U-care: Deep ultraviolet light therapies

The unique properties of light have made it central to our high-tech society. For example, our information-rich world is only enabled by the remarkable capacity of the fibre-optic network, where thin strands of glass are used to carry massive amounts of information around the globe as high-speed optical signals. Light also impacts areas of our society as diverse as laser-based manufacturing, solar energy, space-based remote sensing and even astronomy.

One area where the properties of light open up otherwise-impossible capabilities is medicine. In ophthalmology for example, lasers are routinely used to perform surgery on the eye through corneal reshaping. This involves two different lasers. In the first step, a laser producing very short pulses of infrared light cuts a flap in the front surface of the eye to provide access. In the second step, another laser producing longer pulses of ultraviolet (UV) light sculpts the shape of the cornea and correct focusing errors. The flap is then folded back into place so that the cornea can heal.

The two very-different laser systems in that example illustrate an important point: the effects of light on human tissues are highly-dependent on the specific properties of both the light and the tissues involved. To sculpt the cornea, the laser wavelength of 193 nm is in the deep UV region of the electromagnetic spectrum, much shorter than the visible range (380 - 740 nm) we are familiar with. This is because (unlike visible light) it is very efficiently absorbed by the cornea, so that essentially all the energy of the light is deposited at the surface. Thus only a very thin layer of tissue (a few microns thick) is removed, or "resected", with each pulse of light, facilitating very-precise shaping of the cornea and accurate adjustment of its focusing properties.

193 nm light can be generated by an ArF excimer gas laser, a >40 year-old technology producing a poor-quality low-brightness beam of light. This is suitable for corneal reshaping, but not for a range of other important therapies requiring higher-quality deep UV beams. Unfortunately, alternative ways to generate such short wavelengths are non-trivial, resulting in complex and expensive laser systems not suitable for widespread clinical uptake.

U-care aims to address this gap by exploiting cutting-edge techniques in laser physics. We will develop new sources of deep UV light which will be highly compact, robust and low cost. We will develop ways to deliver this light precisely to tissues, and work to understand in detail the biophysical mechanisms involved. Our efforts will focus on new therapies that target some of the biggest challenges facing medicine: cellular-precision cancer surgery, and the emergence of drug-resistant "super-bugs". Importantly, U-care will involve engineers and physical scientists working in close collaboration with clinicians and biomedical scientists to verify that the therapies we develop are effective and safe. By doing so in an integrated manner, we will drive our deep-UV light therapies towards healthcare impact and widespread use in the clinic by 2050.

This project will achieve impact in a number of important areas:

Patients: We will develop new therapies utilising deep UV light for germicidal and cellular-precision tissue resection. These will improve patient care in some of the biggest challenge areas facing healthcare in the 21st century e.g. antimicrobial resistance and cancer surgery. Although this is an EPS research project, our Pathways to Impact is carefully designed to smooth the path to translation and eventual commercialisation, a goal which is essential for widespread clinical impact.

NHS: U-care will enable new technologies that can target infections in confined areas of the body and medical devices, with the potential to have a significant impact on the NHS. For example, the ability to sterilise catheters in-situ using light is perfectly aligned with the James Lind Alliance's Intensive Care Top 10 priorities, which highlighted a need to investigate "What is the best way to prevent, diagnose and treat hospital acquired infection (e.g. ventilator associated pneumonia, blood stream infections related to the use of invasive lines)". U-care will also develop new approaches to resecting tissues with cellular precision, with key applications in resecting cancers in the brain and upper respiratory tract of the ear, nose and throat. Some of these cancers have the worst treatment outcomes of all cancers, and U-care will provide a new treatment route, making previously inoperable cancers treatable.

UK Industry: Despite its' blue-skies, low technology readiness level (TRL) nature, U-care is strongly supported by relevant industry, with 8 industry project partners contributing >£628k of support (£263k in-cash, £365k in-kind - note the full contribution from all project partners is ~£1.4M). These partners, which include manufacturers of healthcare technology, laser sources and photonic components, recognise the potential of U-care to impact not only healthcare but also a wide range of UK high-tech high-value industries. A collaboration agreement will be put in place between all the collaborating institutes and project partners to ensure that key pieces of intellectual property can be protected and accessed, in order to ensure a smooth road to commercialisation.

UK PLC: U-care aims to maintain and develop the UK's lead in many areas, including cutting-edge EPS healthcare technologies, manufacturing technologies, and advanced instrumentation. Thus, the project will impact UK PLC by enhancing its standing and position in these important areas. The project will also train 20 (13 PhDs and 7 PDRAs) young multi-skilled, cross-discipline scientists and engineers, the key to a high-tech / value economy.

Academia: This project will benefit academic communities in many areas of EPS and beyond. To maximise our academic impact, we will disseminate project results (following suitable intellectual property protection) at international photonics and biophotonics conferences (CLEO-Europe, CLEO, Photonics West) and at biomedical conferences (Infectious Diseases, Intensive Care, Oncology, Neurosurgical Society of America (NSA) Annual Meeting). We will also publish our results in the most prestigious field-specific and multidisciplinary journals.

General public: U-care is a superb opportunity to enthuse the public about the importance of cutting-edge EPS research in next-generation healthcare. We will seek wide-ranging opportunities for impactful engagement with the public, and our public engagement strategist will ensure we have a strong online presence (Twitter, Facebook, project webpage). We will target events such as the Edinburgh Science Festival, deliver lectures at schools, and aim to exhibit at events such as the Royal Society Summer Science Exhibition and also exhibit at Science Museums. The investigators of U-care have a multi-prize-winning record in public engagement, and we are well placed to ensure the maximum possible impact in this area.