Meet Heike Heuer the 2021 Pitt-Rivers Lecturer

Professor Heike Heuer is Professor for Molecular Thyroidology at the Department of Endocrinology, Diabetes and Metabolism at University Hospital Essen – University Duisburg-Essen in Germany. She is interested in thyroid hormone actions in the central nervous system (CNS) and uses mouse models to investigate the function of thyroid hormone transporters and to develop treatment strategies for patients with Allan-Herndon-Dudley syndrome. As the 2021 British Thyroid Association Pitt-Rivers Lecturer, she will present a plenary at SfE BES 2021. In our interview, she talks about her research and highlights how preclinical animal studies can lead to important and useful clinical advances.

Tell us about your career so far

I studied biochemistry at the Leibniz University in Hanover, followed by a PhD in neuroendocrinology at the Max-Planck Institute for Experimental Endocrinology. As a postdoctoral fellow I joined Carol Mason’s lab in the Center for Neurobiology and Behavior at Columbia University, New York, where I extended my neurobiology training. I was appointed as an independent, junior group leader at the Leibniz Institute on Aging/Fritz Lipmann Institute in Jena, where I headed a neuroendocrinology group working on thyroid hormone transporters. Later I became a tenured group leader at the Leibniz Research Institute for Environmental Medicine in Düsseldorf and in 2018, I was appointed as a University Professor for Molecular Thyroidology in Essen.

What inspired you into research?

“I’m pleased that our findings contributed to the rapid establishment of a treatment option for patients with a rare and devastating disease.”

I became interested in neuroendocrinology during my undergraduate degree, as I found it fascinating how peripheral organs communicated with the brain and vice versa. Encouraged by my mentors, Karl Bauer and Theo Visser, I started my research career by examining the thyrotropin-releasing hormone (TRH) signaling system in the rodent CNS. I then became intrigued by the profound effects that thyroid hormones exerted on brain development and function. The breakthrough discovery of the highly specific thyroid hormone transporter MCT8 by Theo Visser and colleagues strongly influenced my research. It became unequivocally clear that thyroid hormones need transporters for transmembrane passage and, consequently, for reaching their receptors. The profound neurological phenotype of patients with inactivating MCT8 mutations (also known as Allan-Herndon-Dudley syndrome) encouraged us to develop mouse models in order to understand the underlying pathogenic mechanisms and also to investigate treatment strategies.

Now, a major focus of my group is to analyse cell-specific TH transporter mouse mutants as we aim to understand which proteins act as critical ‘gate-keepers’ for TH in the CNS, as well as in peripheral organs and how their transport activity is affected under pathophysiological conditions.

“Endocrinology is, in my opinion, a very attractive and exciting research field that offers many interdisciplinary interactions and cross-links with other disciplines.”

What are you proudest of in your career, so far?

With the generation of mice lacking both thyroid hormone transporter Mct8 and Oatp1c1, we successfully established a mouse model that replicates many clinical features of patients with Allan-Herndon-Dudley syndrome, a severe form of psychomotor retardation. Using this animal model, we were able to test therapeutic strategies including the application of the thyroid hormone analog, Triac. This treatment improved many neural impairments and based on our preclinical data, a first Triac Trial was successfully conducted, and a second Triac Trial is in progress. This highlights the importance of preclinical animal studies and I’m pleased that our findings contributed to the rapid establishment of a treatment option for patients with a rare and devastating disease.

What do you enjoy most about your work?

I mostly enjoy lively discussions with colleagues, coworkers and students about scientific studies and novel results.

What will you be presenting in your lecture at SfE BES 2021?

It is indeed a great honor for me to present the Pitt-Rivers lecture at the SfE BES 2021 as Rosalind Pitt-Rivers not only discovered T3 in her pioneering work, but was also the first to establish that the thyroid hormone metabolite, Triac, exerts T3-like effects in animals. To acknowledge her seminal achievements, I will highlight not only the impact of thyroid hormone transporter deficiency on brain development but also discuss how Triac application can improve neural differentiation, and may be a promising treatment option for patients with Allan-Herndon-Dudley syndrome.

What do you think are the main challenges in your field right now?

According to the classical view, TH action is largely determined by circulating TH levels that are mainly regulated by negative feedback loops within the hypothalamus-pituitary-thyroid axis. However, with the recent discovery of patients harboring defects in local TH signaling, e.g. due to genetic TH transporter or receptor mutations, this classical concept of TH action has been challenged. These patients clearly display a discordance between serum TH and TSH concentrations on the one hand, and tissue-specific TH deficiency and/or excess on the other hand. In other words, patients with TH and TSH concentrations within the normal range may still have a “hypothyroid” brain despite a “euthyroid” liver and may benefit from a CNS-specific TH supply. A major challenge is now to identify suitable biomarkers that indicate a tissue-specific change in TH status and to develop clinical strategies to modulate TH status in a cell/organ-specific manner. Certainly, a change in perspective from systemic towards local, tissue-oriented TH action will be needed for comprehensive understanding of TH effects in the body and will ultimately pave the way for the development of novel approaches for modulating cell-specific TH signaling under certain pathophysiological conditions.

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

I envision that the discoveries of novel mechanisms underlying local control of thyroid hormone action (e.g. identification of additional TH specific transporters or novel modes of TH action) will open new avenues to modulate TH signaling in a tissue- or even cell-specific manner (by applying e.g. novel TH receptor agonists, specific TH transporter inhibitors or novel trojan-horse hormone compounds).

Any words of wisdom for aspiring endocrinologists?

Endocrinology is, in my opinion, a very attractive and exciting research field that offers many interdisciplinary interactions and cross-links with other disciplines. Therefore, I can only strongly encourage young researchers or clinicians to become “endocrinologists”.

And for some words of wisdom, ‘Endocrine systems and their regulatory mechanisms and modes of action are complex – thus do not rely on selected serum values only. Always aim for the complete picture or you might miss important (and maybe yet unknown) local effects.’

You can attend Professor Heike Heuer’s Medal Lecture, Role of thyroid hormone transporters in brain development and function on Monday 8 November at 14:00 GMT.

Find out more about the scientific programme for SfE BES 2021.

