Detecting bowel cancer with a drop of blood
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Researchers target spinal cord injury pain
Podcast shares our unique research stories
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MESSAGE FROM THE ACADEMIC DIRECTOR
I am pleased to share our Kolling Institute newsletter, profiling the very latest research progress, and the dynamic teams driving improvements in care. This edition highlights a number of exciting clinical trials, a collection of high-profile recognition awards, and crucial developments with our cancer research. It’s a chance to learn more about our current investigations, and the large number of dedicated clinicians and researchers extending our access to high- quality care. Research Strategy news Encouraging progress has been made with the development of the 2026-2031 Kolling Institute Research Strategy. This strategic framework will have a significant impact on the future direction of the Kolling, the focus of resources and the institute’s research success. A large part of the progress is due to the Kolling Steering Committee, where members have been meeting regularly ahead of wider consultation with the research community. I would like to express my thanks for their expert help and for their valuable time helping to develop the next strategy. It aims to provide a comprehensive plan to strengthen community impact through discovery, innovation and implementation, and to work towards a future where communities thrive as a result of medical and scientific breakthroughs.
Steering committee discussions have centred on a review of the current strategy, the effectiveness of the three-priority research area approach, and what areas need to be enhanced. Discussions have also focused on extending collaborations and increasing sustainability. Further meetings and consultation will be held throughout the year to finalise the strategic blueprint, ahead of its launch in early 2026. Key performance report card We recently received data confirming our key performance indicators are tracking well. Researchers secured $12.6 million in highly-competitive grant funding last year, and this may rise with the outcome of a large number of grants still pending. The figures confirm our category 1 funding, in particular, is well above the national average. Importantly, we are strengthening our international partnerships, with our researchers collaborating on publications with investigators from 130 countries in 2024. This represents a 60 per cent increase since 2021, and includes researchers research activity is expanding with 629 papers published last year, up from 576 in 2023. It is wonderful to see consistent growth in this area, clearly demonstrating the commitment to high quality, peer-reviewed journals. from right across the world. I am pleased to report our
A word of thanks for Professor Baxter I would like to thank Professor Nancy Baxter for her generous contributions and support of the Kolling Institute during her time as Interim Deputy Executive Dean (Research Centres) in the Faculty of Medicine and Health at the University of Sydney. Endocrinologist and senior leader Professor John Prins has now joined the university as the Executive Dean of the Faculty of Medicine and Health, and we look forward to welcoming him as a member of the Kolling Institute Governance Committee. Kolling Symposium It may be a couple of months away, but preparations are in full swing for this year’s Kolling Symposium. The event will be held in the Kolling auditorium on Thursday November 27th. This year’s theme, Discovery and Implementation through Collaboration, highlights the potential of shared ideas to drive improvements in care. We are pleased to announce award- winning broadcast journalist Sophie Scott will be our keynote speaker this year, discussing how to tap into your expertise for thought leadership. Registrations are now open.
http://bit.ly/4gwbFCp Professor James Elliott
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Researchers relieve debilitating spinal cord injury pain When we think of the impact of a spinal cord injury, we tend to focus on the significant limitations with the loss of mobility, but for a large share of people living with this
injury, it’s actually the chronic pain which is one of the most challenging issues to manage long-term. Neuropathic pain affects about 60 per cent of people with a spinal cord injury. It’s generally felt at or below the zone of injury and is often described as sharp, burning, unbearable and even terrifying. It can lead to a range of challenges like depression, catastrophizing or panic thinking, poor sleep, social isolation and reduced physical activity. Professor of Rehabilitation Ashley Craig said medications like antidepressants, antiepileptics and opioids are used to treat neuropathic pain, but they offer limited relief and come with a host of side effects. “Most medications provide only a third of patients with up to a 30 per cent reduction in their pain, while other non-medication approaches have failed to have any real impact,” he said. However, an exciting clinical trial will shortly get underway as a result of a $2.2 million grant through the Medical Research Future Fund.
“Chronic pain after a spinal cord injury results in an altered cortical neurochemistry and blood flow resulting in cortical dysrhythmia,” he said. “This is where brain neuromodulation therapy can really help. It involves a non- invasive approach to correcting the dysrhythmia and improving pain. “Interactive brain computer therapy is an extension of established treatments, while direct brain stimulation is a well-tolerated form of non-invasive brain stimulation to promote brain plasticity. “We are keen to test these approaches through the clinical trial and help provide evidenced based guidelines to relieve neuropathic pain and improve outcomes for those living with a chronic spinal cord injury.”
