Blog

  • Study finds multiple medications impact how we age and the health of our gut

    Study finds multiple medications impact how we age and the health of our gut

    A new study by researchers at the Kolling Institute, in collaboration with the Microbiome Research Centre, has shown that multiple medication use impacts gut microbiome, and may influence the ageing process.

    Gizem Gemikonakli, a PhD student at the University of Sydney, said their findings followed a longitudinal, in vivo study.

    “Interestingly, mice that were given a regimen of five therapeutic medications from middle-age experienced more functional deficits as they grew older, and their gut microbiome was different to mice not taking the medications,” she said.

    “This project represents an important step towards broadening our knowledge of the interaction between medications, microbiome and the ageing process.

    “The microbiome is a developing area of research and we don’t quite know what a healthy microbiome looks like.

    “We do know however, that microbiome affects a wide range of body functions, and is affected by diet, lifestyle factors, disease and medications.”

    In a previous study published on the same cohort of mice, the Kolling researchers showed that the multiple medication or polypharmacy treatment increased frailty among the mice.

    Gizem explained that like other studies, we found the diversity of the microbiome was associated with functional measures, including frailty and activities of daily living in mice.

    “However, in our case it is likely the polypharmacy medications were driving both the microbiome effects and the functional deficits.”

    At 21 months, which is old age, half of the mice had the medications withdrawn, and their microbiome was collected again three months later. Taking these mice off the multiple medication regimen reversed the changes that initially occurred when they started treatment.

    The microbiome however did not recover completely. It was different compared to its composition before starting the medications, and also different to the mice at the same age which were not given any medications throughout the study.

    Professor Sarah Hilmer, Gizem’s supervisor at the Kolling said the two-way interactions between the gut microbiota and medications are very complex.

    “Our translational study describes effects of one high risk polypharmacy regimen on the microbiome, and its partial reversibility with de-prescribing,” she said.

    “This opens up exciting avenues for further research, including understanding the effects of different drugs on the microbiome and understanding how the microbiota impact on drug effects.

    “Differences in microbiome might explain why some people respond better than others to polypharmacy.”

  • Innovative trial aims to reduce the impact of serious spinal cord injuries

    Innovative trial aims to reduce the impact of serious spinal cord injuries

    A simple yet smart approach may hold the key to greatly improved health for those with life-changing spinal cord injuries.

    Researchers from the Kolling Institute’s John Walsh Centre for Rehabilitation Research are launching a project to assess whether a specific breathing technique can improve many of the challenges faced by people with a spinal cord injury, like chronic pain, life threatening unstable blood pressure, fatigue and poor mood.

    The Spinal cord injury, Mind and HeART or (SMART) study has been made possible by $3 million in combined funding from the NSW Ministry of Health and the University of Sydney.

    The research project, to be run at Royal North Shore Hospital, will see participants allocated to two groups. One group will continue with their usual care, while the other will undergo a 10-week specialised program involving guided breathing practice using computer feedback of heart rate function, and psychological strategies like mindfulness and visualisation techniques.

    Study lead Professor Ashley Craig is looking forward to the unique project, with more than 300 adults suffering a spinal cord injury in NSW every year.

    “Spinal cord injuries can have a devastating impact, with a broad range of short and long-term health issues, including some which can be life-threatening like unstable blood pressure,” said Professor Craig, Professor of Rehabilitation Studies at the Kolling Institute.

    “Clinicians currently rely on a host of pain management and treatment approaches, but our team is keen to measure the benefits of this innovative breathing technique to determine if it could be an effective addition to existing treatment strategies.

    “Yoga enthusiasts have long used rhythmic breathing to achieve tranquillity of the mind, and we now know that the way we breathe regulates our nervous system, in turn affecting our blood pressure and our ability to recover from stress.

    “Our study aims to determine if rhythmic breathing can help people with a disrupted nervous system as a result of their spinal cord injury. It will assess whether the breathing and importantly, the feedback of heart function can improve the functioning of the nervous system.

