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La informacion que figura en esta edicion digital esta dirigida exclusivamente al profesional destinado a prescribir o dispensar medicamentos por lo que se requiere una formacion especializada para su correcta interpretacion.
Ayer martes se presentaron los resultados del Estudio Challenge, un ensayo centrado en el tratamiento de las heridas crónicas de origen venoso. Su acción estimuladora del sistema inmunitario ofrece beneficio en las fases tempranas de la enfermedad.
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Innovacion para el medico especialista de hospital y atencion primaria: investigacion medica, gestion, tecnologia y servicios sanitarios.
The initiative will provide capital and some recurrent funding throughout the UK for new research technologies in clinical studies.
In July 2014 an expert review panel awarded funding to 23 proposals spanning a range of disease areas and technological approaches. The newly created facilities will bring into practice novel technologies to address a range of major health challenges such as dementia, cancer, metabolic disorders, arthritis, and respiratory diseases. Investments will be made in close proximity to clinical investigation and care, alongside existing academic research strengths and institutional clinical structures. Investments will be managed as part of a national science base with operating arrangements and technologies designed to be interoperable. Cardiff University will install a new 7 Tesla MRI system within the newly rebuilt and expanded Cardiff University Brain Research Imaging Centre (CUBRIC). This system will sit alongside other imaging systems tailored to revealing the brain’s microscopic tissue structure and electrical activity, making the combination of equipment within the new CUBRIC unique in Europe. Nottingham has considerable expertise and a long track record of success in the development of MRI.
It also has strong research programmes in gastroenterology, liver disease, metabolism, sports medicine, orthopaedics, respiratory medicine, mental health, hearing and radiological sciences. The University of Sheffield is internationally leading in research and development of the methodology for clinical lung imaging with hyperpolarised gases and proton MRI.
Using these techniques they have created highly detailed functional images of lungs affected by conditions such as smoking, cystic fibrosis, emphysema, pulmonary hypertension and asthma. Researchers at the Universities of York and Leeds are developing a new imaging method (SABRE) that has the potential to increase the signal in a MRI image by up to 100,000 fold.
The UK 100,000 Genomes Project will accelerate the application of whole genome sequencing (WGS) into routine care for the National Health Service.
Their interdisciplinary research programme will focus on the molecular study and characterisation of different cell types within each disease and the associated molecular changes in the patient.
This new facility will use new developments in mass spectrometry, such as SWATH-MS and related techniques, that support the measurement of many proteins within a single sample (such as blood, urine, or from tissue such as a tumour biopsy) within a much shorter time than has ever been possible before.
Such approaches will be of huge benefit to clinical researchers as it will allow them to see the differences between samples from, for example, healthy people and people with a specific disease - this will give insights into how that disease develops and, importantly, how it might be treated. A new scientific and computing infrastructure will be built in the School of Clinical Medicine at the University of Cambridge that will allow i) development of new technologies for measuring and imaging molecules in humans, and ii) application of these technologies directly and immediately to major research programmes for understanding and treatment of cancer, metabolic disorders, and many other therapeutic areas.
Three new high-tech facilities will be created; a Stratified Medicine Core Laboratory (SMCL), a Molecular Imaging Centre (MIC), and a High Performance Hub for Informatics (HPHI).
All drugs are associated with variability in response: that is some patients do not respond to drugs, while others develop side effects or adverse drug reactions (ADRs). The internationally recognised MRC Centre for Drug Safety Science (CDSS) allows pre-clinical and clinical scientists to work side-by-side using cutting-edge technologies to analyse well-defined clinical samples.
Radiation therapy involves delivering high-energy X-ray beams to tumours in order to kill cancer cells. For many people with cancer, radiation therapy is very effective and frequently cures their disease. UCL will establish a new facility that aims to revolutionise diagnosis, risk stratification and therapy for people with cancer, based on innovations in MRI technology. The group at QMUL plan to accelerate the use of genetics in medicine, through the study of genome in cases of parental relatedness (e.g.
Cell-based therapies represent the cutting edge of research for new treatments for a variety of conditions. MRI imaging has become a requisite part of the investigation of many brain disorders; but there is a need for more imaging research in dementia. The new 7T MRI scanner at Cambridge will be dedicated to the challenge of dementia, supported by scientific work to understand the normal brain and develop advanced analysis techniques.