Meet Mark Febbraio the Society’s 2021 International Medal winner

Professor Mark Febbraio is a Senior Principal Research Fellow and Investigator of the NHMRC and Head of the Cellular and Molecular Metabolism Laboratory within the Drug Discovery Program at Monash Institute of Pharmaceutical Sciences, at Monash University, Australia. He is also the CSO of N-Gene Research Laboratories Inc., a USA-based Biotechnology Company. His research focusses on understanding mechanisms associated with exercise, obesity, type 2 diabetes and cancer, with the aim of developing novel drugs to treat lifestyle-related diseases. Here he tells us about his unconventional route into research and how he helped start a new subfield of endocrinology!

Tell us about your career path so far

“Being a scientist is a balancing act between small wins and frequent disappointment. Experiments often don’t work out, papers are frequently rejected and grant applications are often not funded. The key is to savour the small wins.”

I didn’t take the conventional scientific path. After completing my undergraduate degree in exercise science, I became a full-time (semi-professional) triathlete. During a race in Japan, I become extremely heat stressed and dehydrated, so I decided to go back to do a PhD looking at the effect of environmental temperature on muscle metabolism during exercise. For the next 6 years, I worked as an exercise physiologist and undergraduate lecturer until I met Professor Bente Pedersen, a clinician from the University of Copenhagen, which got me into research. Since then, approximately 20 years ago, I’ve devoted 100% of my time to research as an NHMRC Research Fellow and Investigator in the area of tissue crosstalk, exercise and metabolic disease.

What inspired you into research?

Professor Bente Pedersen and I shared data that we had independently gathered showing that during exercise, muscle produces and releases IL-6, a cytokine previously thought to be made predominantly by immune cells in response to inflammation. We coined the term “myokine” (muscle-producing cytokine).

Muscle then became known as an endocrine organ. About 15 years earlier my friends and colleagues, Jeff Flier and Bruce Spiegleman, discovered that adipsin, a serine protease homolog, was synthesised and secreted by adipose tissue, and the field of adipokines was created. Muscle was a little late to the party but we got there eventually!

What are you proudest of in your career, so far?

Of course the IL-6 story was a proud moment, but our work on heat shock protein 70 as a therapeutic target for treating metabolic disease, as well as our recent work on extracellular vesicles and the synthesis of the chimeric protein IC7Fc to treat metabolic disease also make me proud.

What do you enjoy most about your work?

By far, training and interacting with my mentees. It has been wonderful to see so many great people transition through the laboratory and go on to be highly successful independent scientists.

What will you be presenting in your lecture at SfE BES 2021?

Basically, I will be presenting the historical story of how we came to discover that IC7Fc could be a viable treatment for metabolic disease. The story has many twists and turns!

My feelings are that the next breakthrough will come from the global push towards artificial intelligence in drug discovery.”

I think the main challenge is that a complex problem like metabolic disease can’t be cured by simple solutions. Whilst “the molecular age” produced so much important knowledge, it become clear that there is no single molecule that, if targeted, will produce the magic bullet to treat or cure a disease that is so complex.

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

My feelings are that the next breakthrough will come from the global push towards artificial intelligence (AI) in drug discovery. I’m not saying that we will get the “slam dunk” from AI, but I’m sure we will learn so much via the big data revolution.

Any words of wisdom for aspiring endocrinologists?

Being a scientist is a balancing act between small wins and frequent disappointment. Experiments often don’t work out, papers are frequently rejected and grant applications are often not funded. The key is to savour the small wins and understand that the failures are part of building success. I often tell my trainees “in order to be successful you must be prepared to fail”. It’s OK, in fact it’s normal. Above all enjoy the process and don’t focus on the outcome.

You can attend Professor Mark Febbraio’s Medal Lecture, Activation of the gp130 receptor: a panacea for the treatment of metabolic diseases? on Tuesday 9 November at 09:00.

Find out more about the scientific programme for SfE BES 2021.

Meet Greet Van den Berghe the Society’s 2021 European Medal winner

Professor Greet Van den Berghe is the head of the clinical department and laboratory of Intensive Care Medicine at KU Leuven University and its University Hospitals in Belgium. The Leuven Clinical Intensive Care department is a large, tertiary referral centre treating over 3,100 patients per year. She is also Professor of Medicine at KU Leuven and actively researches the endocrinology and metabolism of critical illness. Here she tells about her career, research and how important it is to break boundaries and challenge classical ideas in the pursuit of better patient care.

Tell us a little about your career path
After obtaining my medical degree, I trained in anesthesiology and intensive care, then in biostatistics and later completed a PhD in endocrinology. I followed this path so that I could work at the boundaries of several disciplines, which provided an excellent opportunity to build a multidisciplinary research team and to expand on translational research in endocrinology and metabolism of critical illness, from bed to bench and back.

What inspired you into research?
When I was a junior attending physician in the intensive care unit (ICU), I observed that long-stay ICU patients, both children and adults, quickly began to look much older than their chronological age. At the same time they showed endocrine and metabolic abnormalities that mimicked certain characteristic of ‘ageing’. I hypothesised that maybe this ‘accelerated ageing’ phenotype of ICU patients could in part be iatrogenic, and if so, may be preventable. These thoughts formed the basis for my PhD research, in which I demonstrated that dopamine infusion, a drug commonly used at the time for haemodynamic and renal support, was causing an iatrogenic suppression of the anterior pituitary with harmful consequences. Based on these findings the practice of infusing dopamine in the ICU was abandoned.

“Together we have made exciting discoveries and we were able to repeatedly close the loop from an original idea triggered by patient care, to basic research in the lab and back to randomised-controlled trials in patients.”

In my postdoctoral research, we went a step further and identified biphasic neuroendocrine and metabolic responses to acute and prolonged critical illness in both patients and animal models. This research clarified many earlier, apparent paradoxes and provided the basis for our later work that focused on the acute and long-term harmful impact of hyperglycemia, the early use of parenteral nutrition and the pathophysiology of the HPA axis response to the stress of critical illness.

What are you proudest of in your career, so far?
In 2002, I inherited a very large and well organised clinical intensive care department to chair, upon which I have built research from bed to bench and back again. There was no research in the department when I started, so I had to build everything from scratch. Over the years, this growing symbiosis, between high-level patient care and research, has proved to be very successful. This also allowed me to recruit the best clinicians and scientists who now work effectively together as a very close team.