    “A disrupted nervous system can be likened to a car without brakes, with limited moderation of the effects of the nervous system.

    “Our approach will involve a specific type of breathing to regulate heart function to a point where it influences neural function and the autonomic nervous system.

    “The hope is this will in turn deliver wide ranging benefits for the brain, the gut, the heart, sleep and a host of other physical functions.

    “We are keen for at least 100 people to join our study and potentially help establish a new and effective, evidenced-based approach to care.”

    How to participate

    Researchers are now recruiting for the study and are encouraging those interested in taking part to contact them. Please email smart.trial@sydney.edu.au or call 0420 378 157 

  • Researchers closer to better pain management strategies

    Researchers closer to better pain management strategies

    Researchers at the Kolling Institute have taken an important step towards the development of safer, non-addictive pain medications by increasing our understanding of spinal cord pain signalling.

    This valuable progress has been recognised internationally with publication in the Journal of Physiology, a leading scientific journal.

    The findings follow the latest figures indicating more than 20 per cent of the population experience chronic pain, impacting their ability to work, care for families and generally function.

    Dr Karin Aubrey said many people currently rely on opioids, like morphine and codeine, to reduce their pain.

    “We know however, that these medications have serious side effects and in many cases offer only limited help,” she said.

    “Our team, including senior researcher Dr Yo Otsu, is committed to advancing our understanding of how pain signals travel through the body, so that we can use this information to develop safe, new medications.

    “This unique study used advanced techniques to unravel the spinal pain control circuit, and determine how opioids affect a key descending pain pathway. Interestingly, this pathway can enhance and reduce spinal signalling.

    “Our spinal cords are an incredible information highway, responsible for relaying sensory, motor and pain information to the brain.

    “The connections that make up the circuits of the spinal cord are all jumbled together and it’s difficult to unravel them and map how each connection contributes to controlling pain signals in the spinal cord.

    “In this study, we’ve identified how a particular point in the spinal pain circuit is controlled by opioids, giving us a clearer picture of how a good pain medication might work.

    “We currently have a reasonable understanding of the brain and pain circuits, but there is still so much more to discover.

    “Each one of us has about 86 billion cells in our brains called neurons, which is approximately half the number of stars in the Milky Way. Essentially our heads are a small galaxy.

    “This gives some context to the complexities of the brain and pain circuits, and the challenges involved in making significant scientific progress and advances in treatments.

    “We are encouraged by the progress we’ve made and the deeper understanding we now have around the spinal cord pain signalling and potential targets for new therapies.

    “Our findings have broadened our understanding of how the spinal cord pain circuit is organised and affected by opioids.”

    This project was made possible with the support of the Ernest Heine Family Foundation and the Pain Foundation.

  • Innovative research on show

    Innovative research on show

    An impressive group of emerging leaders addressed the Kolling’s Neuroscience and Pain Showcase, sharing details of their diverse and exciting research projects.

    With a broad range of expertise in this field, the showcase involved representatives from the pain management and rehabilitations teams, as well as the ageing, mental health, neurogenetics and neuromuscular imaging groups.

    The early and mid-career researchers discussed their latest progress across the scientific spectrum from their ground-breaking discovery projects through to their potentially life-changing translation and implementation work.

    Co-chair of the Neuroscience and Pain Priority Research Area and pain specialist Professor Paul Glare said there is a tremendous need for new approaches and models of care with an escalating number of people living with conditions impacting the mind, brain and nervous system.

    “We have a large number of researchers making important inroads in this field, and it was encouraging to learn more about their innovative work from an award-winning program to help injured workers get back to work faster to new treatments for Parkinson’s disease,” he said.

    “With the return-to-work initiative, we learnt extra support for injured workers saw them return to the workplace in half the time of those who didn’t receive the extra care. This is a good example of high quality research significantly improving health outcomes for our community.

    “Our researchers are leading a host of valuable projects, including a pilot intervention to reduce the inappropriate use of multiple medications in older in-patients. This program is optimising medication use, while minimising risks to a patients’ physical and cognitive function.”