The team from the Kolling Institute’s John Walsh Centre for Rehabilitation Research will work with national and international experts to investigate the impact of an innovative approach targeting pain pathways in the brain. This new approach will combine direct brain stimulation with an advanced interactive brain- computer neuromodulation therapy. Professor Craig said both these interventions are showing some promising results, and we are looking forward to measuring the impact of their combined approach.
Professors James Middleton and Ashley Craig
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Anh Pham, Professor Mark Molloy, Benita Tse, Gabriella Parrilla, Matthew McKay
Game-changing blood test to detect bowel cancer
Studying polyps Another focus of the research is improving the follow-up process after a positive screening result. Currently, patients with a positive stool test undergo a colonoscopy, where clinicians look for polyps– small growths in the gut lining that can develop into cancer if not removed. Gastroenterologists and colorectal surgeons remove the polyps which are then assessed by pathologists, who examine their size and appearance to determine when the patient should return for a follow-up “surveillance” colonoscopy. But current guidelines as to when this should happen are based on limited evidence and can be improved.
It’s mailed to people over 50, but Professor Molloy says because it requires them to collect the sample themselves, only around 40 per cent return a completed test. “They don’t like handling a stool sample, and early cancers may not leak blood so they can go undetected by this method,” he said. “We’re very interested in whether we can move to a blood test, and not just any blood test. We’re working to do this from a few drops of blood collected from a finger prick.” Working with scientists from Sangui Bio, a biotechnology partner of the Kolling Institute, Professor Molloy has analysed proteins in blood samples from around 1,200 patients. “We can definitely see a signature in the blood from the finger prick sampling that’s linked to the presence of polyps and early cancers, but more research is needed.”
Bowel cancer is the third most common type of cancer in Australia and treating it is both costly and complex. Alarmingly, rates are rising among people under 50, and researchers still don’t know why. It is for these reasons that Professor Mark Molloy is on a mission to prevent the disease in the first place. Based in the Kolling Institute, the leading bowel cancer research specialist is running several projects looking at early detection. He says the first promising pathway is a blood test. Currently, the main screening method is a government-funded test that detects blood in the stool.
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Then there are thoughts about the environment–like the abundance of microplastics that we breathe in and consume–or it could be our more sedentary lifestyle.” He said research is ongoing but there is no agreed upon evidence. The science is still unfolding, but Professor Molloy’s direction is clear: user-friendly screening, targeted follow-up, and a deeper genetic understanding of what drives this deadly cancer. His various avenues of research will hopefully find more answers and help redefine the future of bowel cancer care.
If successful, the research could lead to a test that helps prioritise patients for follow-up colonoscopies based on molecular risk –allowing those patients with the highest risks to be seen more quickly than current guidelines dictate. It is estimated 15,000 Australians are diagnosed with bowel cancer each year. “If you vox popped people in the street, a lot of people would be touched by bowel cancer in some way, if not directly, they would know of someone in their circle.” He said it is unclear why bowel cancer is on the rise, particularly amongst younger people. “Ideas include changing nutrition over time causing changes in our gut microbiome that are known now to be facilitators of some bowel cancers.
“Colonoscopies are a massive resourcing problem for the health system and patients can face delays,” he said. To address this, Mark and his team are researching a more personalised way to improve the timing of a colonoscopy for higher risk patients with polyps. They recruited patients undergoing a colonoscopy and collected small biopsies from polyps and nearby healthy gut tissue. These samples were then analysed at a molecular level. “We’ve now identified a number of genes that appear to be linked to higher risk, and this seems to be independent of polyp size,” he said. Following publication of this finding, the team is doing a follow- on study to confirm whether these gene mutations predict future polyp development.
Professor Mark Molloy
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Researchers help those with osteoarthritis weave more exercise into their day
Dr Duong said it was important to involve the community in the design of this trial. “Last year, we travelled around Australia to help adapt and design the program to ensure it was relevant for people right across the country,” she said. “We hope that by listening to a broad range of communities that we have developed a program which will deliver improved results and better health outcomes.” Co-lead Dr Sarah Kobayashi said the guidelines recommend 150 to 300 minutes of moderate physical activity a week or 75 to 150 minutes of vigorous physical activity a week, or an equivalent combination of both.
Researchers are trialling a new program to support people with knee osteoarthritis to move more and manage their symptoms. Study co-lead Dr Vicky Duong said exercise is one of the most effective treatments for osteoarthritis. The Kolling Institute’s Osteoarthritis Clinical Research Group has launched a clinical trial to identify the best way to incorporate more activity into each day. The trial will involve a 12-week self-guided physical activity program where participants will be offered either a detailed program and a Fitbit activity tracker, or just the assistance of the Fitbit tracker.