“I enjoy thinking outside the box, creating new ideas by crossing boundaries between classical disciplines”

Together we have made exciting discoveries and we were able to repeatedly close the loop from an original idea triggered by patient care, to basic research in the lab and back to randomized-controlled trials in patients. That is such great fun! So, I am most proud of my team, and grateful to them for making me happy every day!

What do you enjoy most about your work?
I enjoy thinking outside the box, creating new ideas by crossing boundaries between classical disciplines, and working with young, enthusiastic physicians and scientists, to generate new knowledge that forms a solid basis for better patient care.

What will you be presenting in your lecture at SfE BES 2021?
In my talk, entitled “Re-thinking critical illness induced corticosteroid insufficiency”, I will present novel insights from our recent research on HPA axis changes that occur in response to acute and prolonged critical illness. I will challenge the classical paradigm of stress-induced increased ACTH-driven cortisol production as the basis for increased systemic cortisol availability in severely ill patients. I will also challenge the idea that a short ACTH stimulation test can diagnose failure of this stress response.

To say it with a metaphor: “What you see is not always what you get”.

Any words of wisdom for aspiring endocrinologists?
Look further than the boundaries of your own discipline, there is much to be learnt and innovated when you go beyond them!

You can attend Professor Van den Berghe’s Medal Lecture, Re-thinking critical illness induced corticosteroid insufficiency on Tuesday 9 November at 18:45.

Find out more about the scientific programme for SfE BES 2021.

Embracing the diversity of endocrinology: an interview with Dr Julia Prague

Dr Julia Prague is a clinical consultant and clinical academic at the Royal Devon and Exeter NHS Trust and University of Exeter. In our interview, she tells us about her clinical practice and research projects, as well as how she thinks endocrine practice will evolve after the COVID-19 pandemic.

Tell us a bit about your current position and what you enjoy most

As a clinical consultant and clinical academic I split my time almost 50/50 through the week. At the moment, my clinical commitments include outpatient endocrinology, and inpatient endocrinology, diabetes and general medicine. I moved from London to Exeter last year, and one of the big reasons to move was that near 50/50 split between clinical commitments and research. It’s a great balance that gives me time and space, not only to be with the patients, but also to investigate and take forward some of the issues that they bring up in clinic. Forming new collaborations and being in a new unit with new colleagues is pretty exciting too.

Don’t let yourself be put off by the general medicine component or thinking that it’s all diabetic feet!

Research wise, I’m particularly interested in the menopause through a number of different collaborations. I’m working with the respiratory department on a project looking at lung conditions and sex hormones. Investigating the impact of the menopause in diabetes. I’m also still involved in establishing the role of neurokinin 3 receptor (NK3R) antagonists to treat hot flushes and improve sleep during the menopause.

What got you interested in research on menopause?

Spending hours with the women in our research study of a new treatment for menopausal flushes, and from receiving hundreds of emails from menopausal women wanting to take part. My admiration for them was huge, not least because they so often described themselves as struggling to cope, yet they were the complete opposite of that, meeting endless challenges with amazing fortitude and whilst mostly suffering in silence. To then see them leave misery and suffering behind and find themselves feeling vibrant and human again was rewarding beyond measure. 

Furthermore, the majority of women will have menopausal symptoms that impact on all aspects of their daily life, but many will also have co-existing medical conditions before their menopause and these can also be impacted too. Many medical conditions are influenced by the menstrual cycle and that’s an aspect that is under-investigated and I think is really interesting. Inflammatory bowel disease, for example, can fluctuate during the menstrual cycle and Crohn’s disease typically gets better in pregnancy.

Diabetes is also impacted by the menstrual cycle, and it’s the same hormones that are changing during the menopause but this hasn’t been investigated, which is why I’m now interested in this, as this is something patients often report as being a problem for them. I think it’s important to listen to what patients are telling you and then try and investigate why that is, to hopefully find an improved solution for them.

There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic.

How was your work affected by the COVID-19 pandemic?

I was a Senior Registrar at King’s College Hospital  at the height of the first wave, so I became involved in  a lot of  the management and service re-design work within the diabetes and endocrinology department, including rota management to facilitate re-deployment to general medicine but whilst maintaining a core specialist service and whilst supporting our junior trainees and particularly our international medical graduates who were isolated from their families, and  ensuring our patients were supported and aware of sick day rules and  had all the medications they needed. Our department was also therefore part of the frontline team. I was the medical registrar on call for the first peak weekend of King’s admissions. Then I got COVID-19 and could not get out of bed/off the sofa for 4 weeks.

I moved to Exeter towards the end of summer 2020 to take up my Consultant job. Since then I have continued to do quite a lot of frontline COVID inpatient medicine. Now we’re involved in recovery and trying to catch up. Many patients couldn’t be seen through the pandemic because resources had to be syphoned off elsewhere.

The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

I never imagined I would interview for my consultant job on Zoom! Moving to a new city, a new department, a new consultant role and a new research role during the pandemic was definitely an interesting twist at such a significant stage of my life and career.

What are you proudest of in your career so far?

My work on menopause and NK3R antagonists – being published in The Lancet was a huge honour, and the potential that this work has to relieve suffering of women is incredible. As a doctor, all you want is to relieve suffering in your patients and this has that opportunity. It’s also given me a platform to continue working in that field and to be invited to speak at international conferences, as well as develop new collaborations.  

This drug class are now in phase three studies and it looks like they’re probably going to be marketed from around 2023/2024. This research is still advancing within the pharmaceutical field, butte top-line results coming out continue to show great promise for the therapy. Seeing the NK3R antagonists come to market will be amazing. For me, to have played some part in that will be awesome and to see patients being able to go to clinicians and get that medication prescribed will be great.

There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic.

What do you think are the biggest challenges in endocrinology?

We have to mention COVID recovery, in what was an already overstretched system. However, somewhat linked to that, is the pull of general medicine on our time as endocrinologists. The pandemic has further highlighted this to be an important issue. Hospital inpatient medicine is busy and can’t be cancelled. However, it is essential for recruitment, training, and retention that our specialist time is more protected. The new internal medicine training (IMT) programme will change the number of specialty training years to shorten it, which could have some quite big consequences for the endocrine discipline.  