The new Centre of Single Cell Biology (CSCB) at Oxford will be coordinated by the Weatherall Institute of Molecular Medicine (WIMM) which has a long-standing technical and strategic expertise in single cell research. Examination of diseases at single cell resolution, both at diagnosis and after treatment, will transform the practice of molecular medicine by improving the quality of patient diagnosis, refining treatment options, monitoring of response to treatment, and detecting the emergence of resistance to treatment. Researchers at Manchester will focus on characterising a group of rare cells (called circulating tumour cells, or CTCs) that give rise to drug-resistant cancers - such as certain lung cancers - and lead to relapse, and specific stem cells (cells with the potential to self-renew or differentiate) that can enable the regeneration of damaged tissues such as muscle, joints, skin and blood vessels.
Exploiting and innovating in the very latest single cell technologies, it will comprise a common integrated pipeline from receipt of clinical samples, to identification and characterisation of single target cells within each sample, to the design of treatments that target these specific cells. Newcastle University has a well-established track record studying the molecular basis of rare disease, underpinned by unique cohorts of patients with defined disease characteristics and biobanked tissues.
Their work on rare mitochondrial, neuromuscular & musculoskeletal diseases, rare childhood cancers, rare immune deficiencies, and novel cell therapies is renowned internationally. The University of Leeds and Leeds Teaching Hospitals NHS Trust will establish a joint facility that will permit new biomedical research approaches, based on the sequential isolation, manipulation, observation and eventual destructive analysis (or culture and expansion) of single cells. While technically innovative, this facility will focus on delivering biological insights and capabilities that are relevant to their clinical areas of expertise and excellence; in this way these discoveries will translate quickly into patient benefit. A possible solution to identifying different cell types in cancers is to study Circulating Tumour Cells (CTCs) as surrogates of tumour tissue.
CTCs are cells that are shed into the circulation and can be isolated from the blood for further analysis. The award will enable Exeter researchers to invest in single molecule real-time (SMRT) sequencing technology and also expand their high performance computing facilities for the analysis of complex genomic data. The equipment will be housed in the new Wellcome Wolfson Clinical Research Facility, within the Research, Innovation, Learning and Development (RILD) building, which the Medical School shares with the Royal Devon and Exeter NHS Foundation Trust.
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In recognition of the need and value of bringing together clinical and research skills and expertise, the MRC and EPSRC have agreed to partner in the establishment of a number of regional Molecular Pathology Nodes a€“ centera€™s of excellence that will bring clinical and research skills and expertise closer together. Gracias a los medicamentos biosimilares, más pacientes tienen acceso a tratamientos y medicamentos de calidad a precios muy competitivos.
La informacion que figura en esta edicion digital esta dirigida exclusivamente al profesional destinado a prescribir o dispensar medicamentos por lo que se requiere una formacion especializada para su correcta interpretacion. The key objective is to support innovation - specifically to fund novel equipment and capabilities that will most effectively advance the UK’s ability to explore new areas in clinical research.
Funds will be available from April 2015 with the majority of projects due for completion by the end of March 2016.

Co-creation opportunities and partnerships with industry will feature strongly, as well as alignments with current clinical research infrastructures such as NIHR Biomedical Research Centres and Units, Genomics England and comparable health department investments in Scotland, Northern Ireland, and Wales. Several new networks emerging directly from the initiative will help facilitate knowledge dissemination, training, and shared access arrangements. CUBRIC will also have a clinic where new treatments can be tested in patients and the way that their brains respond can be measured using the brain scanners. The group were the first in the UK to install and develop a 7T MR scanner, and their work and that of others has proven the capabilities of 7T MR in the brain, for example identifying markers of Parkinson’s Disease.
However, several technical barriers, such as ease of polarisation of the gases used and the additional hardware required for the MRI scanners, still need to be overcome before this technology can become a more routinely used clinical method. The method achieves the magnetic labelling of specific molecules so that they can be visualised as they pass through the body without changing their role.