“This level of activity directly reduces osteoarthritis symptoms and helps people manage the condition, so we’re looking forward to finding an evidenced-based approach to help the community reach that amount of activity,” she said. The study has been funded by the Medical Research Future Fund and supported by Arthritis Australia state groups. If you’re interested in joining the trial, further details can be found on the website https://www. osteoarthritisresearch.com.au/ cascadeoa-study-overview.
Dr Sarah Kobayashi and Dr Vicky Duong
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Jack Dong, Associate Professor Mimi Berman, Dr Sue-Faye Siow, Tina Gonzalez
Improving cancer detection in young people with neurofibromatosis type 1
The study will recruit 50 patients aged 18-40 years old to assess the feasibility and psychosocial impacts of the whole-body MRI screening program. Dr Siow said their project could be life-changing. “This is the first study of whole-body MRI screening of people with neurofibromatosis type 1 in Australia,” she said. “We have the opportunity for early detection in this group of young people who have a high cancer risk.” The research will be conducted through the Royal North Shore Neurofibromatosis Clinic, a statewide service led by Associate Professor Mimi Berman, in collaboration with national partner Omico.
The project aims to inform national guidelines and significantly improve outcomes through earlier detection and treatment of cancer. The Royal North Shore Campus Research Grants scheme funds exceptional research to improve standards of care and health outcomes locally and regionally.
Researchers from the Kolling Institute and Royal North Shore Hospital will lead Australia’s first study of whole-body screening for young people with neurofibromatosis type 1. Led by Dr Sue-Faye Siow from the department of clinical genetics, the study was awarded a grant through the RNSH Campus Research Grants Scheme, and an additional $30,000 in support from the NORTH Foundation. Neurofibromatosis type 1 (NF1) is an inherited condition that affects 1 in 2,500 people. Young adults with the condition face a 20-fold increase in cancer- related mortality, yet there are currently no routine imaging guidelines in Australia.
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Matthew Doane and James Elliott
New podcast offers behind the scenes look at the remarkable people shaping the future of healthcare in Northern Sydney
A fascinating and informative podcast has been launched showcasing groundbreaking research, innovative healthcare, and inspiring stories from across Northern Sydney. Tomorrow’s Medicine Today is an initiative of the Northern Sydney Local Health District and the Kolling Institute, New South Wales’ oldest medical research institute. Co-hosted by the Kolling Institute’s Academic Director Professor James Elliott and leading Royal North Shore Hospital anaesthetist Dr Matthew Doane, the series offers an insight into the impressive clinicians and researchers driving innovation and life-changing healthcare. It’s a behind the scenes look at the latest advances in healthcare, as well as some inspiring stories from clinicians, researchers and their broader teams.
Anthony Schembri, Chief Executive of the Northern Sydney Local Health District, said the podcast offers a great opportunity to highlight our strength in research and innovation. “Our teams are delivering truly outstanding work in healthcare and
Dr Matthew Doane with Professors Stephen Clarke and James Elliott
medical research,” he said. “This podcast is a fantastic
are my colleagues right here at the Kolling Institute and the local health district,” he said. “That’s what inspired this podcast. It’s a chance to share details of the world-class research and healthcare here in Northern Sydney with a wider audience.” New episodes are released fortnightly. They are available on the website https://bit.ly/nslhd- tmt and through Spotify https:// bit.ly/448P755.
platform to share that work with our community and direct the spotlight to the people behind the breakthroughs.” Co-host Professor James Elliott said the series demonstrates the depth of talent and discovery in Northern Sydney. “Each year, Stanford University publishes a list of the top two per cent of researchers globally, and many of those names
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Celebrating over 100 years of innovation
The inaugural Eva Kolling Research Day was staged at Royal North Shore Hospital, providing an opportunity to celebrate the vision and generosity of a true pioneer. Established in 1920, the Kolling Institute is the oldest medical research institute in New South Wales. It has been at the forefront of cutting-edge research for more than a hundred years, with its founding director Dr W. Wilson Ingram opening the first clinic for diabetes treatment in Australia. In 1931, a new two-storey building was officially opened and named the Kolling Institute of Medical Research after businessman Charles Kolling. His widow Eva was a strong supporter of research and made a substantial donation towards the development of the new building. The Kolling’s iconic photo features Eva laying a foundation stone. Her vision and the long-standing impact of the Kolling were highlighted at the inaugural research day by Royal North Shore Hospital honorary archivist
Award winners Daisy (Qinrui) Chen and Temitope Esther Afolabi with Professor James Elliott
Catherine Storey OAM, who shared insights into the Kolling’s remarkable journey. The institute’s Academic Director Professor James Elliott said the event offered a chance for researchers to engage with visitors, to learn more about the health challenges facing the community, and to share details of their current research.