COVID-19 has brought some positives though; it’s highlighted that we can achieve quite a lot remotely with patients using virtual appointments, and some patients prefer fitting their appointments in to their life rather than having to attend the hospital. How this translates going forward though could involve big changes for the specialty.

The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

What do you think will be the major changes in the future of endocrinology?

I think there will continue to be a drive for a smaller number of national centres of excellence in endocrinology. There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic. That will be good for patients overall but the downside could be that there will be a smaller number of centres with specialist services, which means that staff  may have less involvement in specialist endocrinology. A lot of these changes will be driven by the GIRFT recommendations, which will affect how all services are delivered going forward.

What challenges do you see for your research?

Availability of funding will be critical. COVID has had an impact on available funding but so has Brexit, there’s now a lot of European grants that UK researchers will not be eligible for. Universities have less money because they’ve had fewer students and international students may think differently about studying in the UK post-Brexit and post-pandemic. Charities that fund research have also been hit as many of their fundraising activities were suspended during the COVID restrictions. The Government has a significant financial deficit to address. Availability of research funding was already challenging but it’s going to be even more difficult in the years to come. It’s usually funding that restricts research activity rather than a lack of ideas or collaborations.

How would you like to see the Society develop?

My overwhelming memory of attending my first Society meetings in 2006/2007 is of a lot of senior white men wearing tweed jackets! Now every time I come to Society meetings it’s such a stark change from that. Everything that the Society has done, and is doing, to make itself more reflective of everyone within it is really important. Recruiting the next generation is also a huge part of that, and it is great to also see more focus on this now than then too. The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

That level of change takes time and effort and over the years I’ve tried to play some part in helping to make the Society a more different place to the one that I initially knew.

As a Leadership and Development Awardee I was really looking forward to SfE BES 2020 as we were going to be paired with award lecturers, and it is also always a great opportunity to catch up with friends, previous colleagues, and previous as well as potential new collaborators. But of course, that didn’t happen. I’ve just been finding my feet as a new consultant and researcher in a new city but being an Awardee has opened up other opportunities. I’ve been involved in discussions with an external organisation exploring new collaborations and identifying our shared goals and objectives that we could achieve together. I’m sure that being an Awardee has helped me be offered these opportunities.

Who have you been most inspired by?

Prof John Wass, obviously, but I have also been very lucky to have amazing clinical and research mentors. From the literal beginning to the end of my clinical training and beyond (now over 15 years!) with Dr Simon Aylwin at King’s and Dr Roderick Clifton-Bligh in Sydney. I also learnt a lot from Prof Waljit Dhillo whilst doing my PhD at Imperial.

Why do you love endocrinology?

The balance of the acute and long-term follow up of patients, and the importance of making the right diagnosis for patients based on their history, examination and targeted investigation. Many patients with endocrine conditions go undiagnosed or misdiagnosed for a long time, so when you make the right diagnosis and instigate the right treatment, they feel and do so much better and you often see it unfold in front of you. As endocrinologists we are also part of a much wider multidisciplinary team, which is great.

Any words of wisdom for aspiring endocrinologists? 

I’ve always tried to be involved with the Society in recruiting the next generation. It’s important that they get to see the ‘real’ endocrinology and diabetes because often, those rotation attachments are mostly inpatient general medicine.

My advice would be to try to get to clinic as much as possible because a lot of our patients are outpatients, and also to go and review specialty patients on the wards when they are admitted. Remember also that there’s lots of different sub-specialties within endocrinology (and diabetes) so there is a place for everyone and an opportunity to be involved in the areas that you find most interesting/rewarding.

Don’t let yourself be put off by the general medicine component or thinking that it’s all diabetic feet! I also always recommend going to SfE BES, it’s a really good platform for meeting other clinicians and scientists involved in the field, and hearing about the patients that we look after. Get involved, come along and see what the specialty really has to offer.


The Society for Endocrinology is 75 years old in 2021. As part of our celebrations, we are collecting members’ opinions, with a focus towards the future – after a particularly hard year for us all!

We are keen to reflect the diversity and breadth of our discipline by hearing from members across all backgrounds, career stages, career types and geographical locations, to get a true flavour of the range of views, needs and challenges faced by our Society members.

Would you like to get involved and share your views? Simply complete this short questionnaire or send your comments to media@endocrinology.org.

Embracing the diversity of endocrinology: an interview with Dr Alexander Comninos

Dr Alexander Comninos is a consultant in endocrinology and diabetes and honorary clinical senior lecturer at Imperial College London. His research interests are in reproductive endocrinology and metabolic bone disease and he has presented internationally, winning several prestigious prizes including the Society’s Early Career and Clinical Endocrinology Trust Prizes. Alex currently sits on the Society’s Science Committee and is a previous Leadership and Development Awards Programme Awardee. Read our interview with him to find out about his career, the current challenges in his field, and how he thinks endocrinology will change in the future.

*A late night collaborative meeting at a Kebab House during SfE BES 2015

Tell us about your current position

I feel very fortunate as my current role combines clinical work, research and teaching. One day I may be running our endocrine bone clinic, the next day I could be on call for acute medicine, or analysing data and finishing a research paper, lecturing and tutoring undergraduates, or meeting my PhD students. I really enjoy the fact that each day is different and endocrinology is the theme through most of it, with so many opportunities to combine clinical and academic work.

I love endocrinology because it encompasses the whole body system and has so many possibilities for research to improve patient care.

What are you proudest of in your career so far?

Looking back on my career so far, I am so happy that I made it through all the harder times in medicine and academia. Long runs of night-shifts and previous unsuccessful grant applications certainly tested my perseverance but made me stronger!

What do you think are the biggest challenges in endocrinology right now?

With increasing patient use of social media and the internet in general sometimes misinforming patients, we have to ensure that we provide clear and accurate information to patients and address their concerns. In addition, although we are hopefully emerging from the COVID-19 pandemic, an element of remote medicine is clearly here to stay. With patient compliance, subtle symptoms and blood tests so integral to endocrinology, we need to find new ways to monitor these in a remote medicine environment.

