New Centre for Stratified Medicine opened in Ireland

Oct 24 2013

The University of Ulster has opened a new Centre for Stratified Medicine. The only Centre of its kind in Ireland, £11.5m research facility in Derry~Londonderry puts the University at the forefront of medical research into chronic degenerative diseases.

The Centre for Stratified Medicine is co-located at Altnagelvin Area Hospital in Derry~Londonderry and will focus on personalised medicine approaches to managing chronic diseases.

Stratified or personalised medicine is an emerging practice of medicine which examines our genetic make-up along with clinical data to better prevent, diagnose and treat disease at an individual patient level.

Professor Tony Bjourson, Director of the University of Ullster's Biomedical Sciences Research Institute and Head of the new Centre, said a personalised approach to patient care holds huge potential for developing new diagnostic and treatment pathways for human diseases.

"This is one of the most important concepts to emerge from the sequencing of the human genome and Northern Ireland is emerging as an important region within stratified medicine research." 

The Centre for Stratified Medicine will undertake research in areas such as heart disease and stroke; diabetes; bone disorders; inflammatory diseases; mental health, dementia and cancer.

It is estimated that for 90% of prescribed drugs, up to 30-50% of patients will not respond to treatment, while others will see no benefit or could even have an adverse reaction.  

Professor Bjourson continued: "The 'one size fits all' approach to medicine does not work because when it comes to drugs, one size does not fit all.

"In the same way that we all have different risks of developing disease, we also differ in how we will respond to drugs because of our genes and our environmental exposures. By building up an understanding of the 'strata' of responses and the genetics of the diseases, medical researchers can now create more personalised and effective forms of treatment. 

The new centre will facilitate research that can better identify drugs or treatments that meet the specific needs of individual patients - and marks a significant advancement in this strategic research area.

According to Professor Bjourson, the ability to stratify patients into responders and non-responders to therapy can massively improve patient care - and there is a huge global market for stratification tests, considering the non-response rates for major drugs are similar around the world.  

Codeine is a simple example of a drug that is greatly influenced by a patient's genetic make-up, he continued.  

"In order for codeine to work and relieve pain, it first has to be converted into morphine by enzymes in our liver.  Codeine does work for 90-95% of the population, but 5-10% of the population do not have the common liver enzyme required to convert codeine to morphine and so do not get any pain relief.   

"On the other hand, people with over-active liver enzymes convert codeine to morphine much too quickly resulting in a morphine overdose which can be life-threatening in some people due to respiratory and cardiac arrest, even at low codeine doses." 

The same liver enzymes activate Tamoxifen, a drug commonly used to treat a particular form of breast cancer, and some patients will not be able to convert it to the active form of the drug resulting in them deriving less clinical benefit. Our responses to codeine and Tamoxifen and many other drugs can now be detected by genetic testing.

In addition to undertaking cutting edge stratified medicine research, the new Centre is offering the first ever undergraduate degree course in Stratified Medicine in the UK and Ireland, providing a skilled workforce for industry and the health service. 

Professor Hugh McKenna, Ulster's Pro-Vice-Chancellor (Research and Innovation) said the Centre for Stratified Medicine reflects the sort of life enhancing research that the University of Ulster is known for. 

The Centre will reinforce the University's position at the frontier of world-class research with the potential to make a real difference to the health and well-being of many patients. Coupled with the University's Functional Brain Mapping Centre, the Centre will leverage the unique synergy between the Computational Neuroscience research and Biomedical Sciences Research Institute (BMSRI) research at Ulster's Magee and Coleraine campuses. 

Welcoming the new centre, Dr Maurice O'Kane, the Western Trust Head of Research and Development and Chief Executive of C-TRIC, said it will facilitate cutting edge and innovative research, speeding up the translation of clinical research into practice that will directly improve healthcare for our patients.

"The Western Trust is excited that our patients and clinicians will be able to contribute to the Centre. The rapid growth in the prevalence of chronic disease, particularly in our elderly, has highlighted the need for a personalised approach to treatment. This new Centre will allow to us do just that." 

The funding for the Northern Ireland Centre for Stratified Medicine is made up of: £5.6 m (INI) £1.5m NI HSC R&D office and £4.4m from the University of Ulster.

The Centre will create 22 high quality jobs - including 15 lecturers in Stratified Medicine who will be in post by the end of 2013.

In addition to the medical benefits for individual patients, there is a clear economic argument for the development of stratified medicine. Of the £595bn global spend on pharmaceuticals in 2011; an estimated £393bn was used for therapies which did not produce the desired effect.