The NIHR Leicester BRC is devoted to developing leadership that is focused on ensuring constant commitment to all the elements that contribute to a nurturing culture that is mindful of organisational, team and individual goals.

BRC fellows, managers, and post-doctoral researchers received Leadership Training from external consultant Roger Lane focused on introduction to leadership, a profiling insight into their leadership style and coaching sessions. Attendees completed pre-workshop materials and attended two half-day sessions.

We spoke to some of our Rising Stars who attended the workshops about their careers and experiences at NIHR Leicester BRC. You can watch a compilation video of our Rising Stars, or learn more about each of them by watching the videos below.

Compilation Video:

Individual Interviews:

So in the last few years, how polygenic risk scores work and how much they quantify your risk has been established in many, many studies. The question is now how do we apply this in real life, what we’ve done is there are a number of studies going on. In Leicester we’ve done a study called GENVASC where over the last 9 years or so we’ve recruited over 40, 000 people who were attending a GP practice for an NHS health check, looking, as I mentioned earlier, where people’s blood pressure and so on is assessed.

What at last those patients do is provide us with an extra blood sample to look at their DNA. And what we hope this study will show is the value in adding this genetic information on top of the clinical assessment that is done. If we can show real value in a real life situation which is currently applied in the NHS, ie your health check, that it actually better identifies people who might be at risk of having a heart attack and therefore apply better prevention measures to those people, then I think the value of the polygenic risk score has been established in real life practice.

And hopefully that will then get adopted for use in the NHS and other health systems. Of course polygenic risk scores are not only applicable to heart disease and risk of heart attacks, but can be applied to the risk of various cancers including breast cancer so it’s a really exciting area of active research at the moment and particularly an area where you can see it’s translation into clinical practice coming in the next few years. It’s likely that all of us will have our DNA analysed in some way and it’ll be stored in our health record because the ability to assess DNA is becoming much cheaper and much more effective, so in the next decade or two I suspect we will have our genetic sequence in our records and then applying polygenic risk scores will become much easier.

A Polygenic score is something you can get from your DNA. Our DNA is made up of over 3 billion base pairs, letters of the alphabet, and every 100 or so spaces we all differ from each other and that’s what makes us individually unique. What we’ve found over the last two decades of research is that there are particular places in your DNA where if you carry a particular letter of the alphabet, where someone carries a different letter then your risk of heart of disease is different. And we’ve found over 200 such places in your DNA where depending on what variant you carry, your risk changes. So if you put all those things together then some people will, by chance, carry a few at risk letters of the alphabet in those spaces and others will carry a lot. And then when you look at this information you find that people who carry a lot have maybe a 5 or 6-fold higher risk of developing heart attacks.

So polygenic risk score is developed from analysing your DNA and it stratifies people into different categories of risk in the future of developing heart attacks.

So currently doctors assess risk of you developing heart attack or heart disease usually in middle age you know, when you’re in your 40s. And what doctors do is to assess whether you’ve got diabetes or high blood pressure or high cholesterol, whether you smoke, your body weight and they create a clinical risk score. And then they categorise whether you are high or low risk. And while that is useful and valuable of course for identifying people, particularly at high risk, we know that it’s not as accurate as we’d like it to be. We think that a polygenic risk score could add to that assessment, so it would increase the value you get in terms of assessing and stratifying people into different risk categories, adding to the clinical information. But more importantly polygenic risk scores can also be flagged much earlier in life because your DNA doesn’t change, so we could even in the 20s identify people who genetically are at higher risk of getting heart attacks or heart disease and therefore could adopt prevention measures for those people than otherwise is the case at the moment.

So some of the things we’ve been doing as well as scanning all of our patients and investigating all of their arteries and trying to understand how they work, we’ve also been collecting blood from them and also from some fantastic healthy volunteers. Bits of skin we’ve been taking as well and analysing to try and understand how the cells in the skin stick together and whether that’s different in SCAD patients as a way of understanding why these tears and splits develop in the wall of the arteries.

We’ve made some progress, we’ve discovered the first common variant,this is a type of gene that we all carry, if you like it’s like a type of genetic risk factor. So we’ve identified the first risk gene for SCAD and we published that a few years ago. We’ve also been looking at rarer genes which can contribute to the risk of SCAD. So understanding genetics is really important, not just because we can look at somebody’s genes and say whether they’re at higher risk or lower risk and these kind of things, but also because it gives you insights into what’s causing it because the genes take you on a journey to the proteins that they produce and therefore the mechanisms that are happening down at the cellular level to understand what’s going on. So these are just some of the initial steps on what we hope will not be too long a journey, but nevertheless is a journey to understanding the underlying causes of this condition and helping our patient population, hopefully reduce the risk of recurrence and make swift and complete recoveries from this disease.

So we’re very grateful to our patients, we’re hugely grateful to a very, very hardworking team of researchers, research nurses and administrators and so on who allow this all to happen. And a big thumbs up also to the people that fund us, which has included BeatSCAD, which is the patient organisation themselves who’ve raised a lot of money through their efforts to support our research, the British Heart Foundation and the NIHR including the Biomedical Research Centre which is so critical to the research we do in Leicester.