Ground breaking research into the link between osteoarthritis and heart disease
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Travel award winners announced
Rehabilitation researchers help drive a large-scale international study
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Northern Sydney Local Health District
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MESSAGE FROM THE ACADEMIC DIRECTOR
Fresh from a good holiday, it is great to be back and I’m looking forward to a busy and productive year. We have a large share of exciting projects underway and planning is already well progressed for this year’s seminar series. It has been wonderful to see substantial new funding coming to the Kolling to continue our high- quality and impactful program of research. Pleasingly, our teams secured significant funding throughout last year, and in recent weeks our researchers were awarded more than $1.6 million through the National Health and Medical Research Council and more than $750,000 through the National Institutes of Health. Read on to discover the details of these grants. I’m sure a large part of our success is due to our commitment to collaboration both within and outside the Kolling. There are few institutes with so many skilled and experienced researchers under the one roof, and I would like to acknowledge and thank the joint venture partners for their considerable efforts to strengthen our research and increase our impact locally, nationally and internationally. Increased collaboration has been one of our key priorities in recent years, and we are clearly realising the benefits of this approach. Not only are we seeing collaboration on large-scale international projects,
but we are seeing increasing interdisciplinary collaboration across the Kolling. It was pleasing to see a significant investment in a collaborative data science initiative between the Sydney Precision Data Science Centre and the Kolling Institute. This exciting program will increase our research capacity in genomics, bioinformatics, health informatics and statistics. More than $150,000 will be shared equally across six teams. I would like to acknowledge the researchers who are driving substantial improvements in their individual areas of expertise, and I’m pleased that we have been able to direct the spotlight onto some of their significant achievements through the Kolling awards program and the Beryl and Jack Jacobs travel awards. These travel opportunities have been made possible with the very generous support of the Skipper-Jacobs Charitable Trust. Read on to learn more about this impressive group of researchers who are making tangible gains and helping to lift standards of care across the community. Some of our researchers have also received high-profile national awards, including a recent Australian Centre for Accelerating Diabetes Innovation award to one of our up-and-coming researchers Cameron Evans. The funding means Cameron will be able to progress
his work investigating the use of a new medication for diabetic foot ulcers and arterial disease. In 2024, a large collection of events will be co-ordinated from our popular Research Seminar Series to our annual Kolling Research Symposium. The inaugural event was staged at the end of last year, and we have received plenty of positive feedback. It was an excellent opportunity to showcase our expertise to researchers within the Kolling and to a much broader external audience. Planning for this year’s event and many others is already underway. As we head into 2024, it is a good time to assess the impact of our current research strategy and begin discussions around the next one. The implementation of this strategy has delivered measurable improvements to the Kolling and I expect the next strategy will extend on those gains and provide widespread additional support. Thank you to everyone for your continued dedication and considerable contribution. I look forward to another exciting year ahead. Professor James Elliott
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Professor Chris Little and Dr Cindy Shu
Dr Anastasia Mihailidou
Dr Jillian Eyles
Bad knees might cause broken hearts
Exciting research is set to get underway investigating a ground- breaking approach to reduce osteoarthritis associated heart disease. Kolling Institute researcher Professor Chris Little will lead the project after receiving a highly competitive National Health and Medical Research Council Ideas grant of close to $1 million. Professor Little and Dr Cindy Shu from the Raymond Purves Bone and Joint Research Lab will collaborate on the novel study with Kolling heart disease researcher Dr Anastasia Mihailidou and Professor Anthony Ashton from the Lankenau Institute for Medical Research in the USA. Professor Little has welcomed the significant funding, saying it follows years of specialised work in this field. “We’re very excited about this research and we’re hopeful it may make a big difference,” he said. “We have known about the link between osteoarthritis and heart disease for many years, with those experiencing osteoarthritis twice as likely to develop heart disease as those without the painful joint condition.