    Researchers at the showcase also shared details of their work broadening our understanding of the debilitating Ehlers-Danlos Syndrome, as well as conditions characterised by irritability like depression and anxiety.

    We also learnt more about the role of autonomic function in injury recovery, and how it can delay a return to health. 

  • Back pain treatments shouldn’t neglect the mind

    Back pain treatments shouldn’t neglect the mind

    ysiotherapy treatments with those focusing on the mind.

    The study, involving Emma Ho, Professor Manuela Ferreira and Lingxiao Chen, analysed evidence from almost 100 trials worldwide involving over 13,000 patients.

    It found a combination of physiotherapy alongside psychological interventions, like behavioural therapy and pain education, produced the best outcomes for physical function and pain intensity.

    The researchers say these results could help improve the clarity of guidelines to better support patients and clinicians in making treatment decisions.

    Lead author Emma Ho said we know that adults with chronic low back pain not only experience physical disability, but often also suffer psychological distress including anxiety, depression or fear of pain from movement.

    “Clinical guidelines recommend a combination of exercise and psychosocial therapies for managing chronic low back pain, however very little is actually known about the different types of psychological therapies available and their effectiveness,” she said.

    “This often leaves doctors and patients unclear about the best choice of treatment.

    “This uncertainty motivated us to conduct the study and we are pleased to say we now have a clearer picture of the most effective psychological interventions for people with chronic low back pain.

    “Our in-depth analysis looked at a broad range of interventions such as counselling and cognitive programs, and we found behavioural therapy and pain education alongside traditional physiotherapy offered the best results and reduction in pain,” she said.

    Researchers from Australia and Canada were involved in the collaborative research project, with the results to inform healthcare guidelines not just in Australia but internationally as well. 

  • Australia to introduce ground breaking technology to target debilitating Mito disease

    Australia to introduce ground breaking technology to target debilitating Mito disease

    Clinicians, researchers and patients have welcomed a landmark law which will pave the way for remarkable new IVF technology to prevent mitochondrial disease.

    Known as “Maeve’s law” after a young Victorian girl with a rare genetic disorder, the legislation was passed by Federal Parliament allowing the specialised IVF procedure to be carried out in Australia.

    It will involve replacing faulty mitochondria with healthy mitochondria to greatly reduce the risk of a child inheriting the disease.

    Mitochondrial disease can be devastating, causing major organ failure, blindness, deafness, brain disorders, muscular problems and early death. About 50 babies are born with a severe form each year, and many die before the age of five.

    The Kolling’s Executive Director Professor Carolyn Sue is a globally recognised expert in this field, and says the new law is a tremendously important step for many families impacted by Mitochondrial disease.

    “Maeve’s Law will help provide families affected by this inherited disease with the best opportunity to have a healthy, biologically related child,” she said.

    “It will provide hope and may be life-changing for many families, particularly those where multiple generations are affected. It may help relieve the enormous emotional, physical, social and financial burden on affected families.

    “Australia has a long history with procedures involving assisted reproductive technologies and an excellent regulatory environment. This new step will provide families with access to the most advanced technology, and will give them the best chance of having healthy children in the safest possible way.”

    One woman who may benefit from the landmark decision is 37 year old Shelley Beverley. She discovered she had Mitochondrial disease just five years ago following the death of her mother. Her brother Neil also tragically died from the condition at just 34.

    Shelley has a heart condition, hearing loss, muscle weakness and diabetes, which are all linked to the disease.

    Shelley and her husband James have welcomed the passing of the landmark law.

    “This law gives us new hope of having our own healthy biological child without the fear of passing on this devastating disease,” she said.

    “Having lost so much already, it is a dream come true, one that we have longed for. This procedure is a huge milestone that will genuinely save lives and an incredible amount of unimaginable heartache.”