How do you think your field of research will change in the future

Genetics is such a rapidly developing field. I suspect we will be routinely performing full cheap gene sequencing and using this information to guide management at an individual level.

In the future I think we will see the increasing incorporation of genetics to guide individualised treatment.

What is it like being involved with the Society for Endocrinology?

We are lucky to have such a well-run society. I currently sit on the Science Committee which is an absolute pleasure. Interacting with other basic and clinical endocrinologists, each with different opinions and interests is really fascinating and constantly thought-provoking. I would like to see the Society push on with in-person meetings, when safe to do so, as I feel this is so important for our morale on an individual as well as a collective basis.

Who are your most inspirational endocrinologists?

Like many others, Professor Karim Meeran is a large part of why I chose endocrinology, and Professor Waljit Dhillo is the inspiration behind my academic pursuits. Their dedication to trainee development, super approachable nature, calmness and sense of what is best, is really incredible and I am sure numerous trainees would agree. I also have to say that Dr Cox at St Mary’s has been a real clinical inspiration for me. I was his house-officer many years ago, and now to sit next door as a consultant colleague always makes me smile. His incredible experience, knowledge and deep interest in endocrine physiology have certainly helped shape my early consultant years, and we have had many enthralling clinical discussions!

Any words of wisdom for aspiring researchers in endocrinology?

It is a wonderful specialty, full of surprises and opportunities. Be inquisitive constantly, question things to understand concepts and remember the journey is lifelong.



The Society for Endocrinology is 75 years old in 2021. As part of our celebrations, we are collecting members’ opinions, with a focus towards the future – after a particularly hard year for us all!

We are keen to reflect the diversity and breadth of our discipline by hearing from members across all backgrounds, career stages, career types and geographical locations, to get a true flavour of the range of views, needs and challenges faced by our Society members.

Would you like to get involved and share your views? Simply complete this short questionnaire or send your comments to media@endocrinology.org.

Embracing the diversity of endocrinology: an interview with Dr Gareth Nye

Dr Gareth Nye is a lecturer in anatomy and physiology at the University of Chester. His main research interests are maternal and foetal health. In our interview, he tells us about his career so far, his research and how he thinks his field will develop in the future.

Tell us a bit about your current position

My recent research has been focused on improving outcomes for both mum and baby before, during and after pregnancy. More specifically I’ve been researching placental causes of foetal growth restriction, whilst also looking into the ongoing impact of the COVID-19 outbreak on maternity care.

I love endocrinology because it impacts every aspect of human health and disease

The most enjoyable aspect of my role as a lecturer is getting engagement from the students. When a student is really exploring a topic and that enthusiasm comes out in lectures or otherwise, it’s such a great feeling. With my research being in a field where you can make such a huge difference is also so rewarding. There’s still so much we don’t fully understand around pregnancy, so there is always new areas to look into.

What are you proudest of in your career so far?

There are many career moments that I’m proud of, for a wide range of reasons. Being nominated for “most inspirational lecturer” from students at the University of Chester is an achievement I’m proud of, for both personal and professional reasons.

Additionally, I’m particularly proud of our review of placental oxygenation in the Journal of Physiology and finally, speaking at the International Federation of Placenta Associations conference in Tokyo was an amazing experience!

What do you think are the biggest challenges in your field of research right now?

I think there are multiple challenges within maternal and foetal health and pregnancy research. If I had to name three major themes they would be

  • Ensuring every baby is delivered healthy and that every mum remains healthy, during and after the pregnancy. Finding novel interventions to improve foetal outcomes in utero, without the need for early delivery and shining a spotlight on the physical and mental changes that pregnancy has on the mother’s body, both during and after the pregnancy itself
  • Fully understanding the impact the maternal environment has on foetal lifelong outcomes – this involves the discussion around Developmental Origins of Health and Disease
  • Exploring the maternal/foetal interface to improve outcomes for the baby – this includes the placenta, breastmilk and circumstances following birth

Can you explain more about how you think your field of research will change in the future?

In the future we will challenge the current understanding around pregnancy and early childhood. Not enough is known yet and it's limiting our ability to intervene productively.

As pregnancy research, particularly in humans, is challenging for a number of reasons I can see the field collaborating more with other disciplines, even though not necessarily involved in medicine. For example, I have recent research papers with mathematicians, engineers and physicists, who can bring their knowledge and expertise to fill in gaps in our biological knowledge. Additionally, with the improvement of imaging techniques, we can slowly begin to understand the important microanatomy of the placenta and uterus to see if/how we can improve pregnancy outcomes. Without thinking of our research fields as one slice in a huge pie, we can never make true advances and so collaborating with different areas is key. Particularly as everything can be influenced by the body’s endocrinology!

What is it like being a Society for Endocrinology member?

I have to say, since joining this society I have felt so welcomed into a community. I’ve been given opportunities that have never been presented to me before from other societies. The Society on the whole seems to actively push and support their more junior members.

Unfortunately, I’ve not had the chance to attend any Society events in person yet but hopefully I will get the opportunity to attend soon!

Who is your most inspirational scientist?
Again, speaking personally, the most inspirational endocrinologist to me is Frederick Banting, the discoverer of insulin. This is because my 4 year old daughter has type 1 diabetes and without insulin, she wouldn’t be with us anymore! I think a lot of people have Banting’s discovery to thank!

John Hunter always sticks out as someone who should be more famous than he is. He truly is one of the greatest anatomists of our time, discovering much of what we know now around anatomy and physiology all without a formal school education. Of interest to my work – he was the first to note that maternal and foetal blood supplies are separate during pregnancy

Any words of wisdom for aspiring researchers in endocrinology?

Speaking from experience, something I like to tell my students is not to stick to your own little bubble. Everything in medicine and biology is connected in one way or another and keeping an open mind to your research can allow you to progress, where you may not have otherwise. Due to this, don’t be afraid to switch “topics” because you can always find common themes.

Finally, make sure you enjoy what you do! I’ve been lucky to work in some amazing areas, with amazing people but what’s really helped is enjoying my work!



The Society for Endocrinology is 75 years old in 2021. As part of our celebrations, we are collecting members’ opinions, with a focus towards the future – after a particularly hard year for us all!

We are keen to reflect the diversity and breadth of our discipline by hearing from members across all backgrounds, career stages, career types and geographical locations, to get a true flavour of the range of views, needs and challenges faced by our Society members.

