work has been followed up by the pharmaceutical industry, to develop a kisspeptin analogue that can hopefully facilitate translation from bench to bedside.
Over the last decade, what do you think have been the most useful advances in neuroendocrinology?
There is increasing appreciation for the role of anti-müllerian hormone (AMH) as a hormone that is secreted by the ovary and stimulates GnRH pulsatility at the hypothalamus, rather than it merely being a marker of ovarian reserve. Although not yet included in the new international diagnostic criteria for polycystic ovarian syndrome (PCOS) -predominantly due to the lack of accurate assays in the past and no agreed international measuring standard- this is only a matter of time. Some researchers believe AMH to be key in the pathogenesis of PCOS, and there are a number of ongoing research avenues where AMH action is manipulated, which will be very informative.
What drove you to become a Society Media Ambassador?
Research studies are conducted for the benefit of patients. It is important that patients are made aware of the results of research, in which they may have taken part. Similarly, it is important that the public are informed about the results of publicly funded research.
Researchers are increasingly encouraged to demonstrate the impact of their work and disseminate their findings directly to the public via the media. While scientists are very aware of the need to avoid over-exaggeration of the implications of their research in academic publications, the media need to generate excitement about their articles in the short term. Thus, it is very important that media articles are peer-reviewed by researchers to ensure that any claims are ratified by the data, to put findings in context of the current literature, and ultimately, to not misinform the public.
A frequent example is that of cross-sectional surveys that measure a huge number of lifestyle and dietetic variables and then relate one of these to a treatment outcome. It is very difficult to robustly account for all possible confounders using such a study design – whilst it may be useful for hypothesis generation, a subsequent interventional study is required to confirm that the associations found are in fact causal. In such situations, reassuring the public of the need for caution before implementing advice based on these studies is an important public service.
An important step forward in this regard is the involvement of the public in all aspects of research, from the design stage through to dissemination of results, termed ‘patient and public involvement’. Co-producing statements for the press with a lay member of the research team can enable more accurate communication of research findings.
What do you think are the biggest challenges faced by endocrinology?
One of the great attractions of endocrinology lies in the intellectual challenge it brings. There is a risk that financial pressures faced by the health service could reduce the time available for endocrinologists to engage in the academic activities needed to advance the specialty. Thus, it is more critical than ever to ensure that job plans are designed to protect time for non-service provision endeavours -research, education, and service improvement- to ensure that our specialty continues to thrive.
Do you have any words of wisdom for aspiring clinical endocrinologists?
Do seek out opportunities to get involved in research if possible, as it can equip you with important training in evaluating the scientific literature and practicing evidence-based medicine. We are all continuously exposed to data that we need to interpret correctly and use to make decisions. The skills acquired during research can readily be transferred to many other situations during your career, even if you do not ultimately choose to pursue an academic path.
Also, plan well ahead and speak to senior colleagues early to find out about upcoming opportunities, especially in research areas that are of interest to you. If they don’t have any opportunities at the time, they may well be able to direct you to someone who does.
Find out more about the work of Society Media Ambassadors, and how to become one.
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