“Our research could lead to both a diagnostic test as well as a therapeutic target. It could change the health advice around risk factors for heart disease. “Our grant success highlights the breadth of expertise we have at the Kolling and the impact of collaboration, where we have researchers specialising in different fields coming together to identify new avenues to research. “It’s certainly one of the great things about working in the Kolling. “I would like to acknowledge the crucial preliminary work undertaken by Dr Cindy Shu, and the earlier financial support from the Raymond E. Purves Foundation and the Hillcrest Foundation through Perpetual Philanthropy.” There was further good news for the Kolling with musculoskeletal researcher Dr Jillian Eyles receiving a prestigious $660,000 Investigator grant to develop strategies to promote best- practice for osteoarthritis care.
“We had thought the conditions were linked because they shared the same risk factors like age, obesity and a lack of exercise, but our recent research has showed for the first time, that there might be a biological connection where the joint disease might actually be causing heart disease. “Our team found that if we induced osteoarthritis in one knee of a mouse that was otherwise fit, young and healthy, within 16 weeks that mouse had evidence of heart disease. “We then went onto show that if you take serum from these mice or a patient who has diseased joint tissue from a knee injury like a cruciate ligament tear, that serum caused heart cells to become sick. “We were able to identify a group of factors (micro-RNAs) that were released into the blood from the joint tissue that were causing this.” The new research project funded through the NHMRC will now investigate which specific micro RNAs are contributing to the development of heart disease. “If we can define which factors released into the blood are the most important, we may be able to help develop a new diagnostic tool for heart disease and potentially stop osteoarthritis contributing to cardiovascular disease,” Professor Little said.
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Kolling Symposium celebrates life-changing impact of research
• PhD completion Dr Natassia Rodrigo • PhD supervision Associate Professor Claire Ashton-James and Dr Ryan Davis • Professional Staff Shihani Stoner and Quoc Nguyen Professor Elliott said I would like to thank the Workforce and Culture Research Enabler and the Kolling Executive Committee for their co-ordination and support of the awards. “Each of these award winners is driving substantial improvements in their individual areas of expertise, and I’m pleased that we’re able to direct the spotlight onto their significant achievements through the Kolling awards program.”
A large group of inspiring researchers delivered presentations at the inaugural Kolling Institute Symposium, highlighting the strength of research underway at the institute. Close to a hundred people attended the event at the Northside Conference Centre focusing on the key themes of collaboration, innovation and wellbeing. Senior researchers and up-and- coming investigators took to the stage, outlining the progress being made with the Kolling’s basic science through to its crucial implementation research. Academic Director Professor James Elliott said it was evident that significant achievements are being delivered, and I would like to recognise the considerable efforts by all our researchers.
“It’s during big events like this one where we gain a much better idea of the ground-breaking work being undertaken at the Kolling and where we have the chance to meet with like-minded investigators from other teams.
“It was also encouraging to hear from four consumer
representatives who generously discussed their personal health experience. They provided crucial feedback on how to further involve consumers in our research community and future strategic initiatives.” At the event, Professor Elliott announced the successful recipients of the 2023 Kolling Awards where eight researchers were recognised across five categories. • Clinical Research Dr Vicki Duong and Dr Sumit Sahni • Discovery Research Professor Jose Antonio Lopez-Escamez
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Kolling researchers to inform best care for those with a spinal cord injury The expertise of our rehabilitation researchers at the Kolling Institute has been recognised with a prestigious international competitive grant to investigate the impact length of stay has on rehabilitation outcomes following a spinal cord injury. The National Institutes of Health in the US has awarded more than $9 million to the overall project, with over $750,000 coming to Australia. The five-year research project will investigate the impact of length of stay for rehabilitation programs in different countries including the USA, UK, Netherlands, Australia, Brazil and Canada. It will assess international approaches to the management of these challenging injuries and associated rehabilitation programs. Professor Ashley Craig from the John Walsh Centre for Rehabilitation Research has been appointed the chief investigator lead in Australia, with support from colleagues Dr Ilaria Pozzato, Dr Mohit Arora and Professor James Middleton. Professor Craig has welcomed this prestigious grant delivered through the National Institute on Disability, Independent Living and Rehabilitation Research scheme. “This is a very significant international collaborative grant
Professor James Middleton, Professor Ashley Craig, Dr Ilaria Pozzato and Dr Mohit Arora