Would you like to get involved and share your views? Simply complete this short questionnaire or send your comments to media@endocrinology.org.

Resolving Uncertainties in Diagnosis & Management of Thyroid Neoplasia

CARLA MORAN WEB IMAGES 1 (3)Dr Carla Moran is a Consultant Endocrinologist at the University of Cambridge and a convenor of the Society’s Thyroid Endocrine Network. In 2017 she was awarded a Society Themed Scientific Meeting Grant to hold the one-day meeting, Resolving Uncertainties in Diagnosis & Management of Thyroid Neoplasia, on 8 March 2019 at Churchill College in Cambridge. The meeting brought together international and UK experts, as well as practicing clinicians and non-clinical scientists, to discuss advances in the field. Here Carla gives us a report of the day.

Need for the meeting
The landscape of investigation for thyroid neoplasia and management of low risk thyroid cancer is changing. Overascertainment of thyroid nodules has fuelled an epidemic of thyroid neoplasia but the death rate from thyroid cancer is unchanged. Many of these nodules are unnecessarily over-investigated, and if cancer is detected, may be overtreated. It has been suggested that more than 200,000 cases of thyroid cancer have been unnecessarily detected in the USA between 1988 and 2007, and the UK has not avoided this phenomenon of overdiagnosis[1]. In addition, in the UK, almost all radiologically and cytologically indeterminate nodules undergo surgery for diagnosis, resulting in high rates of unnecessary surgery for benign disease. Although our international colleagues are using RNA and DNA diagnostic techniques to stratify the likelihood of malignancy in these nodules, such tests have not been evaluated in UK clinical practice. Pathological definitions of thyroid neoplasia are being revised, such as redesignation of follicular variant of papillary thyroid cancer to noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP). Lastly, management of thyroid cancer is evolving, with surgical extent, radioiodine use and dose and TSH suppression all being tailored to disease risk. This suggests that a stratified approach, with use of better markers (radiological, cytological, molecular) to select nodules for investigation and treatment, is required.

Overview of the day
Current guidelines advocate a multidisciplinary approach to thyroid nodules and cancer, with input from endocrinologists, radiologists, pathologists, surgeons, oncologists and nurse specialists, however no national meetings are held with all these disciplines in attendance. Led by the Society Thyroid network, in partnership with the British Thyroid Association and UK Endocrine Pathology Society, this meeting gathered international and UK experts in all these disciplines, as well as practicing clinicians and non-clinical scientists, to discuss current UK practice and advances in the field. Invitations extended to members of other societies (e.g British Association of Endocrine and Thyroid Surgeons) and patient groups (British Thyroid Foundation, Butterfly Thyroid Cancer Trust) interested in the field.

Topics reviewed included: the thyroid cancer epidemic (Krishna Chatterjee, Cambridge), ultrasonographic classification (Steve Colley, Birmingham), cytological categorisation (Sarah Johnson, Newcastle), molecular pathogenesis (Chris McCabe, Birmingham), nodule molecular diagnostics (Bryan McIver, USA), pathological risk stratification (David Poller, Portsmouth), surgical management of low risk tumours (Dae Kim, London), papillary microcarcinoma (Carla Moran, Cambridge) and stratified management of thyroid cancer (Jonathan Wadsley, Sheffield). Oral presentations demonstrated that high quality UK research is being performed in this field.

Collaboration is key
Collaboration between disciplines was essential for this meeting; the primary speciality leading diagnosis & management of nodules varies widely between centres across the UK, such that specialist society (e.g. endocrine, surgery, pathology, radiology) meetings often exclude many interested professionals; it is exceptionally rare for all relevant disciplines to meet to discuss the topic. Discussing areas of uncertainty identified by all specialties allowed us to compare approaches. Internationally, variation in practice variation is also substantial, most notably with regard to the use of molecular diagnostic techniques. Clinicians in the UK do not have any significant experience of using such diagnostic tools, such that Dr McIver’s experience and opinion of this area was highly informative. Lastly, attendees were individuals experienced and interested in the field; this ensured that discussions were highly applicable and informative.

Funding was crucial
When organising this meeting, funding received from the Society for Endocrinology was invaluable; without it we would not have been able to attract such high-quality speakers from the UK and US. Feedback from the meeting was universally strongly positive, with many attendees expressing a desire to attend a similar meeting in future.

Future
A unique aspect of the meeting was the workshop held the day after the main programme, attended by those interested in pursuing research aiming to identify solutions to challenging areas of current practice. We hope the meeting will inform scientific design of a UK-wide, multicentre, prospective study to evaluate diagnostic utility of new molecular technologies alongside current cytological/pathological practice. In addition, participants in this meeting are likely to be key members of a working group which will formulate national guidance on the diagnosis & management of thyroid nodules in the UK.

References
1. Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. N Engl J Med. 2016 Aug 18;375(7):614-7.

Meet the editor – Professor Martin Haluzík

Meet Professor Martin Haluzík, Professor of Internal Medicine at the Charles University in Prague, Deputy Head of Centre for Experimental Medicine and Head of the Department of Experimental Diabetology at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. Professor Haluzík is a deputy editor of the Journal of Endocrinology and Journal of Molecular Endocrinology. His major research focus is on the etiopathogenesis of obesity, insulin resistance and type 2 diabetes. In this interview, Professor Haluzík tells us more about his research and career.

Tell us about your particular field and research?

Our lab explores the etiopathogenesis of obesity and type 2 diabetes aiming to find preventive and treatment strategies. We are particularly interested in bariatric surgery and endoscopic methods of treatment along with novel pharmaceutical targets. Our research is both experimental and clinical, involving patients with obesity and type 2 diabetes.

What techniques do you use in your research?

At the moment, a lot of our research is focused on immunometabolism/subclinical inflammation in adipose tissue using flow cytometry and continuously trying to refine it. We are also using metabolomic and proteomic methods in collaboration with other laboratories. In patients, we often use glucose clamps to characterise insulin sensitivity before and after interventions. We are also testing numerous novel endoscopic methods for treatment of obesity/type 2 diabetes in both experimental models and in patients.

What inspired you into endocrinology?

