Tommy's Reproductive Health Biobank

Lead Research Organisation: University of Warwick
Department Name: Warwick Medical School

Abstract

The Tommy's charity exists to save babies' lives, funding research into the causes and prevention of pregnancy complications that lead to miscarriage, stillbirth and premature birth. Tommy's also provide pregnancy health information for parents-to-be.
Tommy's fund research in four centres of excellence:
The Tommy's National Centre for Miscarriage Research (Warwick, Imperial, Birmingham)
The Tommy's Maternal and Fetal Research Centre in St Thomas's London
The Tommy's Maternal and Fetal Research Centre in Edinburgh
The Tommy's Maternal and Fetal Research Centre in Manchester

Research is aimed at understanding reproductive pathology so that baby's lives can be saved. Each day in the UK, 2,127 babies are born, 10 babies are stillborn, 648 babies are miscarried and 152 babies are born preterm. Often clinicians are not able to give couples causes for their pregnancy losses, so Tommy's exist to find causes and prevent these deaths. However, there is a limit to what Tommy's charitable fund raising can achieve, and by the terms of Tommy's mission, they prioritise funding for research that has the potential to deliver new diagnostics and treatments, not funding for the development of research infrastructure.

The goal of the proposed Tommy's Reproductive Health Biobank is to augment and enhance six existing biobanks at four Tommy's funded centres, to provide added value for research. The biobank will be unique in combining expertise from these centres, four of the largest reproductive health research groups in the UK, into a single functional unit of international significance. The samples comprise of tissues obtained before pregnancy, at the time of miscarriage or during complex pregnancies, as well as in normal pregnancy. Clinical data will be linked to the samples using advanced soft-ware technology. Tommy's Net is a software package and a server recently developed using funding provided by the Tommy's charity. Tommy's Net contains information on couples with recurrent miscarriage that consent. It is also able to link this information to other test results, samples and pregnancy outcome details held on other NHS databases. The MRC biobank funding will allow data on other pregnancy complications to be stored in the same way in the same system. As part of Tommy's Biobank, we will build on the Tommy's Net system to provide a registry of databases for historic collections, and a combined database using an agreed dataset for each sample collected in the future. This linked biobank will allow samples from each site to be characterised and tracked, and make them more accessible to the wider research community.

Technical Summary

The Tommy's Reproductive Health Biobank aims to facilitate researchers in reproductive health to move the field from one of excellent science and excellent pragmatic trials to a precision medicine focused field, where women at high risk of complications can be given appropriate care and new effective interventions can be developed. Tommy's four centres of excellence include research teams from Edinburgh, Manchester, King College London, Imperial, Birmingham and Warwick who all have the ability to obtain detailed mechanistic information from tissue samples using techniques including sequencing of DNA, RNA in whole tissues, RNA sequencing in single cells, DNA methylation gene reads, and proteomics. Clinical phenotyping in-terms of past history and importantly future pregnancy, neonatal and infant outcomes is needed to facilitate translation of this scientific excellence to patient benefit.

Across the four Tommy's centres, a wide-ranging variety of samples are/will be collected including pre-conceptual endometrium, sperm, serum, plasma, serial samples in high and low risk pregnancy of plasma, serum, vaginal, dental microbiome, then at delivery adipose tissue, myometrium, placenta, membranes, cord blood, and after delivery neonatal brain. Currently these tissues are stored in six separate biobanks, all striving to achieve the same ideal situation. By combing these six into one virtual entity, it will allow us to ensure 1) quality and consistency of sampling and outcome ascertainment through unified SOPs for sample collection, 2) processing and tracking, 3) working with software engineers to link relevant clinical data and the development of a searchable database. The resulting biobank will have details of large numbers of women with diverse pregnancy problems, with high quality data collection and outcome follow up. This will ensure that samples are of maximum benefit to Tommy's researchers, as well as for others in the field and the wider research community.