By incorporating this into routine care it will transform the health services people receive, changing the processes of diagnosis and management. They will 6 develop and test the integration of multiple diagnostic methods, including mass cytometry, metabolic phenotyping and analysis of single cells. In addition, by examining the differences in the levels of particular marker proteins from patients who respond to a drug compared to those who don't respond, doctors will be able to identify which drug is the best treatment for individual patients. The SMCL will allow measurement of a large number of peptides and other molecules in blood or other tissue samples with enhanced accuracy and sensitivity.
New state-of-the-art technologies funded through this initiative will build upon this infrastructure by helping to identify the best treatments for patients based on how drug responses vary, how diseases differ between individuals, and how this information relates to variation in clinical outcomes.
Unfortunately, when treating tumours, nearby healthy tissues will inevitably receive some of the radiation and this is associated with side effects that can severely affect a patient’s quality of life.
It brings together data from around 2 million study participants to try and discover the causes of dementia, and to find ways of delaying onset and slowing progression. The group at UCL will use innovative MRI technology in their dedicated Dementia Research Scanner Centre to maintain and enhance their position as a leader in clinically applied dementia imaging research and also to maximise their contribution to the UK Dementia Platform. It will be a major contributor to the UK Dementia Platform, a unique approach to join up medical research across the country's specialist centres and drug company partners in the fight against dementia. The new investment will be used to enhance single-cell research capabilities across the campus, providing new capabilities for data analysis, new laboratories, and new equipment. Cambridge scientists have been at the forefront of basic research in single cell expression profiling and the analysis of circulating tumour DNA, as well as setting up local Biotech companies that develop novel single cell technologies.
In this way, they will expedite progress to cell-based and 'personalised' treatments for some of the most challenging diseases and degenerative conditions of man. Single cell functional genomics and proteomic approaches have the potential to advance understanding of these diseases and thus explain why patients with the same disorder develop a different clinical presentation, and respond to treatments in different ways.
CTCs are very rare cells by comparison with blood cells and highly sophisticated technology has been developed to enrich for CTCs and isolate them. The new technology will enable researchers to identify and analyse regions of the genome hidden from current methods for gene discovery, facilitating research into the functional mechanisms involved in disease. Despite this success, however, many regions of the genome remain hidden to contemporary DNA sequencing approaches.
Using the 7T MRI system researchers will investigate the causes and treatments of brain conditions including schizophrenia, dementia, Parkinson's disease, Huntington's disease, multiple sclerosis and conditions that can cause damage to the brain such as hypertension (high blood pressure). The new investment at the SPMIC will allow the capability of their 7T scanner to be expanded beyond just the brain.
The expansion of the gas polarisation facilities enabled by this grant will have many benefits for both Sheffield and collaborating centres, by creation of a national hyperpolarised gas imaging facility for collaborating institutions that don't have access to this technology.
With this technique it is possible to label both drugs and substances that occur naturally in the body, making the method widely applicable. The UK 100,000 Genomes Project seeks to drive this change by sequencing 100,000 genomes of individuals affected by rare diseases and cancer (and their families) and infectious disease pathogens.
Through this, they will obtain new insight into the mechanisms of how diseases develop and progress, and their responsiveness to treatment, with the aim to drive innovative discoveries into clinical practice through the establishment of stratified diagnostics and targeted therapies. The MIC will allow measurement of molecules by imaging patients, rather than by lab analysis of tissue samples. For example, understanding why some patients who take statins develop muscle-related problems could help identify an alternative treatment strategy for these groups. Therefore, when treating patients with radiotherapy, there is a clear need for the treatment to be delivered as accurately as possible.
Whilst imaging helps to find disease, doctors don't always know whether a lesion on an image is cancer or whether it is benign. In individuals with parental relatedness, certain genes that would usually be switched on, can be completely inactivated. Currently there is a significant gap in the UK's clinical research capabilities and infrastructure to deliver trials involving cell-based therapy, largely because cell therapies require specialised facilities to safely manage the cells for human administration. The platform, launched in 2014, represents a growing collaboration of UK Universities and pharmaceutical companies. The upgrade to their existing 3T MRI scanner will not only enhance the imaging capabilities locally but the related innovations will help direct the way for major multi-centre clinical trials in dementia, which are increasingly reliant on 3T infrastructure. The new scanner will be located on the Cambridge Biomedical Campus, next to Addenbrooke’s Hospital, and will be used to detect and characterise the changes over time in major brain diseases like Alzheimer's, stroke and Parkinson's disease as well as mental health disorders and healthy ageing.