It was primarily my mentor, Professor Vratislav Schreiber, who was a leading, internationally-recognised, experimental endocrinologist. His primary focus was hypothalamus/hypophysis research but he was the one who, after discovery of adipose tissue hormone leptin, came up with the idea that we should focus on the endocrine function of fat.

What do you enjoy most about work?

I really enjoy its variability – doing both experimental and clinical research brings some challenges but this combination is never boring. I very much like scientific discussion with my colleagues about our results and brainstorming how to explain it and put it into context. I also like writing the papers, especially when nobody is calling and I have a couple of hours to focus on thinking about data and writing.

What does your day-to-day work life involve?

I do both clinical work (seeing patients with diabetes/endocrine diseases) and experimental research. Nevertheless, I have to admit that I am not very useful in the lab anymore. My job is mostly to write grant applications, organize things, write and refine the papers and support my colleagues and PhD students.

What are you most looking forward to in becoming an editor?

I am very much looking forward to a chance to contribute to shaping and refining the focus of such well-respected journals of Journal of Endocrinology and Journal of Molecular Endocrinology. Also, I really like interaction with the Editorial Board and other members of the team that bring most interesting ideas that help us to improve the journal.

Who/what research has inspired you the most?

My first mentor, Professor Vratislav Schreiber, who contributed to the discovery of TRH. He was very inspiring by a combination of being extremely smart and modest at the same time, while having an unforgettable sense of humour.

What is the best feedback or advice you have ever received?

“Work smart not hard” although I am still learning how to do it, which involves a lot of hard work.

Is there any advice you can give to someone just starting off in science?

Go for it! I would make the same choice again if I could start over. It is a lot of work but you don’t really need any other hobbies. You can think about science all the time.

Meet the Endocrinologist: Stafford Lightman, expert on regulation of the hypothalamo-pituitary-adrenal axis

Meet Stafford Lightman, Professor of Medicine at the University of Bristol. His research focuses on understanding the role of the hypothalamo-pituitary-adrenal (HPA) axis in health and disease, and in particular its interface with stress and circadian rhythms and its effects mediated through glucocorticoid signalling. He has been awarded the SfE Medal and will be delivering his Medal Lecture at SfE BES 2018, 19-21 November in Glasgow. In our latest interview, he tells us more about his career, research and what he is looking forward to at the SfE BES 2018 conference.

*Prof Lightman is pictured at the Goroka Festival, Papua New Guinea’s equivalent of Glastonbury! 

Can you tell us a little about your current position and research?

When I was appointed Professor of Medicine at the University of Bristol, very little endocrine research was going on there, which had the great advantage of providing me with a clean slate and the ability to develop my own research theme. Now I have a lab group that ranges from the very basic cell and molecular science through physiology, right up to clinical research. I really enjoy being able to translate up to humans and then back translate down again to animal models. Having a group of scientists and clinicians working together is a really exciting environment to work in.

Can you tell us a little about what inspired you into endocrinology?

I was always interested in human biology and my earliest research was in anthropology, which naturally led into human behaviour and to neuroscience. I initially wanted to be an academic clinical neurologist but at that time neurology research centred around the peripheral nervous system, and I was interested in the brain! The one way I could investigate brain function was through the window of hypothalamic-pituitary function, therefore I became a neuroendocrinologist. Since then I have been working at the interface of endocrinology and neuroscience, which I find fascinating.

What you are most proud of in your career so far?

I am most proud of the people that I have helped to train, who have gone on to do well afterwards. It is also really rewarding to have set up lots of collaborations with mathematicians, and fascinate them in the dynamics of hormones. They have of course also been very both for me and the subject, developing   the concept of hormone dynamics. With the exception of GnRH, endocrinology was often considered a homeostatic but relatively static science, where hormone levels are measured and found to be either too high or too low. This is clearly far from reality and trying to bring the idea of dynamic hormonal systems into the mainstream is something I have been very involved with.

Tell us what you enjoy about your role as President of the British Neuroscience Association (BNA)?

I love meeting lots of really interesting people. The brain is such an interesting area and I enjoy understanding how it interacts with all aspects of our lives. The BNA 2019 Festival of Neuroscience will be held in Dublin on 14-17 April 2019, and will be in collaboration with the British Society for Neuroendocrinology, and include a scientific symposium sponsored by the Society for Endocrinology. So, there will also be a strong element of endocrinology running throughout the meeting. However, it is a great event for bringing together lots of diverse areas of neuroscience.

What are you presenting in your Medal Lecture at SfE BES 2018?

I will be discussing how aspects of HPA physiology are governed by dynamics, from the stress response to the circadian rhythm. The underlying dynamics of this system are what allow us to be flexible and to maintain a homeostatic state. I will also be talking about improved ways of diagnosing endocrine disorders. If we can harness novel technologies to measure dynamic changes in hormone levels in patients at home, we can gather much better information for diagnosis and treatment.

What are you looking forward to at this year’s conference?

From my own point of view the best part of the conference will be discussing posters with young, enthusiastic scientists right at the start of their careers. The posters are a really exciting area where people are putting out new ideas, in all areas of endocrinology. I like to be educated, so enjoy going to posters in areas where I don’t know much and hearing about what people are doing and why they find it exciting.

What do you think are the biggest challenges in endocrinology right now?

I think there are two main challenges, one of which I alluded to earlier.

  1. In terms of HPA the challenge lies around how we can measure dynamic changes in hormone levels in patients at home. I think the whole field of medicine is moving away from keeping people in hospital, to do lots of blood tests, sending them home, calling them back in to discuss results and finding you don’t have the right answer. Diagnosis can then be prolonged, inaccurate and very expensive, all of which is bad for patient care. The real challenge is finding better ways of doing this, and doing it in patients at home.
  2. Another challenge concerns the best way to give glucocorticoid replacement therapy. There is currently great debate on this in the field but it is important that we find the answer. Poorly managed glucocorticoid replacement is associated with considerable morbidity and mortality, so lots of attention is focused on finding a better way of doing it.

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

I think the ability to monitor patients’ hormone levels over a 24 hour period will be a major breakthrough, and will provide the basis for better understanding of normal physiology and better diagnostic methodologies.