Planned Impact

This project focuses on building a National Biobank for Reproductive Health. The outcome will be a collection of tissues linked to other NHS databases containing pregnancy outcomes, subsequent pregnancy outcomes, neonatal and infant outcomes. This research topic is a key area relevant to MRC Strategic Aim 1: Theme Life course perspective. By delivering the project objectives, we will therefore make a significant contribution to MRC's strategic plan.

Wider Research Communities:
As well as benefitting researchers working in the Tommy's funded centres, the work will also have potential to impact in other research communities, specifically those interested in reproductive health and the developmental origins of adult disease. The samples linked to clinical meta-data will open new avenues of research for these groups.

General Public:
The work being done in this project is of direct interest to non-scientists, the project relates to overarching questions. These questions include "Why did my baby die?" "Why did I miscarry?" "Will this happen again?" The importance to the public is shown in the National Tommy's centre for miscarriage research that now enables 24,000 women per year to access treatment and support and participate in Tommy's research studies. Tommy's #misCOURAGE campaign continues to grow and resonate with women, attracting a UK and global audience. To date the campaign has reached over 16 million women on Facebook, with 7 million of them watching the campaign film; 7,000 taking part in a miscarriage survey and over 1,000 women bravely sharing their personal #misCOURAGE story.

Industry:
The planned project outcomes will make a significant contribution to our enhanced understanding of pregnancy complications. Since this topic is an important commercial biomedical research area, with considerable interest in new tests and therapies for the prediction, stratification and prevention of pregnancy complications. This biobank will be of direct interest to industries in this sector. More specifically, the project will provide one of the leading tissue banks in reproductive health worldwide and one of the objectives of this bid is to make these tissues and the associated metadata available to industry.

Medical Practitioners and Patients:
Although delivering the project aims is not expected to have an immediate impact on clinical practice, short term, it will facilitate the current Tommy's reproductive health research programme. Looking longer term (5-10 year horizon) the resource will facilitate a new personalized medicine revolution in the speciality. through the ability to aid the understanding of the mechanisms of pregnancy complications, the ascertainment of new biomarkers, and the development of new predictive tests Training and Skills:
The project will provide tissues for a large number (>100) of scientists, doctors, engineers, midwives, medical students, nurses to obtain research degrees (masters, MD, PhD) and develop their post-doctoral careers across all the Tommy's Centres and beyond. Thus this project will provide excellent training opportunities and will therefore positively impact the UK skills base. These skills will provide a positive impact first to the individuals in their future career and second to their future employers in either the industrial or academic sectors.

Tommy's Charity:
The establishment of the proposed Tommy's Biobank will be fundamental in adding value to the existing resources provided by Tommy's to their Centres of Excellence, and thus help to achieve their overall objective to help save babies lives.

Publications

10 25 50
 
Description BUMP Feasibility Study
Amount £500,000 (GBP)
Organisation Borne Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2022 
End 06/2023
 
Description INNOVATE
Amount £150,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 09/2017 
End 09/2018
 
Description Non-invasive biomarkers of stress in mothers, fathers and infants in urban and rural Malawi: a feasibility study
Amount £99,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 07/2020 
End 07/2021
 
Description The Tommy's National Centre for Miscarriage Research
Amount £5,000,000 (GBP)
Organisation Tommy's 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2016 
End 03/2026
 
Title Tommys net 
Description The biobank will collect samples and metadata about reproductive health problems. Bespoke software is being developed for this 
Type Of Material Database/Collection of data 
Year Produced 2018 
Provided To Others? No  
Impact this will be available to other later in the year and we expect it to have a great positive impact on reproductive health research 
 
Description The Tommy's centre are working together on the Biobank 
Organisation Imperial College London
Country United Kingdom 
Sector Academic/University 
PI Contribution The biobank is a collaboration between reproductive health experts in Imperial College, Kings College, Birmingham, Warwick, Manchester, Edinburgh universities.
Collaborator Contribution All partners are contributing expertise and samples.
Impact not yet only just started
Start Year 2017
 
