Taking a personalised approach to medical research

tony-bjourson-ulster

Ulster University is developing pioneering diagnostic tools for a wide range of diseases

Genomics professor Tony Bjourson joined Ulster University in 2001 after participating in a diverse range of projects such as the breakthrough European Union yeast genome sequencing project in the 1990s.

He has since established or led several large infrastructure and research initiatives, including as research director of Ulster’s Centre for Molecular Biosciences. Today he leads the Northern Ireland Centre for Stratified Medicine. As part of its wide-ranging research on personalised medicine, it has a focus on genome sequencing.

Bjourson’s current research is in genomics-based personalised medicine. “It’s the combination of our genetics and our environmental exposures that determines which diseases we may succumb to and secondly how we may respond to treatment…Personalised medicine aims to personalise our approach,” he explains.

Personalised, or stratified, medicine takes into account the intricate balance of multiple factors such as genetics, existing medical conditions, circadian rhythm (biological clock), metabolism, environmental exposure, lifestyle and diet. Using computational methods, researchers analyse this clinical, lifestyle, genetic or epigenetic and environmental data to identify potential novel sub-classes of patients with medical conditions such as cancer, rheumatoid arthritis, depression and multiple sclerosis, all with specific but sometimes shared biological or environmental drivers affecting how patients may respond to treatment.

As NICSM’s director, Bjourson leads Ulster University’s research into personalised medicine that is aimed at better diagnosing or informing treatment for autoimmune and cardiovascular disease, diabetes, cancer and mental health pharmacogenomics.

Bjourson opened NICSM at the Clinical Translational Research and Innovation Centre as a partnership between Ulster University’s Biomedical Sciences Research Institute, Derry City and Strabane Distract Council, the Western Health and Social Care Trust at Altnagelv in Area Hospital in Derry in 2013 with £11.5 million in grants from the European Union Regional Development Fund, the European Union Sustainable Competitiveness Programme for Northern Ireland, the Northern Ireland Public Health Agency’s Health and Social Care Research and Development Office and Ulster University. The project included the sequencing of the human genomes and building a biobank combining genomic, clinical, proteomic and lifestyle data for patients with multimorbid degenerative diseases. Part of the initiative was in collaboration with Genomics Medicine Ireland. Almost 3,000 of a potential 7,000 genomes have been completed so far. The NICSM team now has more than 20 invention disclosures going through the intellectual property process, which it aims to commercialise either through partnering with companies or by forming spin-outs.

In 2018 the team continued to expand, with a new NICSM-led partnership of 14 partner organisations drawn from academia, business and health sectors facilitated by the award of €8.6 million (£7.5 million) from the European Union, establishing the Centre for Personalised Medicine, Clinical Decision Making and Patient Safety with a focus on improving patient outcomes.

In addition to this research, the NICSM and C-TRIC teams work with the Northern Ireland Health Trusts and primary care providers undertaking a major patient recruitment contract for Genomics Medicine Ireland, an Irish subsidiary of genomic information company WuXi NextCODE, with the global-scale resources and platform to realise one of the largest whole-genome sequencing programmes in the world. This involves recruiting many thousands of patients for whole-genome sequencing of patients with Alzheimer’s disease, inflammatory bowel disease, multiple sclerosis and other conditions.

Bjourson and his team hope to convert academic discoveries into usable treatments. “Libraries are full of journals people like me have written about a new treatment or test for a disease, but invariably they just sit on the shelves and are often not translated into actual patient benefit,” he says.

C-TRIC works with businesses to develop and test novel diagnostics, providing access to facilities and expertise in biomedical science, engineering and IT. It also helps international companies that want to carry out research in Northern Ireland find lab space and navigate the ethical and regulatory requirements of clinical trials.

“We see ourselves as very much a facilitator and driver for pushing forward personalised or stratified medicine,” says Bjourson. That means not just enabling research but providing a pipeline of academic talent and a skilled workforce for regional development, and embedding the ethos of personalised medicine into the everyday lives of busy clinicians and society.

“I wanted to recruit biomedical staff that were computer literate and could write computer code [but] those people are rare and it’s hard to find people with this dual skill set,” he adds. In response, in 2013 the NICSM established both undergraduate and master’s courses in personalised medicine that teach students and researchers not only biomedical sciences but also computer coding skills to enable them to analyse large data sets of genomic and clinical data.

Meanwhile, many of NICSM’s talented and ambitious researchers – who joined initially as early-career researchers – are now developing programmes and expanding partnerships of their own that will further improve and increase this field. This includes a clinical trials start-up, a neuromuscular disease centre and a centre for paediatric oncology.

“The secret is to continue to adopt and expand research in various disease areas,” says Bjourson. “That’s where we’re at and it’s an exciting place to be.”