    It’s anticipated women undergoing the new procedure will be supported by Royal North Shore Hospital’s clinic for Mitochondrial disease patients. It is the largest Mitochondrial disease clinic in Australia and well placed to provide the latest treatments to patients across the country.

    Professor Sue said we have the clinical experience and an established specialised clinic that is well known for our expertise and ability to care for patients with mitochondrial disease.

    “Our job would be to identify, prepare and treat those patients with mitochondrial disease to undertake the procedure. We would work to provide these patients with the support they need to have biologically related children and find the optimal path as they plan their future families.” 

  • Researchers identify the best way to ease chronic pain

    Researchers identify the best way to ease chronic pain

    With large numbers of people across the community looking for effective and lasting ways to treat pain, our researchers at the Kolling Institute are driving nationally significant projects to reduce a reliance on opioid medication and promote proven alternative options.

    The research by our team from the Pain Management Research Centre follows the latest figures which indicate around 20 per cent of the population experience chronic pain and a large share of those are still relying on opioid treatment to reduce the impact of their pain.

    Centre Director and RNSH specialist Professor Paul Glare said despite the wide use of opioids, we now know they are not an effective, long-term option for most people, and cause a wealth of adverse side effects including addiction issues.

    “Opioid use is directly linked to an increase in mortality, and now accounts for more deaths than car accidents,” he said.

    “Our research is focusing on the best ways to reduce opioid use considering the complex challenges with medication withdrawal and patient fears that their pain will become unmanageable.

    “Our research indicates that cognitive behavioural therapy is the most effective option to reduce pain, and patients are three times more likely to be able to stop their opioid use if they adopt the self-management strategies promoted through the cognitive based therapies.

    “With the number of people experiencing chronic pain continuing to escalate, it’s crucial that we’re able to provide the very latest evidenced-based data around the treatments that work and help people manage their pain. It can make a life-changing impact.”

    One part of the research program is assessing the effectiveness of digital technologies to support those with chronic pain while reducing their reliance on opioids.

    Associate Professor Claire Ashton-James says with demand for support at an all-time high, they are investigating the value of a technological approach which can be delivered to a large number of people at any time of the day.

    “Our research has initially focused on how patients would like to engage with the programs, and one key trend has shown us that the community would prefer to receive consistent SMS messages, rather than tap into an App,” she said.

    “It’s important that we seek consumer input early to ensure our strategies will be effective and broadly adopted.

    “Our research has led to the development of carefully-scripted messages, videos and patient testimonies.

    “We anticipate these resources will complement the care provided by clinicians and we are undertaking a clinical trial to test their effectiveness in providing additional support. This trial is being funded by the Ernest Heine Family Foundation and we hope the strategies will directly assist those living with constant pain.”

  • Kolling researcher to join prestigious Harvard Medical School program

    Kolling researcher to join prestigious Harvard Medical School program

    Congratulations to Kolling Institute researcher Dr Manasi Mittinty who has been selected for the Advanced Global Clinical Scholar Research training at Harvard Medical School.

    Dr Mittinty is a medical trained researcher with the Pain Management and Research Centre and a University of Sydney lecturer. She has a keen interest in translation research and the connections between musculoskeletal conditions, pain science and neuropsychology.

    The one-year training program provides clinicians and clinician-scientists with advanced training in health care research. One of its key aims is to help participants develop cutting-edge translational research on a global scale.

    Places in the program are highly competitive with only established academics and leaders in their field selected. The program has previously attracted participants from more than 40 countries in high profile positions such as chief physicians, medical directors, fellows, scientists and medical specialists.

    Manasi has welcomed the opportunity to join the program.

    “I feel very excited and privileged to be selected from a global pool of scholars for this training. I look forward to learning from the distinguished faculty at Harvard Medical School,” she said.

    “This training will help me develop and lead transformative research to promote enhanced wellbeing for people living with arthritis and their families.”

    Manasi has received several prestigious awards including the Australian Post-graduate award and the Commonwealth funded Endeavour Post-doctoral Research Fellowship, and can now add this opportunity to her list of achievements.