The lead programme of research in the CSCB will be focused on inherited disorders of red blood cells.
A new shared core facility for single cell analysis will be created (the Cambridge Single Cell Analysis Clinical Core Facility [SCACCF]), which will serve all major molecular medicine programmes in Cambridge including cancer, neurosciences, immunity and inflammation, infectious diseases, stem cell and regenerative medicine, metabolic medicine and experimental therapeutics. Researchers aim to bring together expertise and infrastructure focused on the molecular characterisation of single cells by forming the Newcastle University Single Cell Functional Genomics Unit (NUSCU). In parallel there have been technological advances in genetic sequencing such that it is now possible to identify mutations and analyse gene expression in single cells. Only three other SMRT sequencers are currently installed in the UK, and this will be the first directly embedded within a clinical research facility.
The proposed research will also link the discovery of genetic factors associated with brain disease to 4 detailed assessments of brain structure and function made with the 7T MRI system. This technology will then be applied to a much broader set of research programmes at Nottingham. The continuing methodological research in to MRI scanner hardware and image acquisition, clinical evaluations and work with drug companies evaluating new respiratory therapies on the new 1.5T scanner will ensure that the UK becomes the leading nation in this important area of diagnostic pulmonary medicine.
Through previously and currently funded work, the York group has been developing the technical aspects of this method. The UK Infrastructure for Large-scale Clinical Genomics Research will provide the infrastructure which, using the information from the 100,000 Genomes project, will develop the UK as an international centre of excellences for the analysis of very large and complex biomedical datasets.
The HPHI will provide the computational resources required to store and analyse the very large volumes of data produced by the SMCL and the MIC, whilst enabling linkage of the data to individual patient records and sharing with the wider scientific community. In most cases, radiotherapy is planned using a CT scan to show the position of the tumour; this is usually done before the treatment starts. The group will therefore combine the latest imaging technologies with an understanding of the cellular and molecular environment of cancers in order to verify diseased tissues.

Finding such genetic variants and examining their consequences and benefits can lead both to an increased knowledge of how human genes work and an improved understanding of the health consequences of genetic variation in the relevant communities. A new cell therapy facility will be established in Belfast to enable the testing of cell therapies in clinical trials for conditions including respiratory failure in the critically ill and vision loss. This investment will increase the capability of Dementias Platform UK by enhancing the UK dementias research infrastructure in terms of facilities and science networks, putting the UK at the forefront of dementia research worldwide.
The need is urgent to identify people in the earliest stages of such diseases, or even before symptoms, in order to test treatments that combat dementias. These disorders are amongst the most common of all human genetic diseases worldwide with an estimated 300,000 affected babies born each year and a total number of affected UK patients of ~16,000. The SCACCF will act as a hub for the UK and will work closely with strategic partners in the Cambridge area (Babraham Institute, Wellcome Trust Sanger Institute, the European Bioinformatics Institute, the MRC Laboratory for Molecular Biology, major pharma & biotech), to bring their different capabilities to bear on clinical research challenges. This means that, for the first time scientists can begin to understand tumour heterogeneity at the single cell level. We will also establish high-performance computing infrastructure needed to store and analyse this complex data. This will give a clearer picture of underlying disease mechanisms that will in turn suggest new treatments.
They will also be able to share their experience gained in pioneering MR studies at 7T with the other newly awarded UK centres. The award will also allow expansion of the image processing facilities in Sheffield to provide large volumes of digital data for phenotyping pulmonary diseases with computational modelling approaches being pioneered at the Insigneo Institute for In Silico Medicine in Sheffield. As a national resource for the development of new knowledge it will provide transformative advances in the speed and range of research into the causes and consequences, prevention and treatment of disease. This will facilitate translation of findings in the laboratory to clinical care (bench to bedside), but importantly lessons learnt in clinical settings will also be investigated further in the laboratories (bedside to bench), so that more can be learnt about disease processes. But even with a CT scan image it can be very difficult to determine precisely where the tumour is.
