Senior Research Fellow

· The Physiological Society

· Society for Sarcopenia, Cachexia and Wasting Disorders

Research

· Molecular and functional biomarkers for skeletal muscle frailty (main collaborators Prof KCH Fearon/ Prof JA Ross)

· Clinical trials in cancer cachexia (main collaborator Prof KCH Fearon)

· Imaging biomarkers of muscle loss (collaborators Dr Calum Gray, Dr Tom MacGillivray, Prof Neil Roberts)

· Factors influencing the responsiveness of healthy elderly people to physical training (collaborator Dr Philip Atherton)

· Exercise after stroke/ fatigue after stroke (collaborator Dr GE Mead)

· The role of glucocorticoids in the regulation of muscle mass in sarcopenia/ cachexia (collaborators Prof KCH Fearon, Dr I Gallagher, Prof B Walker, Dr R Andrew, Prof K Chapman)

Teaching

· Supervision of University of Edinburgh undergraduate (hons.) projects and postgraduate researchers

 · Contributor to the Copenhagen Institute of Sports Medicine/ University of Copenhagen International PhD course "Exercise physiology in basic and applied research "

Methodological Skills

 · Design and conduct of studies of exercise and muscle function in very elderly people/ frail patient groups (e.g. upper GI cancer, stroke, hip fracture)

 · Design, conduct and co-ordination of clinical trials for cachexia/ sarcopenia in upper GI cancer, elderly community dwelling men and women

1.Molecular and functional biomarkers for skeletal muscle frailty

Funded by Cancer Research UK, the Translational Medicine Research Collaboration, the Melville Trust and the Cachexia network. PI KCH Fearon, Professor of Surgical Oncology, University of Edinburgh.

This is a programme of research in cancer cachexia/ sarcopenia. We hypothesise that there are early changes influencing regulation of muscle mass in sarcopenia/ cancer cachexia which may be identified (as well as the underlying mechanisms) from molecular/ biochemical changes in blood, urine, tumour and skeletal muscle. If early markers of cancer cachexia can be identified, such patients could benefit from entry into trials of prophylactic treatment of cancer. We are also researching measurement techniques and patient-centred outcomes having utility in both cachexia and sarcopenia research.

I am the Lead for the Physiological Society’s Human and Exercise themed group, a member of South East Scotland Research Ethics Committee, a member of the Exercise after Stroke Reference Group, a member of the Cachexia network and Co-ordinator of the NIHR Age and Ageing Specialty Group (Scotland).

1.1 Cancer cachexia/ sarcopenia Translational Medicine Research Collaboration (co-PI with Prof KCH Fearon, Prof JA Ross)

1.2 Muscle protein synthesis as an outcome measure for intervention studies in cancer cachexia (co-I with Dr A MacDonald, Prof JA Ross, Prof T Preston, Prof KCH Fearon)

1.3 Direct objective physical activity monitoring as an outcome for studies of ageing/ cancer cachexia (collaborators Prof KCH Fearon, Dr E Ferriolli, University of Sao Paolo and Dr Sebastien Chastin, Glasgow Caledonian University)

2. Clinical trials in cancer cachexia

Funded by Acacia Pharma Ltd., Novartis Institutes for Biomedical Research, Danone Nutricia. Main collaborator Prof KCH Fearon, University of Edinburgh

The primary outcome measures of these trials in advanced upper GI cancer patients and in elderly community dwelling men and women is muscle mass and function.

3. Imaging biomarkers of muscle loss

Funded by Research into Ageing (now Age UK), the Moray Endowment Fund and the Edinburgh University small project grant. Main collaborators Dr Calum Gray, Prof Neil Roberts Dr T MacGillivray

These are exploratory studies, based in the Clinical Research Imaging Centre in which we are using state of the art imaging techniques to measure muscle cross-sectional area, volume, metabolism and stiffness. These function functional markers may be used not only as outcome measures in their own right but also as correlates of putative molecular/ biochemical markers (see 1. Molecular and functional biomarkers for skeletal muscle frailty).

3.1 Magnetic Resonance Elastography
3.2 3D freehand ultrasound
3.3 Magnetic Resonance Imaging
3.4 Magnetic Resonance Spectroscopy

4. Factors influencing the responsiveness of healthy elderly people to acute & chronic exercise

The purpose of this work which began as a Research into Ageing funded Research Fellowship, is to provide new insights into the responsiveness of elderly muscle to a hypertrophic stimulus and the underlying adaptive mechanisms. An improvement in our understanding of how old human muscle adapts to an intended rehabilitative stimulus may help to explain the differences in the speed and degree of recovery observed in frail elderly patients following acute illness or surgery. This knowledge will enable the development of effective countermeasures against physical frailty and the optimisation of rehabilitative strategies designed to maintain physical independence.

5. Exercise/ fatigue after stroke

Funded by the Chief Scientist Office and The Stroke Association (PI Dr GE Mead)

5.1 Fatigue after stroke: a longitudinal cohort study of frequency, prognosis and relationship with physical activity and physical deconditioning. Chief Scientist Office (co-I with Dr GE Mead (principal), Prof M Dennis, Prof M Sharpe, Dr A MacLullich, Dr S Lewis)
5.2 Using pedometers to promote physical activity in patients after stroke. The Stroke Association PhD Fellowship awarded to Sarah Carroll July (Dr CA Greig co-Supervisor, Dr GE Mead Principal Supervisor)

6. Influence of glucocorticoids on muscle function in sarcopenia/ cancer cachexia

Main collaborators Prof KCH Fearon, Prof K Chapman, Dr R Andrew, Prof B Walker, Prof A MacLullich

The purpose of this research is to investigate the role of glucocorticoid dysregulation as a potential mechanism of muscle loss in sarcopenia/ cancer cachexia.