NoseToDiagnose

So for me it was convincing funders to fund what we do, because it is so extraordinary. I wrote very big proposals initially and they just went nowhere. I switched to make a much smaller proposal to a small grant that’s run by the charity Parkinson’s UK and that was successful. Not only is this work so extraordinary, but I think it was also because we needed to establish ourselves. We now have three major publications and more coming, so that helps and I hope it will be easier next time!

It's what chemistry is all about. I used to say for a very long time that I’m a chemist who uses physics to understand biology. Chemistry is an extremely interdisciplinary science of its own: I have synthetic chemistry colleagues who are being really helpful about the sort of molecules we’re finding and how to analyse them better. I’ve also had fantastic collaborations with neurology consultants as well as experts in the analysis of odours, mentoring us on the study design. It’s also been great to work with younger members of team – and for them to work with Joy – who brings joy to our work. Also the technical and support staff in our team, who keep the instruments running and have supported what we’ve done. Also a final shout out to Anatune – when we first started, we didn’t have an instrument that would simultaneously measure the volatile components of the patient’s samples while allowing Joy to smell. They allowed us to go into their lab in Cambridge and to develop the instrument we needed. We’ve collaborated with industry, medicine, young people, mature people, and foundations – all supported by our university.

Looking at what we’ve done and working with other people, I can see there is a good side to working with other companies, such as big pharma, but we’d like to see these companies speak to people living with Parkinson’s. I give the example of big pharma producing a drug for Parkinson’s which grossly increases constipation. However, one of the first signs of Parkinson’s is increased constipation, which starts very early and lasts for the whole of the disease. A good research environment is one where there is an end-to-end approach.

I was in the height of my career as a nurse when the first whitepaper on preventative medicine came out. The clinics were superb – looking at heart disease, diabetes etc., but since then, the NHS has become burdened by extra costs and strict processes of referrals. What I have seen from the testing is that this could be a tremendous help to an overburdened NHS, and when I was nursing, I did smell other diseases too. Some of the young people with Parkinson’s have spent ten years going from pillar to post before they are diagnosed and it’s the same with cancer, Alzheimer’s and diabetes. I think analytical chemistry has the ability to revive the NHS.

As a Parkinson’s disease (PD) clinician, I feel there are 3 very novel and exciting results from this research study.

Firstly that we can distinguish PD from control fairly accurately using a simple skin swab. The possibility of using a simple cheap skin swab as an aid to helping PD diagnosis is a step closer. Clinical examination is only around 75% accurate when patients first present with mobility issues. Even then the disease process is known to already be very advanced. Currently available tests such as DAT scans are very expensive and not widely available.

Secondly that a simple skin swab may help gain pathophysiological insight into the neurodegenerative process in PD. Obviously this needs to be studied further but the initial results are very interesting in this regard.
Thirdly is the fact that we get such amazing information from swabbing sebum on the skin. We have never really used sebum as a diagnostic biofluid before and the possibilities (within and outwith PD) are enormous.

It is extremely important for clinicians to collaborate with the chemical sciences. We are just chemistry. When we go wrong it is just chemistry. In the end I believe chemistry will be able to treat almost all human disease.

I feel very lucky to have worked with such a gifted, passionate and dedicated chemistry team on this collaborative project. Our teams consists of laboratory scientists, statisticians, clinicians and importantly people who have been affected by Parkinson’s disease.

I joined the team during the first year of my PhD research as an aspiring analytical chemist. My initial role was in study design alongside the generation and processing of (many) sampling kits. I have been the lead analytical scientist in the development of methods and strategies for the analysis of sebum for Parkinson’s disease diagnosis.

Our team encapsulates a variety of backgrounds and career stages from analytical scientists, bioinformaticians, experienced clinicians and medical researchers to an integral team member who has experienced first-hand the effect this disease has on a person and their family.

Not only are we working with a biofluid that is not routinely used for medical diagnosis, but we are also investigating a disease that has so far evaded the development of a clinical diagnostic test. There has been a combination of striving to develop solutions to the analytical challenges associated with sebum, alongside those associated with a multifaceted disease such as Parkinson’s disease.