win and I believe the first National Institutes of Health grant won by the John Walsh Centre for Rehabilitation Research. “It is wonderful to be working with colleagues in Australia and internationally to progress our research to determine the best care for those with a spinal cord injury, and to ensure that everyone who experiences this type of injury, can access the very latest evidenced-based care and support.” Spinal cord injuries often have a catastrophic impact, affecting multiple bodily systems and functions. In addition to sensory and motor loss, there is a high chance of secondary conditions including chronic pain, diabetes, cardiovascular and respiratory problems, as well as cognitive impairment and mental health challenges. Spinal cord injuries can also lead to reduced social autonomy, difficulties gaining and sustaining employment, weight gain and sleep disturbance. Professor Craig said given these complications, it’s crucial patients have access to an evidenced- based, multidisciplinary intensive rehabilitation program. “We know that currently there’s a big difference in the length of time patients spend in
rehabilitation programs in NSW and around the world,” he said. “COVID has also negatively impacted the length of stay in rehabilitation. “There is an urgent need to investigate the impact that a short length of stay, say three of four weeks has compared with a longer stay, of up to 12 weeks. “We are pleased to be part of this large-scale, international project to determine the optimum length of stay, and deliver the best long- term health outcomes.” The John Walsh Centre for Rehabilitation Research is looking for participants for an innovative clinical trial to support those with a spinal cord injury. It’s a world-first technique using breathing and heart rate feedback to reduce pain, improve brain fog, stabilise blood pressure and improve sleep. If you would like to know more or would like to join the trial, email smart.trial@ sydney.edu.au Join a Clinical Trial
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Philanthropic support building our research expertise A collection of researchers will develop their skills and establish
crucial new collaborations following generous funding through the Skipper Charitable Trust. Six researchers have received a 2024 Beryl and Jack Jacobs Travel Award, enabling them to travel for conferences and work with experts across the globe. Academic Director Professor James Elliott was thrilled to announce the successful recipients, saying each researcher demonstrated how their travel opportunity will broaden their research expertise and lead to exciting new progress. Dr Karen Bracken from the Osteoarthritis Clinical Research Group will travel to the University of Bristol to work with the team at the renowned Bristol Trials Centre. There she will gain a better understanding of recent advances in clinical trials, directly supporting her role as a clinical trials program lead. Dr Barbara Lucas from the John Walsh Centre for Rehabilitation Research will attend the Australasian Academy of Cerebral Palsy and Developmental Medicine Conference in Cairns to present her ground-breaking research from the Best START trial into early intervention in children with Cerebral Palsy. Dr Vicky Duong from the Osteoarthritis Clinical Research Group will travel to the United States and Canada to work with researchers at Harvard University, the University of North Carolina and the University of Toronto. This is set to be a valuable opportunity
for Vicky to expand her international networks following her successful Category I NHMRC funded project in Australia. Brian Kim from the Neuromuscular Imaging Research Laboratory will visit the United States to work with colleagues at the Northwestern University in Chicago. Brian is establishing machine learning methods to automatically quantify the soft tissues of the shoulder in patients needing surgical repairs. Dr Vibha Patel from the Meniere’s Disease Neuroscience Lab will travel to Spain to build on her work into the genetics of Meniere’s Disease, a debilitating disorder of the inner ear. Amanda Purcell , a PhD student in the Renal Laboratory, will also travel to Spain and the UK
to further her studies around predicting gestational diabetes in early pregnancy. Amanda is set to learn cutting-edge techniques, complementing her growing knowledge in this field and strong analytical skills. Professor Elliott said these opportunities would not be possible without the financial boost delivered through the
Skipper Charitable Trust. “I would like to thank the
family behind the trust for their wonderful ongoing support of our early and mid-career researchers,” he said. “Their help is directly strengthening our research expertise and increasing our long term impact.”
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Dr Vicky Duong
Researchers find most people with knee pain receive low-value, inappropriate care
With knee pain affecting a large share of the community, our researchers at the Kolling Institute are calling for clinicians and GPs to avoid delays in adopting the most up to date, evidenced-based guidelines. Investigators from the Kolling’s Osteoarthritis Research Team report that knee pain is particularly disabling, accounting for five per cent of all visits to a GP. The most common causes of pain are knee osteoarthritis, patellofemoral pain and meniscal tears. Knee osteoarthritis affects an estimated 654 million people worldwide–a tremendous number of people, while meniscal tears affect approximately 12 per cent of the adult population. (Meniscal tears can occur following a twisting injury or as a result of a degenerative condition.)