“A key part of our research success will depend on the strength of our community ties, including community driven clinical trials and broad community involvement,” he said. “I would like to thank the NORTH Foundation for their ongoing support, and for raising awareness of the dedicated and skilled clinician researchers within the Kolling Institute.” Early-to-mid-career researchers presented a poster display, illustrating their commitment to improving health outcomes, driving new health policy, and realising global reach. Two awards were announced, including an Excellence in Clinical Translation Science gong to Temitope Esther Afolabi from the Kolling’s Lab of Ageing and Pharmacology, and an Excellence in Basic Science award to Daisy (Qinrui) Chen from the Renal Research Lab.
Researchers at the inaugural Eva Kolling Research Day
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International honour for Kolling researcher after 40-year service to spinal cord injury care
Lisa said she was very grateful to receive the top honour. “I feel particularly proud to have received the International Spinal Cord Society gold medal on behalf of allied health professionals, especially physiotherapists everywhere who have never been recognised in this way,” she said. “I would like to pay particular tribute to Associate Professor Joanne Glinsky who has been instrumental to my career and who, along with Claire Boswell Ruys, nominated me for this award.”
A career dedicated to improving the physiotherapy management of people with spinal cord injury has been recognised with the highest honour by the International Spinal Cord Society. Leading physiotherapist and researcher Professor Lisa Harvey was presented with the gold medal in front of the world’s best spinal cord injury clinicians and researchers in Belgium. Professor Harvey, who works at the John Walsh Centre for Rehabilitation Research in close collaboration with the Spinal Unit at Royal North Shore Hospital, received the award for her outstanding contribution to the field of spinal cord injuries. Lisa has held many positions with the international society over the last three decades, including chair of the Education Committee, Editor-in-Chief of the society’s official publication, Spinal Cord, board member and now chair of the Science and Research Committee. She has been instrumental in the development of online training for healthcare professionals treating people with spinal cord injuries and has overseen the development of freely available software to support physiotherapists prescribing exercises.
These resources can be found at www.elearnSCI.org and www. physiotherapyexercises.com Lisa has taught physiotherapy management for people with a spinal cord injury in most corners of the world and has authored the leading textbook in the field. Along with colleague, Joanne Glinsky, Lisa runs online courses for up to 25,000 students. She is also an active researcher, publishing widely and supervising PhD students. She is currently leading one of the largest international clinical trials to examine the effectiveness of a type of physiotherapy in the early days after injury.
Professor Lisa Harvey
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Unique online resource launched for Menière disease Researchers from the Kolling Institute have joined with international collaborators from Spain, America, South Korea and Brazil to develop a website to improve the genetic diagnosis and management of Menière disease. The Menière Disease Atlas of Genes and Cells is a free, open resource which can be used by researchers and clinicians globally as a reference
Professor Jose Antonio Lopez Escamez
dataset for diagnosis and personalised medicine.
It can be used by researchers to better understand the molecular basis of hearing loss. The web portal hosts the reference multi-omic dataset which includes genomics, epigenomics and transcriptomic information. Kiana Bagheri, computer science research associate in the Kolling Institute’s Menière Disease Neuroscience Lab, and several Masters students in data science at Macquarie University designed the web portal. World leading researcher and head of the lab, Professor Jose Antonio Lopez Escamez said the resource provides information for diagnosis and management of triggers for the condition. “Our collaboration means it will be possible to generate data from patients from across the world to support the genetic diagnosis of the disease.”
Inflammation key indicator The genomic dataset lists all
“This is our goal, a personalised approach,” said Prof Lopez Escamez. “Practice can change quickly once most doctors perform genetic and immunological testing.”
variants and genes found in 425 patients with Menière disease. “By examining the gene expression data through blood samples, we are able to determine the immune response in Menière disease patients. “This is a way to understand if the patient has a persistent inflammation associated with the disease, a finding observed in 50 to 60 per cent of patients.” He said researchers and doctors could search for genes and immune dysfunction, comparing data from one patient with the dataset to see if other patients have the same genetic mutations and type of immune response. In future, this may assist with tailoring therapy to each patient based on their genetic profile to reduce symptoms or cure the disease.
Patients who would like to have their genetic profile assessed can email meniereaustralia@ sydney.edu.au The web portal can be accessed through https://multiomic-md. sydney.edu.au/
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