  • Living with Parkinson’s disease

    Living with Parkinson’s disease

    As a single mum of four children, Jo Makamaka is juggling many responsibilities. She is not complaining though, just cherishing the opportunity to look after her children and take part in a host of activities which were not always within her reach.

    Jo first saw a neurologist in her early-20s in response to a collection of unusual symptoms, but it was not until many years later that she was diagnosed with Parkinson’s disease after seeing neurologist and Kolling Institute Executive Director Professor Carolyn Sue.

    “I was just relieved to get the diagnosis, not mad,” Jo said.

    “There was tremendous pressure with having something wrong, but not knowing what is was. It had a huge emotional toll and was a very challenging time, with plenty of tears.”

    The diagnosis of Parkinson’s disease and tailored treatment approach has transformed Jo’s life.

    “What this has done for me is give me my life back. It’s meant I’ve been able to be a mum, to take my kids to school, to make lunches and even drive.

    “Before, I would never put my hand up for simple activities like helping out at the school canteen, or signing my kids up for weekend sport.

    “I couldn’t do that as I wasn’t reliable, but I’m now able to do things everyone else can do. I can make plans and commit to activities, and be confident I will be able to follow through.

    “The medication is not only helping me physically, but mentally as well as I am more confident and less anxious.”

    Jo is tremendously grateful to Professor Sue, an internationally recognised expert on movement disorders and mitochondrial diseases. Professor Sue runs the largest clinic in Australia for patients with Mitochondrial disease, while also driving globally significant research.

    Jo’s tailored treatment was informed by the latest research and clinical experience, and she is thankful for the care she has received.

    “Professor Sue is really special and her passion for what she does is amazing. Her work is really valuable and I have benefitted greatly from her expertise and experience.

    “I have greatly welcomed her understanding, as she carefully listened to what I was going through.

    “Everything she does she cares about, putting her heart and soul into it.

    “I am so appreciative of the care I’ve had access to. The advice that I received, backed by research, has not only changed my life, but my family’s experience as well.”

  • World-leading research in the spotlight

    World-leading research in the spotlight

    The Neuroscience and Pain Research Showcase provided a timely opportunity to demonstrate the breadth of expertise across this priority research area at the Kolling.

    Co-ordinated by Professors Paul Glare and Lisa Harvey, the online event attracted more than 250 people.

    A diverse range of presentations focused on the cutting-edge research targeting mitochondrial disease, psychiatric disorders, spinal cord injuries and traumatic brain injuries. Researchers shared details too of world-leading projects to reduce the damaging impact of multiple medications.

    Senior researcher Professor Lisa Harvey said it was an important opportunity to promote the talented researchers across this priority research area and their significant achievements.

    “Our neuroscience and pain researchers have a unique breadth of skills, with their research progress directly influencing clinical practice and policy frameworks, and improving community health,” she said.

    “Our research ranges from investigations into new stem cell technologies through to large international clinical trials, and it was great to hear more about these exciting projects.

    “It was also encouraging to hear from the impressive early and mid-career researchers, who shared details of their ground breaking work.”

    Pain Management Research Institute Director Professor Paul Glare said the presentations aligned well with the keynote talks from Professor Don Nutbeam, the Executive Director of Sydney Health Partners and Dr Tony Penna, the Executive Director of the Office for Health and Medical Research, who both highlighted the importance of translating research into clinical practice.

    “The showcase emphasised the importance of research collaborations, including existing partnerships within the priority research area, and the development of new opportunities with national and international collaborators,” he said.

    “The Pain Management Research Institute for instance is already working closely with our Ageing and Pharmacology team around opioid tapering, and is looking towards closer ties with the John Walsh Centre for Rehabilitation Research.

    “Stronger national and international partnerships will also bolster our efforts to improve the lives of people living with neurological conditions and disabling pain.

    “We’re looking forward to our next showcase which will hopefully be run in-person at a time that looks very different to now.”

NSWGOV logo