In young people, knee pain is often the result of an acute traumatic injury, such as an ACL injury, meniscal tear or patellofemoral
and importantly, surgery is not indicated for most people. “Surgery is only recommended in specific circumstances, for instance where patients have end- stage osteoarthritis with disabling pain. “We hope that our work will help inform the clinical community about the optimal, evidence- based care and that those recommendations are adopted as quickly as possible throughout hospitals and the broader community.” The research involved national and international collaborators including teams from La Trobe University, the University of Medicine, Mandalay and Southern Medical University, China. The paper has been published in the prestigious JAMA journal.
pain, and these conditions typically affect sporting populations under 40.
Following extensive investigations, our researchers have found that the majority of people with these conditions receive low-value and inappropriate care. Dr Vicky Duong said our latest research indicates that the first- line treatment for these conditions should focus on conservative management, including exercise, education and self-management. “Our research demonstrates the importance of initially visiting a GP or physiotherapist to aid diagnosis and management,” she said.
“Imaging is not required to diagnose these conditions,
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Professor Nick Pavlakis
Dr David Chan
Cancer experts inform national guidelines A collection of expert clinician researchers from the Northern Sydney Local Health District (NSLHD) have had a key role in the development of new national guidelines for the treatment of neuroendocrine tumours. The COSA NET guidelines provide information for oncologists, health care providers and patients regarding the latest evidence- informed practice. The new recommendations replace the previous ones drafted more than 10 years ago and The guidelines have been developed by Australia’s leading clinical and academic experts, including NSLHD clinicians Drs Nick Pavlakis, Jas Samra, Rory Clifton-Bligh, David Chan and Richie Maher. Dr Pavlakis said our team contributed to the new guidelines by drawing on our expertise in nuclear medicine, systemic therapies, surgery, interventional radiology and our clinical trial experience. “We are confident the new
Centre of Excellence, one of just three centres in the southern hemisphere. Dr Chan said the accreditation is a testament to the exceptional team of clinicians, surgeons, nurses, allied health professionals and researchers at the hospital. “It’s a credit to a very large number of teams, from medical oncology, radiology and surgery to genetics, palliative care and nutrition,” he said. “It means patients can have confidence that they are receiving the very best care in the world, and that their treatment will be in line with the latest international advances.” To access the new guidelines for the treatment of neuroendocrine tumours: https://app.magicapp. org/#/guideline/7724
reflect the significant advances in neuroendocrine tumour treatment over that time. There’s new information about Multiple Endocrine Neoplasia 1, familial NET syndromes and information about supportive care.
guidelines will provide tremendously valuable,
evidenced-based information in a format which is easy to access and adopt,” he said. In recent years, Sydney Theranostics North–based at Royal North Shore Hospital was named a Neuroendocrine Tumour
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Cameron Evans
New grant announced for up-and-coming Kolling Institute researcher
One of our impressive researchers has taken out a prestigious national award to broaden treatment options for diabetes. Despite tough competition, Cameron Evans from the Cardiovascular Discovery Group has been awarded the 2024 Australian Centre for Accelerating Diabetes Innovation (ACADI) PhD grant. The funding means Cameron will be able to progress his research investigating the use of a new medication for diabetic foot ulcers and peripheral arterial disease. Mirabegron is currently used to treat overactive bladder syndrome, but this research will help determine if it could be a suitable option for diabetic foot ulcers and vascular disease, where dysfunctional blood vessels
reduce oxygen and nutrients in the tissue, and cause chronic wounds. “Our use of Mirabegron works by improving blood flow to the lower limbs and increasing levels of nitric oxide, one of the body’s natural antioxidants,” Cameron said. “This will help blood vessels and diabetic tissue function normally and heal ulcers. “Current treatments include a cocktail of medications or vascular surgery which are invasive, costly and risky. “So we hope our research will confirm if Mirabegron will reduce amputation, improve quality of life and increase life expectancy.”