Description The Tommy's centre are working together on the Biobank 
Organisation King's College London
Department School of Medicine KCL
Country United Kingdom 
Sector Academic/University 
PI Contribution The biobank is a collaboration between reproductive health experts in Imperial College, Kings College, Birmingham, Warwick, Manchester, Edinburgh universities.
Collaborator Contribution All partners are contributing expertise and samples.
Impact not yet only just started
Start Year 2017
 
Description The Tommy's centre are working together on the Biobank 
Organisation Manchester University
Country United States 
Sector Academic/University 
PI Contribution The biobank is a collaboration between reproductive health experts in Imperial College, Kings College, Birmingham, Warwick, Manchester, Edinburgh universities.
Collaborator Contribution All partners are contributing expertise and samples.
Impact not yet only just started
Start Year 2017
 
Description The Tommy's centre are working together on the Biobank 
Organisation University of Birmingham
Country United Kingdom 
Sector Academic/University 
PI Contribution The biobank is a collaboration between reproductive health experts in Imperial College, Kings College, Birmingham, Warwick, Manchester, Edinburgh universities.
Collaborator Contribution All partners are contributing expertise and samples.
Impact not yet only just started
Start Year 2017
 
Description The Tommy's centre are working together on the Biobank 
Organisation University of Edinburgh
Country United Kingdom 
Sector Academic/University 
PI Contribution The biobank is a collaboration between reproductive health experts in Imperial College, Kings College, Birmingham, Warwick, Manchester, Edinburgh universities.
Collaborator Contribution All partners are contributing expertise and samples.
Impact not yet only just started
Start Year 2017
 
Title This 
Description we have refined the test for chronic endometritis as the entry criteria for the CERM trial 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2019
Development Status Under active development/distribution
Impact This will depend on the outcome of the CERM trial. 
 
Description Invited Talk UCL/GOS Online symposium- Linking Perturbations in the Microbiome to Clinical Outcomes in Childhood 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk (title: The influence of the vaginal environment on risk of spontaneous preterm birth) about our work related to preterm birth research and interests in how the infant gut is colonised during and following birth.
Year(s) Of Engagement Activity 2021
 
Description Invited Talk - CME Accredited Sidra Research Series - Influence of the cervicovaginal environment and risk of spontaneous preterm birth. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dissemination of our research related to preterm birth
Year(s) Of Engagement Activity 2022
URL https://www.sidra.org/events-calendar/event-details/pmfg2021
 
Description Invited Talk Polish Perinatal Society, Online Feb 2021. The Vaginal Environment and Risk of Spontaneous Preterm Birth 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Dissemination of our research related to preterm birth - mechanism and discovery and validation of prediction tools
Year(s) Of Engagement Activity 2021
 
Description Invited talk - Society for Reproductive Investigation, Prebic Satellite Meeting, Mar 2022. Utilising the QUIPP app and other novel biomarkers for prediction of preterm birth. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk disseminating our research and vision for biomarker discovery and prediction.
Year(s) Of Engagement Activity 2022
URL https://www.sri-online.org/meetings-calendar/2022/program/satellite-meetings/joint-satellite---myome...
 
Description Invited talk: Mirvie Inc. California. Mar 2020. Mechanisms of Spontaneous Preterm Birth - how can research inform clinical practice? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Research talk to explain the value in understanding mechanism of preterm birth and need to develop accurate prediction tools for preterm birth.
Year(s) Of Engagement Activity 2020
 
Description Precision Medicine and Functional Genomics 2021, Sidra Medicine, Doha, Qatar Dec 2021 - A Precision Approach to Prediction of Spontaneous Preterm Birth. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk disseminating our research related to preterm birth, understanding the role of the cervico-vaginal environment in causing preterm birth, and identification of biomarkers for the prediction of preterm birth
Year(s) Of Engagement Activity 2022