Added to this will be the development of new technologies to deliver precise treatment to individual cancer sites. A large-scale community based programme has commenced, studying as many as 9 25,000 apparently healthy people. This state-of-the-art facility will provide all of the capabilities required; from the storage and subsequent preparation of cell therapies for patient administration, through to the manufacturing of cell based therapies. The new scanner will give much greater detail of the whole brain’s structure, function and chemistry allowing researchers to understand how the brain works as a whole while still seeing detail at a sub-11 millimetre scale. Currently, severely affected individuals are treated with supportive care, including lifelong blood transfusion and treatment to prevent accumulation of iron in the body, which is costly, burdensome, and gives rise to serious, long-term clinical complications. A dedicated facility will be established with state-of-the-art equipment to enable researchers at UCL to study CTCs and improve the outcomes for patients with cancer. Beyond 7T MRI, Nottingham has also developed strong technical expertise relating to two recently-developed methods for increasing the sensitivity of MR: hyperpolarized inert gases and dynamic nuclear polarization (DNP). This grant, we will create the infrastructure needed to apply this to patients with heart disease, cancer and joint disease within 5 years. The problem is compounded by the fact that radiation therapy is usually given as a series of doses (called fractions) divided over a period of weeks and the tumour may be in a slightly different position each day or may shrink during the course of treatment.
Of these, individuals found to possess natural gene inactivating variants considered to be of biomedical importance, will be invited for detailed medical assessment. The facility will be based in a recognised UK centre for translational research and will be available for use by external universities, hospitals and companies. For imaging, a network of new machines that can combine positron emission tomography (PET) – visualising a short-lived radioactive tracer molecule in the body to show protein deposition- with Magnetic Resonance Images that show brain structure, will be established across the UK. This detail is especially important for diseases like Alzheimer's and Parkinson's, for which small and deep parts of the brainstem are critical but difficult to see with conventional MRI. Initially they will establish methods to undertake complex single cell analysis and then develop and validate tests in patients who are undergoing treatment for cancer.
Both of these techniques have the potential to produce a step change in the way MRI is used clinically. The new method has however the potential to improve diagnosis through MRI imaging of a very wide range of diseases and will help speed up the development of new drugs.
To make matters even more difficult, tumours often occur in tissues that move, such as lungs. This will allow the molecular processes going on inside the brain that cause dementia to be studied in greater detail. This programme is one example of many projects in development across the campus which will be greatly facilitated by the development of improved single cell research capabilities.
They will also study these cells in order to understand how they are able to successfully spread through the blood stream to other organs and cause metastases. They will exploit the increased sensitivity of HP inert gases in the study of lung disease and will also undertake completely novel studies that involve using DNP to study metabolism in muscles and in the brain. The Institute of Cancer Research, London, aims to revolutionise radiation therapy by developing a new type of machine called an MR-Linac (to be installed at The Royal Marsden NHS Foundation Trust). These studies will be enabled by development of a purpose constructed clinical research facility, adjacent to the major hospital at Whitechapel, in East London. For informatics, many different types of clinical data will be brought together in secure environments to make them more accessible to researchers.
Metastasis is responsible for the death of 90% patients with cancer and it is critical to understand how this happens in order to develop more effective therapies. This machine combines a state of-the-art radiation machine (called a linear accelerator) with an MRI scanner. The facility will allow substantial engagement of the local East London communities and enable coordination of more highly specialised assessments, to be undertaken with and through other leading medical research centres across the UK and abroad. For stem cells, skin and blood cells from adults with and without dementia will be re-programmed to become neural cells and studied to find out how these cells change as the dementia begins and progresses. Such a machine will not only provide very accurate visualisation of the tumour, but will do so at the same time that each fraction of radiation therapy is delivered, tracking the movements of a tumour in real time within a patient during a dose of radiation.
This investment will enable better science at lower cost, delivering an integrated environment for innovative and coordinated research programmes, making the UK an internationally unique place to study dementia. With these improvements, the margins placed around tumours can be reduced, but with confidence that the tumour will be targeted accurately. This will give both clinicians and patients greater confidence that the treatment will be effective and with fewer side-effects.

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