Diabetes is continuing to escalate globally, with around 650 million people likely to have the disease by 2040. “It’s anticipated, one in five of those with diabetes is likely to develop an ulcer, so we could potentially be helping more than 130 million people with our research. “I am tremendously grateful for the ACADI PhD grant, which will
greatly boost our project. “Working weekends and
researching five days is a tough slog, so receiving this grant is an incredible help. “It’s a weight off my shoulders, and will give me dedicated time to progress our valuable investigations.”
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A/Professor Rebecca Kozor, Mai Duong, Dr Lisa Kouladjian O’Donnell and Professor Sarah Hilmer
Awards highlight the impact of drugs on frail older people with heart failure
One of our up-and-coming researchers within the Kolling’s Ageing and Pharmacology Lab has taken out two prestigious awards. Pharmacist and PhD student Mai Duong received the initial award at the International Pharmaceutical Federation World Congress in Brisbane. The APSA awarded Mai the Outstanding Oral Presentation in Pharmacy Practice prize for her discussion on the different perspectives of adverse drug events with heart failure medications in frail older people. She also took out an award for her presentation at the Cardiovascular Symposium hosted by the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists.
Mai’s research has greatly benefitted from a new collaboration within the Kolling Institute involving researchers from the Ageing and Pharmacology Lab including Professor Sarah Hilmer and Dr Lisa Kouladjian O’Donnell and A/ Professor Rebecca Kozor from the Cardiology Department. She said her work has highlighted the contrasting consumer and clinician views on clinical outcomes, patient priorities and medication management of frail older people with heart failure. “We know that heart failure is becoming more common in the ageing population, leading to frequent hospital visits and claiming lives,” she said. “Patients report that the big problem for them is the number of medications they’re on and the possible interactions.
“We are seeing that some medications for heart failure can cause falls, dizziness, renal impairment and other adverse events. “We know that optimising heart failure medication can be complex, but we hope that following our research there will be a greater focus on frailty and quality of life when these medications are prescribed. “We found that clinicians recognised that frailty status was important, but it was not routinely measured or included in medication management plans. “Backed by our research, we would like to see frailty measures considered when prescribing these medications, so that clinicians can tailor their approach for each patient for the best outcome.”
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NSLHD CE Anthony Schembri congratulates the recipients of the Ramsay research grants program
Significant investment in research announced A large collection of research projects will get off the ground following generous funding through the Ramsay Research and Teaching Fund Scheme. • Associate Professor Joanne Glinsky
“I look forward to following the progress of these projects, as well as their impact on lifting our standard of care and our understanding of a broad range of conditions. “Personally, as a fellow allied health worker, it’s great to see our allied health practitioners being recognised with these important research grants.” The recipients were congratulated by North Shore Private, Ramsay Healthcare Acting CEO Christian Hoengaard, who said the grants represented a tremendous investment. “We look forward to all the good outcomes that will flow as a result of this research and I’m sure it will help us deliver the best care that we can,” he said. “We have a long history of collaboration and I look forward to building on that partnership for another two decades.”
• Associate Professor Karl Ng • Associate Professor Sean Seeho • Dr Sally Baron-Hay • Dr Grace Gifford • Dr Matti Gild • Dr Pierre Janin • Dr Barbara Lucas • Dr Sharon McCracken • Dr Lauren Monds • Dr Leo Pang • Dr Kathy Willowson NSLHD Chief Executive Adjunct Professor Anthony Schembri AM welcomed the investment saying it will help the district maintain its reputation as a hub of research excellence and high value care. “We know that districts with an active research culture, where research is embedded as part of clinical care have a higher patient experience, less errors and better health outcomes,” he said.
The scheme has directed more than $10 million to research on the Royal North Shore Hospital campus over the last 20 years, and this year a further $850,000 will be shared across 17 projects. A diverse range of studies will be supported, strengthening investigations into cardiovascular disease, cancer and diabetes as well as osteoarthritis, neonatal care, thyroid function and physiotherapy programs. The successful recipients are: • Professor Dale Bailey • Professor Roderick Clifton- Bligh • Professor Gemma Figtree • Professor David Hunter • Associate Professor Sarah Glastras
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The NORTH Foundation is the official charity partner of the Northern Sydney Local Health District
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