We have been developing a wearable collecting device that can be worn by patients at home. Using this device, patients would need only a quick visit to have it fitted and another, 24 hours later to have it removed. This is sufficient to provide full tissue biochemistry over a 24 hour period. This would minimise the time in hospital and provide a personalised medicine approach with a wealth of data that gives an overall picture of the individual’s health. This type of approach could revolutionise diagnostics and really improve patient care.

Once we understand how to apply this technology we will have better more rational ways of targeting and timing treatments, to address the challenges mentioned in the previous question.

What do you enjoy most about your work?

I love the challenge of new ideas and using them to work out answers to important questions. It is also a pleasure and privilege to have the opportunity to work with great colleagues.

Who do you admire most in the world of endocrinology?

The first piece of endocrinology that ever excited me was Vincent Wigglesworth’s work on the hormone, ecdysone. He was a brilliant entomologist and his beautifully designed experiments on the extraordinary process of metamorphosis was a real eye opener. He was my first endocrine hero!

Any words of wisdom for aspiring endocrinologists out there?

Enjoy, enjoy, enjoy! You really need to enjoy your work, or you should be doing something else. I describe what I do as privileged play!

You can hear Professor Lightmans’s SfE Medal Lecture, “HPA activity: Don’t forget the dynamics” on Monday 19 November, in the Lomond Auditorium at 17:30. Find out more about the scientific programme for SfE BES 2018.

Meet the Endocrinologist: Leanne Hodson, expert on metabolic physiology

Meet Leanne Hodson, Professor of Metabolic Physiology at the University of Oxford. She specialises in changes in metabolism caused by nutrition including the metabolic consequences of obesity.  She has been awarded the SfE Starling Medal and will be delivering her Medal Lecture at SfE BES 2018, 19-21 November in Glasgow. In our latest interview, she tells us more about her career and what she is looking forward to at this year’s conference.

Can you tell us a little about your current position and research?

I am currently a British Heart Foundation Senior Research Fellow in Basic Science and Professor of Metabolic Physiology at the University of Oxford. The lab is focussed on research related to human health and metabolism; this includes the influence of specific nutrients and the consequences of obesity and obesity-related diseases, such as non-alcoholic fatty liver disease (NAFLD). Although our work has a focus on hepatic metabolic physiology, it covers a number of broader areas including: endocrinology, nutrition, hepatology, diabetes and liver transplantation.  We use a combination of human in vivo, ex vivo and in vitro models to undertake our studies.

Can you share some of your proudest career moments?

I am originally from New Zealand and had various career paths before eventually making it to University, where I obtained my PhD.  In 2004, I received the Girdlers Health Research Council (New Zealand) career development fellowship which provided the opportunity to work at the University of Oxford with Professors Keith Frayn and Fredrik Karpe. I was awarded a British Heart Foundation Intermediate Basic Science Research Fellowship in 2011, and became an Associate Professor of Diabetes and Metabolism in 2014. In 2015, I was awarded a British Heart Foundation Senior Basic Science Research Fellowship and in 2018 became Professor of Metabolic Physiology.

I am proud of many things including the reputation and the quality of work my lab, which leads to collaboration requests from well-respected and very talented scientists. Getting my fellowships, becoming a professor and getting the SfE Starling medal are definitely highlights. However, I am most proud of the environment I have been able to create for my research group, which is dynamic, productive and supportive – I am fortunate to work (and collaborate) with a wonderful group of individuals.

What are you presenting at your Medal Lecture at SfE BES 2018?

My group is interested in understanding why fat starts to accumulate in the liver and what the effects of insulin and specific nutrients or therapies are on this process, including the subsequent effect this then has on metabolism. In my Medal Lecture I will present what we have learnt over the last 14 years and how we have further developed and incorporated new models and state-of-art methodologies to study human liver fat metabolism.

Is there anything you are particularly looking forward to at this year’s conference?

I am very much looking forward to hearing the Early Career talks and going to the poster sessions, as it is a great chance to learn what work is coming out. Also I am going to the applied physiology workshops, as these are something I have not experienced before and I am sure I will learn a lot from them.

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

Developing models (particularly in vitro models) that better recapitulate the human disease that we are trying to study, as the historical ones, although interesting, are not reflective of human physiology.

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

Good question! I would like to think we will soon have more sensitive and specific biomarkers to detect the different stages of NAFLD. Improved biomarkers will allow us to study changes in hepatic metabolism at clearly defined stages during the progression of NAFLD, therefore increasing our likelihood of developing therapeutic agents to treat the disease.

What do you enjoy most about your work?

There are two things I most enjoy about my work:

  • the process of watching projects come to fruition and seeing the results come together is really exciting,
  • creating a supportive environment that challenges individuals to reach their full potential and grow in confidence.

Who do you most admire professionally?

Professionally, there have been many people (both senior and junior) past and present who I admire for a multitude of reasons; including their professionalism, patience, knowledge, determination, resilience and enthusiasm. They have passed on little gems of information – through their actions and words. These individuals know who they are and I cannot thank them enough for their support over the years.

I have been involved in the sport of rowing for over 30 years and, as a coxswain, I have been involved in boats that had world-class coaching and two coaches particularly stand out, despite their very different coaching manners. They both fostered a strong team commitment, had the ability to personalise their coaching to bring out an individual’s full potential (and beyond), and kept the focus on the process (rather than the outcome). For this I have huge admiration and have learnt to apply these techniques to my academic career.

Finally my grandfather, who passed away 4 years ago was a very important person in my life, along with a great work ethic (and zest for life) he was an incredibly well-respected rugby coach who had a unique ability to bring out the best in teams.

Any words of wisdom for aspiring endocrinologists out there?

Take the unexpected opportunities that present themselves (they could be the best decision you ever make) and if you are unsure find a mentor, who you trust and who is honest and constructive (listen to their advice, even if it is not what you want to hear). Remember that an academic career comes with disappointments. I don’t use the word failure as none of us fail, we just take different paths to successes, so it is important to persevere and build resilience but most importantly enjoy what you do!

 

You can hear Professor Hodson’s Starling Medal Lecture, “Hepatic fatty acid metabolism: the effect of metabolic and nutritional state” on Monday 19 November, in the Lomond Auditorium at 14:45-15:15. Find out more about the scientific programme for SfE BES 2018.